Inadequate control of diabetes and metabolic indices among diabetic patients: A population based study from the Kerman Coronary Artery Disease Risk Study (KERCADRS)

Abstract

Background: The goal of diabetes control should be feasible in order to minimize the risk of its adverse events and to reduce its burden and cost on patients. The current study aimed to assess the status of glycemic control in male and female patients with Type 2 Diabetes Mellitus (T2DM) in Kerman, Iran. Methods: In the present study, 500 T2DM (300 women and 200 men) from the Kerman Coronary Artery Disease Risk Study (KERCADRS), a population-based study from 2009 to 2011, were selected. Patients were >18 years old, had Fasting Blood Sugar (FBS) higher than 126 mg/dl, and had been through treatment for their diagnosed disease. All participants underwent Glycosylated Hemoglobin (HbA1c) analysis. HbA1c less than 7% was considered as good glucose control. Other metabolic indices based on American Diabetes Association (ADA) target recommendations were considered. Results: The mean level of HbA1c in total subjects was 8.56 ± 4.72% that only 31.66% of men and 26.00% of women had controlled level of HbA1c. Total cholesterol less than 200 mg/dl was reported in 64.50% of men and 44.00% of women, High Density Lipoprotein (HDL) more than 40 mg/dl was revealed in 20.50% of men and 34.67% of women, and Low Density Lipoprotein (LDL) less than 100 mg/dl was reported in 41.50% of men and 25.33% of women. In multivariate logistic regression model, longer duration of disease and higher Waist Circumference (WC) were positively associated with uncontrolled diabetes status. Conclusion:The findings of the present study revealed that diabetes control in T2DM was inadequate. Changing the policy of treatment in individual patient and establishing better diabetes clinic to decrease the frequency of uncontrolled T2DM are crucial. Paying attention to other affecting metabolic components such as WC in the process of T2DM management is important.

Glycaemic control in patients with type 2 diabetes initiating second‐line therapy: Results from the global DISCOVER study programme

“…As might be expected, having a time since diagnosis of T2D of at least 10 years compared with 0 to 5 years was also strongly correlated with poor glycaemic control. This finding is consistent with other observational studies that have demonstrated a positive relationship between disease duration and poor glycaemic control . The trend is likely to reflect the continual decline in β‐cell function that is characteristic of T2D.…”

HbA1c as an index of glycemic status in obese type 2 diabetics

“…Good glycaemic control (HbA1c < 7%) was observed in approximately one-thirds of the diabetic rural and urban population in our study which is in accordance with the study by Unnikrishnan R [17]. Another study [14]reported the mean level of HbA1c in total subjects as 8.56 ± 4.72% (mean 7.80%) in which only 31.66% of men and 26% of women had controlled level of HbA1c (<7%). Our study showed a lower mean HbA1c of 8.2±1.64, and a higher percentage 34.9% of males and 31.6% of the female diabetics having an HbA1c <7%.…”

“…Studies have shown that the mean BMI of the Asian subjects was lower compared to that of patients from other ethnic backgrounds and the risk of type 2 diabetes starts at a lower BMI for Asians than other ethnicities. The mean BMI of the subjects in other studies was 26 kg/m 2 [13] and in another study BMI in female diabetics was 28.60 ± 4.91 and 26.47 ± 4.68 in male diabetics [14]. Our study is in agreement with this study with BMI being 28.58±5.02 and 26.64±4.87 in female and male diabetics.…”

“…Our study is in agreement with this study with BMI being 28.58±5.02 and 26.64±4.87 in female and male diabetics. Yousefzadeh G et al [14] observed mean BMI and WC were significantly more prevalent in women than men but in our study, though mean BMI and WC were significantly more prevalent in women than men, it was not statistically significant. In a study by Sheth et al the prevalence of central obesity was found to be higher (75 %) compared to peripheral obesity (59.83 %) in overall study population [15].…”

Patterns of Hyperglycemia in Patients With Type 2 Diabetes Mellitus With or Without Hypertension, Requiring Emergency Care and Hospitalization

“…Other studies suggest a gender disparity of 10-15%, women being the dominant group [65,66]. The under-recognition of the risk of hyperglycemia in women with T2DM may lead to less effective prevention, clinical care, and outcomes.…”