Determinants of Glycosylated Haemaglobin among Adults with Type 2 Diabetes Mellitus

Abstract

Purpose: The purpose of this study is to assess the determinants of demographic and clinical factors associated with HbA1C levels among adults with type 2 diabetes mellitus (T2DM) in Muscat. Glycosylated Hemoglobin (HbA1C) is used as marker for long term blood glucose control in adults with type 2 diabetes mellitus. Methods:A cross-sectional design was used. Simple random sampling was used to select 300 adults with T2DM in Oman in 2011. Ethical approval and hospital permission was completed from the Institutional Research and Ethics Committee. Informed consent was obtained from the participants. Chi-square and multiple logistic regression models with demographic and clinical characteristics as predictors of glycemic control (HbA1C) were used to analyze the results. Results: Nearly half percentage of the adults with T2DM had better or controlled HbA1C (<7%) while the rest had poor or uncontrolled HbA1C (>7%). Younger ages, females, higher education, non-tobacco users, short duration of diabetes, compliance with OHA and high waist-hip ratio predicted better control of HbA1C. Conclusions:Socio-demographic and clinical factors were consistently associated with glycemic control. Gender, education, perception of prevention of ADL, doctor-patient relationship, compliance with medications, and non-tobacco users were significant predictors of better glycemic controls among adults with T2DM. Relevance to clinical practice. Assessment of determinants of HbA1C may assist in determining individualized goals and strategies, subsequently improve glycemic control and enhance self-care management.

Foot care behaviors among adults with type 2 diabetes

“…Poor education status, diabetes awareness and care was associated with poor foot care while blood glucose monitoring and compliance to diet improved foot care [46]. This finding is consistent with studies showing moderate level of activities of daily living, ability to manage diabetes, average knowledge of diabetes [47], and lack of knowledge increased the risk of foot ulcers [23,48]. Frequency of self-monitoring of blood glucose decreased and inconsistent timing of dietary existed with poor knowledge [30].…”

Factors influencing diabetes self-management among Omani patients with type-2 diabetes: Patients’ perspectives

“…They need to be empowered to set forth rules that stop them from compromising their health. As recommended in previous research, [18] making gymnasiums available for women throughout the country would help them stay physically active.…”

“…While the healthcare services in Oman have witnessed tremendous improvement, the quality of care of diabetes has been reported to be sub-optimal. [16][17][18] It is needless to say that improvement in the quality of care of diabetes contributes to preventing the devastating complications of diabetes mellitus and thereby reducing the burden on the patients, their families, and the healthcare cost. [5,6,36] Decision makers should ensure that enough resources are made available for the care of patients with diabetes.…”

“…[14,15] Research has indicated that diabetes care is suboptimal, [16,17] and hindered by many challenges such as lack of human resources, medications, and laboratory support. [17] A key element in improving the quality of diabetes care recognized by many researchers in Oman [16][17][18] was through implementing self-management programs.…”

How do multi-modality strategies affect outcomes in T2D using a randomized control trial?

“…18,19 Age, education, duration of DM and diabetes education were significant determinants of glycosylated hemoglobin. 20 Omani adults with longer duration of diabetes may have developed better adaptation strategies to self-manage diabetes compared to those with shorter duration of diabetes. Healthy BMI showed a controlled HbA1c with diabetes education among adults with T2D.…”