Factors associated with glycemic control in people with diabetes at the Family Health Strategy in Pernambuco

Abstract

Objective: Identifying factors associated with glycemic control in people with type 2 Diabetes Mellitus (DM) registered in the Family Health Strategy (FHS) in Pernambuco, Brazil. Method: Associations between glycemic control (glycosylated hemoglobin A lower or equal to 7%) presented by people with DM and variables related to sociodemographic conditions, lifestyle, characteristics of diabetes, treatment and follow-up of patients by health services were investigated by multiple regression. Results: More than 65% of the participants presented inadequate glycemic control, especially those with lower age, longer illness duration, more annual contacts with FHS and complex therapeutic regimen. People with DM without referrals to specialists presented greater glycemic control. Associations with education level and obesity did not remain significant in the multivariate model. Conclusion: The evolution of diabetes hinders adequate control, however, attention to younger people with DM and referrals to specialists are factors that can improve glycemic control. DESCRIPTORS

The relationship between patient characteristics and glycemic control (hba1c) in type 2 diabetes patients attending Thika level five hospital, Kenya

“…The current study showed a high prevalence (77.8%) of inadequate glycemic control (HbA1c>7%) as well as a high mean (8.5%) above the recommended level of HbA1c<7% in Type 2 diabetes mellitus patients studied. The findings of the study are in agreement with other studies conducted in Type 2 diabetes mellitus patients that showed higher mean of HbA1c above 8% as well as high prevalence's of > 60% of poor glycemic control (HbA1c>7%) [21,22].…”

Beliefs related to insulin use in people with Type 2 Diabetes Mellitus

“…This affirmation can be justified by the high glycemic levels and glycated hemoglobin present in this sample, in addition to the chronic complications identified. Research on the factors associated with glycemic control found a greater probability of inadequate glycemic control in people with a longer diagnosis of the disease, with fewer referrals to endocrinologists and with complex pharmacological therapy (9) . Thus, the need to revert negative beliefs against the disadvantages of established therapy is reinforced.…”

“…The low integration of health professionals with patients is indicated as one of the factors that negatively influences the knowledge and acceptance of the disease and, consequently, inadequate adherence to the treatment. Care management must be co-responsibility between health team and users, with accessibility to a sensitive and motivational dialogue (9) .…”

“…Evidence in the literature indicates low adherence to oral treatment among patients with Type 2 Diabetes Mellitus (2DM) (5)(6)(7)(8) . Adverse effects, complex therapeutic regimen, difficulties in understanding the therapeutic prescription, forgetfulness, financial resources for medication acquisition, daily routine, fragility in the outpatient follow-up and prolonged diagnosis are factors described for non-adherence to the Oral Antidiabetic regimen (OAD) (5,(8)(9)(10)(11) . As a result of low oral therapeutic adherence, it is necessary to introduce insulin therapy as the last pharmacological resource to achieve clinical stability of the disease, due to the lack of control of glycemic levels.…”

“…As a result of low oral therapeutic adherence, it is necessary to introduce insulin therapy as the last pharmacological resource to achieve clinical stability of the disease, due to the lack of control of glycemic levels. Another study, whose objective was to identify the factors associated with glycemic control in people with 2DM, pointed out weaknesses in the injectable therapeutic regimen, so that people with 2DM in insulin use had a significantly higher probability of presenting inadequacy in glycemic control (9) .…”