Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil

Abstract

ObjectiveLong-term complications of type 1 diabetes mellitus (DM1) can be prevented with adequate glycaemic control. However, high levels of glycated haemoglobin (HbA1c) occur in 60%–90% of the patients with DM1. Thus, we aimed to investigate the role of sociodemographic, behavioural and clinical factors on the HbA1c levels of patients with DM1 in Brazil.Design, setting and participantsA cross-sectional study was conducted in ambulatory patients with DM1 aged ≥18 years from 10 Brazilian cities. Sociodemographic, behavioural and clinical data were obtained through interviews.Main outcome measuresHbA1c level was measured by liquid chromatography. Hierarchical multiple variable linear regression models were used to identify factors correlated with high levels of HbA1c.ResultsOf 979 patients with DM1, 63.8% were women, and the mean age was 40 (SD 14.6) years. The mean HbA1c level was 9.4% (SD 2.2%), and 89.6% of the patients had HbA1c ≥7.0%. Factors independently correlated with increased HbA1c levels included: lower education, non-participation in diabetes classes/lecture during the year before, having a self-perception of poor adherence to diet and insulin, not having private medical care and not measuring the HbA1c levels in the prior year. Of note, poor adherence to diet and insulin were the independent factors most strongly associated with high levels of HbA1c (mean increment in HbA1c levels of 0.88% and 1.25%, respectively).ConclusionPoor glycaemic control, which is common among Brazilian patients with DM1, is associated with lower education, self-perception of insufficient adherence to diet and insulin and inadequate monitoring of HbA1c levels. Specific actions, particularly those targeting improving adherence to diet and insulin, may contribute to successful management of patients with DM1.

Estimation of magnesium level in type 2 diabetes mellitus and its correlation with HbA1c level

“…The HbA1c levels were uncontrolled in about 82% of patients enrolled in this study, and our results were in agreement with many studies which reported high HbA1c levels in T2DM …”

“…22 The HbA1c levels were uncontrolled in about 82% of patients enrolled in this study, and our results were in agreement with many studies which reported high HbA1c levels in T2DM. 23,24 Our results showed no correlation between serum Mg level and HbA1c level in contrast to many studies reported that there is an inverse correlation between serum Mg level and HbA1c, 25 some studies showed normal Mg levels in T2DM but lack data correlation to HbA1c.…”

Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen

“…[1][2][3][4] Difficulties with insulin dosing and inaccurate dose timing have been shown to result in poor glycemic control for people with diabetes. 5,6 The impact of missed insulin injections on HbA 1c levels is well established, [7][8][9][10][11][12] leading to an increasing risk of diabetes-related complications. 13,14 Technological advances offer opportunities to optimize insulin delivery, reduce dosing errors, and improve regimen management.…”

Using an injection port helps improve metabolic control and compliance to a strict basal‐bolus regimen in children and adolescents with type 1 diabetes

“…In a study of 16 children and adolescents with T1DM using another indwelling catheter for insulin administration, Hanas and Ludvigsson found that metabolic control was not altered by the use of the device. 7,8 In the present study, at the end of the 6-month period, 68% of participants (seven from Group A, 10 from Group B) decided to continue with the I-PORT Advance. In contrast, in Group B there was a reduction in HbA1c levels over the 6-month follow-up period, and although there was a slight trend for increasing HbA1c in the second part of the follow-up period (3-6 months), HbA1c remained significantly lower than baseline.…”

“…Several studies of treatment adherence have been published using data from self-reported questionnaires. 7,8 In the present study, at the end of the 6-month period, 68% of participants (seven from Group A, 10 from Group B) decided to continue with the I-PORT Advance. The reasons for refusing or discontinued use of the device included trouble wearing the device during sport or other social activities.…”