Prevalence of and factors associated with suboptimal glycemic control among patients with type 2 diabetes mellitus attending public hospitals in the Greater Male’ Region, Maldives: a hospital-based cross-sectional study

Abstract

Background Suboptimal glycemic control of type 2 diabetes mellitus (T2DM) which is defined as having HbA1c greater than 7% is a major public health problem in several countries, including the Maldives. The study aimed to estimate the prevalence and determine factors associated with suboptimal glycemic control among T2DM patients. Methods A hospital-based cross-sectional was applied to collect data from T2DM patients who attended public hospitals in the Greater Male’ Region, Maldives where were one of the highest reports of T2DM and suboptimal glycemic control cases in the country between January to March 2023 by a validated questionnaire and anthropometric measurements. Five (5) ml blood specimens were collected to measure the glycated hemoglobin (HbA1c) level. Univariable and multivariable logistic regressions were employed to determine factors associated with suboptimal glycemic control of T2DM at a significant level of α = 0.05. Results A total of 341 participants were recruited for the study: 65.7% were female, 42.5% were aged 40–60 years, and 42.2% were married. The overall prevalence of suboptimal glycemic control was 50.7%. Ten variables were found to be associated with suboptimal glycemic control in multivariable logistic regression. Those aged 40–60 years (AOR = 3.35, 95% CI = 1.78–6.30), being single (AOR = 2.53, 95% CI = 1.21–5.30), preparation of food using more than three tablespoons of cooking oil (AOR = 2.78, 95% CI = 1.46–5.28), preparation of food with more than three tablespoons of sugar (AOR = 2.55, 95% CI = 1.31–4.93), no exercise (AOR = 2.04, 95% CI = 1.15–3.61), DM diagnosed with more than twenty years prior (AOR = 2.59, 95% CI = 1.34–4.99), obese body mass index (BMI) (AOR = 3.82, 95% CI = 1.75–8.32), high total cholesterol (AOR = 2.43, 95% CI = 1.36–4.35), high triglycerides (AOR = 3.43, 95% CI = 1.93–6.11), and high-level stress (AOR = 2.97, 95% CI = 1.48–5.93) were having a greater odds of having suboptimal glycemic control than those who did not have these characteristics. Conclusion A large proportion of T2DM patients in the Greater Male’ Region fail to control their blood glucose. Effective public health interventions should be introduced, especially interventions focused on reducing cooking oil and sugar in daily cooking practices, encouraging regular exercise, and maintaining cholesterol levels, particularly for those diagnosed with diabetes mellitus for more than 20 years prior.