Predictors of Good Glycemic Control Among Type Ii Diabetes Patients in Palestine

Abstract

Objectives: The aim of this study is to assess glycemic control and its relationship with patient characteristics, health-care system factors, and self-care management in type II diabetes patients. Methods:A retrospective cross-sectional study was conducted among 330 type II diabetes patients who met the inclusion criteria and whose medical records covered a period of 1 year. Data concerning patient characteristics, health-care system factors, self-care management, and available last reading of hemoglobin A1c (HbA1c) were collected through personal interviews and a medical records' review using structured questionnaires and data collection forms. Good glycemic control was defined as HbA1c ≤7%. To assess the results, the Statistical Package for Social Sciences (version 16) was used to undertake descriptive, univariate, and multivariate analyses. Results:The mean±standard deviation age was 60±9.7 years. More than half of the participants were male (51.2%), and the majority had additional chronic diseases (88.5%). Of the total 271 participants whose HbA1c levels have been monitored, 16.7% had good glycemic control. Multivariate analysis showed that unemployment was significantly related to a decreased odds of good glycemic control (odds ratio=0.34; 95% confidence interval=0.12-0.98; p<0.05). Conclusion:The study noted that the proportion of patients with good glycemic control was low, a result comparable to studies from many countries. Further investigation and improvement of inappropriate health-care system factors and self-care management together with educational programs that emphasize the importance of self-care management and the health-care providers' role would be of great benefit in glycemic control.

Glycaemic control and its associated factors in patients with type 2 diabetes in the Middle East and North Africa: An updated systematic review and meta‐analysis

“…Their results contradict previous findings because of differences in the demographics of the studied populations, especially in terms of the age distribution (Radwan et al, 2018). Higher percentages of participants were of older age in the Palestinian samples than in other study groups, with 34% of participants >61 years (Radwan et al, 2018) and more than 50% ≥58 years (Mosleh et al, 2017). The second demographic aspect examined was gender.…”

“…Their results contradict previous findings because of differences in the demographics of the studied populations, especially in terms of the age distribution (Radwan et al, 2018). Higher percentages of participants were of older age in the Palestinian samples than in other study groups, with 34% of participants >61 years (Radwan et al, 2018) and more than 50% ≥58 years (Mosleh et al, 2017). However, studies from Aldossari et al (2019), Nemeh et al (2011), and Saghir et al (2019) providing data from Saudi Arabia, Jordan, and other locations, respectively, did not show a significant inverse correlation between age and HbA1c.…”

“…Studies have reported that physical activity enhances GLUT4 translocation on the myocytic membrane, thereby increasing the rate of glucose uptake by muscles and improving glucose homeostasis (Colberg et al, 2010; Perseghin et al, 1996; Röckl et al, 2008). On sensitivity analysis, three records were excluded to resolve the observed heterogeneity (AL‐Eitan et al, 2016; Alramadan et al, 2018; Mosleh et al, 2017). The first two of these observed no significant association between physical exercise and glycaemic control, which AL‐Eitan et al (2016) ascribed to possible selective information sharing by the participants during their interviews, commonly known as reporting bias, resulting in the inconsistent findings of studies in this review (AL‐Eitan et al, 2016).…”

Glycemic control and its associated factors among patients with diabetes mellitus: a cross-sectional study in Bangladesh

“…It buttresses the report of some other studies where increment of age, particularly above 40 years, was associated with an elevated level of HbA 1c that is having poor glycemic control (Tokuyama et al, 2008;Harrabi et al, 2014;Camara et al, 2015;Oladoyinbo et al, 2019). But, there are also some studies that found negative or no significant association between poor glycemic control and age of the participants (Adham et al, 2010;Khattab et al, 2010;Yazidi et al, 2016;Mosleh et al, 2017;Tekalegn et al, 2018). The possible explanation for the poor glycemic control among the participants of the middle-age group found in our study might be for their reluctance about the disease control, self-care and adherence to treatment recommendations because of their busy life schedule and/or less interaction with health-care providers.…”

“…This low level of glycemic control has been similarly shown in some other studies. In Palestine, for example, about 83.3% had low glycemic control (Mosleh et al, 2017); in Ethiopia, about 81.7% (Angamo et al, 2013); and about 80% (Tekalegn et al, 2018); in Saudi Arabia, about 78% (Harrabi et al, 2014); in Malaysia, about 77% (Ahmad et al, 2014); and in Venezuela, about 76% (Moreira et al, 2010) of the patients had poor glycemic control.…”