Profiles and factors associated with poor glycemic control among inpatients with diabetes mellitus type 2 as a primary diagnosis in a teaching hospital

Abstract

Context:Diabetes mellitus is a growing health problem in most countries. In Malaysia, there was an increase in prevalence over the years. This makes diabetes also a growing concern in Malaysia, which warrants strengthening of the prevention and control programme.Aims:This paper aims to describe the profiles of diabetes mellitus type 2 in tertiary setting and to identify the risk factors for high level of HbA1c among the study population. The findings will give a glimpse on current status of diabetes in our country and may reflect the achievement of the country in combating this disease.Settings and Design:A cross-sectional study was conducted in UKM Medical Centre.Methods and Material:Medical records of patient with E11 ICD-10 code were collected using Case Report Form.Statistical Analysis Used:Descriptive analysis done of mean and median while test of association were done using Spearman correlation and logistic regression.Results:The results showed that majority of inpatients of DMT2 showed mean age of 58.8 + 12.6 years and most were males (56.7%) with secondary level of education (41.7%). Median duration of disease was 12.0 + 11.0 years with median HbA1c level of 8.9 ± 4.4%. Only small proportion of patients achieved the desired level of HbA1c <6.5% (21.3%) and significant association was found with tertiary level of education [AOR = 0.10, 95%CI = 0.01-0.96] and with type of anti-diabetic therapy [AOR = 15.90, 95%CI=1;2.03-124.30].Conclusions:In conclusion, diabetes mellitus type 2 inpatients still showed unsatisfactory glycemic control and holistic approach using health education should be advocated continuously in the future in view of education being one of the predictors for the good HbA1c outcome.

Factors Associated with Glycaemic Control among Diabetic Patients Managed at an Urban Hospital in Hanoi, Vietnam

“…Other studies in Ethiopia indicated that 59.2-70.8% of patients did not achieve controlled blood glucose levels [ 4 – 6 ]. This phenomenon was also observed in other countries such as India (78.2% among patients with diabetes complications) [ 7 ], Malaysia (79.7%) [ 8 ], and Brazil (76%) [ 9 ]. Factors affecting glycaemic control in patients with DM are complex and varied [ 10 ], including socioeconomic (e.g., advancing age, male, or low education), clinical (e.g., long duration of treatment, adherence to regular follow-up, having comorbidities, or type of medications), or behavioral (e.g., lack of physical activity or smoking) characteristics [ 3 – 9 ].…”

“…The sample size was calculated by using the formula to estimate the proportion with specified absolute precision. With the confidence level = 95%, the expected proportion of uncontrolled glycaemic level = 79.7% (according to a previous study in Malaysia [ 8 ]), and the absolute precision = 0.06, the essential sample size was 173 patients. An addition of 15% of the total sample size was added to prevent people who did not accept to participate or not complete the interview, leading to a total of approximately 200 patients included in the sample frame.…”

Glucose Control in Diabetic Patients Attending Parirenyatwa Group of Hospitals in Zimbabwe

“…Results in the present study may be owing to the fact that patients may well be physically active, hence their glucose utilisation remains high, which leads to normal blood glucose levels. In contrast, a similar Ethiopian study reported increasingly poor glycaemic control with age which became substantial above 58 years of age whereas Zambia reported high prevalence of poor glycaemic control in patients below 50 years of age [17,23]. Many factors such as lifestyles, concurrent illnesses and socioeconomic status could play a role [11,26].…”

“…The minimum sample size required for this study was 303. This sample size was calculated using the Dobson's formula at a confidence interval of 95%, maximum tolerable error of 5% and prevalence of 27% [17].…”

How Much Do We Know about the Biopsychosocial Predictors of Glycaemic Control? Age and Clinical Factors Predict Glycaemic Control, but Psychological Factors Do Not

“…Being unemployed or retired and having up to tertiary education are all protective factors against poor glycaemic control. Psychiatric disorders, such as depression and anxiety, have not been found to be predictive of glycaemic control in Malaysian diabetic patients [9][10][11]. However, personality traits, such as type D personality (social inhibition, negative affectivity, and neuroticism), have previously been associated with diabetes mellitus [12].…”