Predictors of Glycemic Control among Patients with Type 2 Diabetes in Najran Armed Forces Hospital: A Pilot Study

Imed Harrabi, Fawaz Al Harbi, Saad Al Ghamdi

Department of Family and Community Medicine, Najran Armed Forces Hospital, Najran, KSA.
Department of Internal Medicine, Najran Armed Forces Hospital, Najran, KSA.

DOI: 10.4236/jdm.2014.42021                

Abstract

Background: Diabetes mellitus is a serious condition with potentially devastating complications that affects all age groups worldwide. The purposes of this study are to describe the glycemic control levels and to determine the associated factors of poor glycemiccontrol among type 2 diabetes patients followed in Najran Armed Forces Hospital. Methods:We conducted a retrospective analysis of administrative data from adult patients with diabetes type 2 followed in NAFH clinics. To be included in the pilot study, patients needed to meet the following criteria: 1) Be identified as having diabetes type 2 using algorithms employed by disease management oasis program; 2) Be at least aged 18; 3) Be male or female; 4) Have Fasting Plasma Glucose (FPG) and HbA1c measured at least twice during the last year. Both univariate and multivariate approaches of logistic regression were applied to determine factors associated with poor glycemic control. Results: Data from a total of 100 patients were analyzed. There were 22% of patients that achieved glycemic control. The risk factors associated with poor glycemic control were being female, age < 65 years old and those who had not achieved the target total cholesterol. Conclusion: The findings of this study showed that diabetic control is suboptimal. This study provides factors that predict poor glycemic control. With this information, sub-groups with high risk of disease morbidity were identified. Barriers that prevent these patients from meeting their goals must be explored to improve health outcomes.

Keywords

Glycemic Control, Diabetes Type 2, Adults

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	American Diabetes Association (ADA) (2002) Implications of the Diabetes Control and Complications Trial. Diabetes Care, 25, S25-S27. http://dx.doi.org/10.2337/diacare.25.2007.S25
[2]	The Diabetes Control and Complications Trial Research Group (1993) The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus. New England Journal of Medicine, 329, 977-986. http://dx.doi.org/10.1056/NEJM199309303291401
[3]	IDF (2003) International Diabetes Federation: Diabetes Atlas. IDF. http://www.idf.org/sites/default/files/IDF_Diabetes_Atlas_2ndEd.pdf
[4]	Whiting, D.R., Guariguata, L., Weil, C. and Shaw, J. (2011) IDF Diabetes Atlas: Global Estimates of the Prevalence of Diabetes for 2011 and 2030. Diabetes Research and Clinical Practice, 94, 311-321. http://dx.doi.org/10.1016/j.diabres.2011.10.029
[5]	The Diabetes Control and Complications Trial Research Group (1993) The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus. New England Journal of Medicine, 329, 977-986. http://dx.doi.org/10.1056/NEJM199309303291401
[6]	UK Prospective Diabetes Study (UKPDS) (1998) Group. Intensive Blood-Glucose Control with Sulphonylureas or Insulin Compared with Conventional Treatment and Risk of Complications in Patients with Type 2 Diabetes (UKPDS 33). The Lancet, 352, 837-853. http://dx.doi.org/10.1016/S0140-6736(98)07019-6
[7]	American Diabetes Association (2002) Implications of the United Kingdom Prospective Diabetes Study. Diabetes Care, 25, 528-532.
[8]	Sharon, H., Judith, F. and Catherine, C. (2004) Poor Control of Risk Factors for Vascular Disease among Adults with Previously Diagnosed Diabetes. The Journal of the American Medical Association, 291, 335-342. http://dx.doi.org/10.1001/jama.291.3.335
[9]	Al-Elq, A.H. (2009) Current Practice in the Management of Patients with Type 2 Diabetes Mellitus in Saudi Arabia. Saudi Medical Journal, 30, 1551-1556.
[10]	Alfadda, A. and Abdulrahman, K. (2006) Assessment of Care for Type 2 Diabetic Patients at the Primary Care Clinics of a Referral Hospital. Journal of Family & Community Medicine, 13, 13-18.
[11]	Canadian Diabetes Association Clinical Practice Guidelines Expert Committee (2013) Target for Glycemic Control. Canadian Journal of Diabetes, 37, S31-S34.
[12]	American Diabetes Association (2014) Standards of Medical Care in Diabetes. Diabetes Care, 37, S14-S80. http://dx.doi.org/10.2337/dc14-S014
[13]	Sarah, J.B., Soma, S.N., Margaret, J., Jeremy, M., Shiva, S. and Charles, M. (2004) Adequacy of Glycemic, Lipid, and Blood Pressure Management for Patients with Diabetes in a Managed Care Setting. Diabetes Care, 27, 694-698. http://dx.doi.org/10.2337/diacare.27.3.694
[14]	Al-Nozha, M.M., Al-Maatouq, M.M., Al-Mazrou, Y.Y., Al-Harth S.S., Arafah, M.R., Khalil, M.Z., et al. (2004) Diabetes Mellitus in Saudi Arabia. Saudi Medical Journal, 25, 1603-1610.
[15]	Charpentier, G., Genes, N., Vaur, L., Amar, J., Clerson, P., Cambou, J.P. and Gueret, P. (on Behalf of the ESPOIR Diabetes Study Investigators) (2003) Control of Diabetes and Cardiovascular Risk Factors in Patients with Type 2 Diabetes: A National Wide French Survey. Diabetes & Metabolism, 29, 152-158. http://dx.doi.org/10.1016/S1262-3636(07)70022-8
[16]	Yoshiharu, T., Toshiharu, I., Kana, M., Toru, E. and Azuma, K. (2008) Predictors of Glycemic Control in Japanese Subjects with Type 2 Diabetes Mellitus. Metabolism—Clinical and Experimental, 57, 453-457. http://dx.doi.org/10.1016/j.metabol.2007.11.004
[17]	Kellow, N.J., Savige, G.S. and Khalil, H. (2011) Predictors of Poor Glycaemic Control during the Initial Five Years Post-Diagnosis in Rural Adults with Type 2 Diabetes. Australian Journal of Rural Health, 19, 267-274. http://dx.doi.org/10.1111/j.1440-1584.2011.01222.x