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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2024; 07(04): 185-194
DOI: 10.1055/s-0044-1791692
Original Article

Trend, Level, and Predictors of Glycemic Control among Iranians with Type 2 Diabetes: A 12-Year Retrospective Cohort Study

Amanuel Godana Arero
1   Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Soghra Rabizadeh
1   Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Mende Mensa Sorato
1   Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Mohamad AlJasem
1   Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Godana Arero
2   Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
,
Alireza Esteghamati
1   Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
,
Nakhjavani Manouchehr
1   Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
› Author Affiliations Funding None.
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Abstract

Objective We aimed to determine the trend, level, and predictors of glycemic control among adult type 2 diabetes on regular follow-up.

Material and Method A 12-year unmatched retrospective cohort study was conducted at Imam Khomeini Hospital, Tehran, Iran.

Statistical Analysis Descriptive statistics was computed for most variables, such as sociodemographic factors, medication-related factors, and disease-related factors. Multivariate logistic regression analysis was conducted to identify the functional independent predictors of good glycemic control among type 2 diabetes.

Results A total of 297 patients with regular follow-up were included in this study. Patients' mean body mass index was 28.51 ± 4.61 kg/m2. The mean glycated hemoglobin (HbA1c %) was 7.4 ± 1.25%. One hundred thirteen (30%) patients achieved the glycemic control target (i.e., HbA1c < 7.0%). The mean systolic blood pressure level was 132.88 ± 16.23 mm Hg. The mean diastolic blood pressure level was 76.58 ± 9.2 mm Hg. The mean level of low-density lipoprotein (LDL)-cholesterol was 79.23 ± 28.69 mg/dL. The highest trend of glycemic control was recorded in 2014 to 2015 (49.5%). Age less than 50 years, taking oral antidiabetic monotherapy, having blood pressure (BP) less than 140/90 mm Hg, and having LDL-cholesterol level < 70 mg/dL were independently associated with good glycemic control.

Conclusion Glycemic control levels among type 2 diabetes on regular follow-up were low. Young age was negatively associated with good glycemic control. Taking oral antidiabetic monotherapy, achieving BP, and meeting LDL-cholesterol targets were positively associated with good glycemic control. Therefore, addressing these factors can improve glycemic control and reduce associated complications.

Keywords

ABC control - type 2 diabetes - trends - predictors of good glycemic control - Iran

Declaration of Helsinki

The study was conducted following the ethical principles of the Declaration of Helsinki. Ethical clearance was obtained from Tehran University of Medical Sciences, and an official letter of approval was received from Imam Khomeini Hospital prior to the commencement of the research.


Authors' Contributions

All authors read and approved the manuscript. A.G.A. conceived the study, conducted data collection, framed the research design, and conducted data analysis. M.M.S. participated in data analysis and developed the manuscript. S.R., M.A., G.A., E.A., and M.N. reviewed the manuscript and polished the manuscript language.


Ethical Approval

Ethical clearance was obtained from the Tehran University of Medical Sciences, and Imam Khomeini Hospital prior to the commencement of the research.


Availability of Data Statement

Data concerning this manuscript is available upon reasonable request to the corresponding author.




Publication History

Article published online:
09 October 2024

© 2024. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Almetwazi M, Alwhaibi M, Balkhi B. et al. Factors associated with glycemic control in type 2 diabetic patients in Saudi Arabia. Saudi Pharm J 2019; 27 (03) 384-388
    CrossrefPubMedSearch in Google Scholar
  • 2 Badedi M, Solan Y, Darraj H. et al. Factors associated with long-term control of type 2 diabetes mellitus. J Diabetes Res 2016; 2016: 2109542
    CrossrefPubMedSearch in Google Scholar
  • 3 Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci 2014; 11 (11) 1185-1200
    CrossrefPubMedSearch in Google Scholar
  • 4 Smolen J, Burmester G, Combeet B. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet 2016; 387 (10027): 1513-1530
    CrossrefPubMedSearch in Google Scholar
  • 5 Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of type 2 diabetes - global burden of disease and forecasted trends. J Epidemiol Glob Health 2020; 10 (01) 107-111
    CrossrefPubMedSearch in Google Scholar
  • 6 Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet 2017; 389 (10085): 2239-2251
    CrossrefPubMedSearch in Google Scholar
  • 7 Association AD. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 2003; 26 (Suppl. 01) S33-S50
    CrossrefPubMedSearch in Google Scholar
  • 8 Association AD. American Diabetes Association. 6. Glycemic targets: standards of medical care in diabetes-2020. Diabetes Care 2020; 43 (Suppl. 01) S66-S76
    CrossrefPubMedSearch in Google Scholar
  • 9 Abdelwahid HA, Erwi SM, Alahmari FS, Ibrahim AA, Dahlan HM. Pattern and predictors of glycemic control among type 2 diabetics in Armed Forces Hospital of Jizan, southwestern Saudi Arabia. World Family Med J. 2017; 99 (4024): 1-9
    Search in Google Scholar
  • 10 Ahmad NS, Islahudin F, Paraidathathu T. Factors associated with good glycemic control among patients with type 2 diabetes mellitus. J Diabetes Investig 2014; 5 (05) 563-569
    CrossrefPubMedSearch in Google Scholar
  • 11 Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications 2010; 24 (02) 84-89
    CrossrefPubMedSearch in Google Scholar
  • 12 Organization WH. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva: December 8–11, 2008. 2011
    Search in Google Scholar
  • 13 Kwo PY, Cohen SM, Lim JK. ACG clinical guideline: evaluation of abnormal liver chemistries. Am J Gastroenterol 2017; 112 (01) 18-35
    CrossrefPubMedSearch in Google Scholar
  • 14 Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron J 1976; 16 (01) 31-41
    CrossrefPubMedSearch in Google Scholar
  • 15 Coresh J, Stevens LA. Kidney function estimating equations: where do we stand?. Curr Opin Nephrol Hypertens 2006; 15 (03) 276-284
    CrossrefPubMedSearch in Google Scholar
  • 16 Martin SS, Sperling LS, Blaha MJ. et al. Clinician-patient risk discussion for atherosclerotic cardiovascular disease prevention: importance to implementation of the 2013 ACC/AHA Guidelines. J Am Coll Cardiol 2015; 65 (13) 1361-1368
    PubMedSearch in Google Scholar
  • 17 Amini M, Parvaresh E. Prevalence of macro- and microvascular complications among patients with type 2 diabetes in Iran: a systematic review. Diabetes Res Clin Pract 2009; 83 (01) 18-25
    CrossrefPubMedSearch in Google Scholar
  • 18 Vouri SM, Shaw RF, Waterbury NV, Egge JA, Alexander B. Prevalence of achievement of A1c, blood pressure, and cholesterol (ABC) goal in veterans with diabetes. J Manag Care Pharm 2011; 17 (04) 304-312
    PubMedSearch in Google Scholar
  • 19 Buse JB, Wexler DJ, Tsapas A. et al. 2019 update to: management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2020; 63 (02) 221-228
    CrossrefPubMedSearch in Google Scholar
  • 20 Garber AJ, Handelsman Y, Grunberger G. et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm–2020 executive summary. Endocr Pract 2020; 26 (01) 107-139
    CrossrefPubMedSearch in Google Scholar
  • 21 Babaniamansour S, Aliniagerdroudbari E, Niroomand M. Glycemic control and associated factors among Iranian population with type 2 diabetes mellitus: a cross-sectional study. J Diabetes Metab Disord 2020; 19 (02) 933-940
    CrossrefPubMedSearch in Google Scholar
  • 22 Aghili R, Polonsky WH, Valojerdi AE. et al. Type 2 diabetes: model of factors associated with glycemic control. Can J Diabetes 2016; 40 (05) 424-430
    CrossrefPubMedSearch in Google Scholar
  • 23 Noureddine H, Nakhoul N, Galal A, Soubra L, Saleh M. Level of A1C control and its predictors among Lebanese type 2 diabetic patients. Ther Adv Endocrinol Metab 2014; 5 (03) 43-52
    CrossrefPubMedSearch in Google Scholar
  • 24 Ji LN, Lu JM, Guo XH. et al. Glycemic control among patients in China with type 2 diabetes mellitus receiving oral drugs or injectables. BMC Public Health 2013; 13: 602
    CrossrefPubMedSearch in Google Scholar
  • 25 Mobula LM, Sarfo FS, Carson KA. et al. Predictors of glycemic control in type-2 diabetes mellitus: evidence from a multicenter study in Ghana. Translational Metabolic Syndrome Research. 2018; 1: 1-8
    CrossrefSearch in Google Scholar
  • 26 Osborn CY, Bains SS, Egede LE. Health literacy, diabetes self-care, and glycemic control in adults with type 2 diabetes. Diabetes Technol Ther 2010; 12 (11) 913-919
    CrossrefPubMedSearch in Google Scholar
  • 27 Reisig V, Reitmeir P, Döring A, Rathmann W, Mielck A. KORA Study Group. Social inequalities and outcomes in type 2 diabetes in the German region of Augsburg. A cross-sectional survey. Int J Public Health 2007; 52 (03) 158-165
    CrossrefPubMedSearch in Google Scholar
  • 28 Wang J, Wang MY, Wang H. et al. Status of glycosylated hemoglobin and prediction of glycemic control among patients with insulin-treated type 2 diabetes in North China: a multicenter observational study. Chin Med J (Engl) 2020; 133 (01) 17-24
    CrossrefPubMedSearch in Google Scholar
  • 29 Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW. Achievement of goals in U.S. diabetes care, 1999-2010. N Engl J Med 2013; 368 (17) 1613-1624
    CrossrefPubMedSearch in Google Scholar
  • 30 El-Kebbi IM, Cook CB, Ziemer DC, Miller CD, Gallina DL, Phillips LS. Association of younger age with poor glycemic control and obesity in urban African Americans with type 2 diabetes. Arch Intern Med 2003; 163 (01) 69-75
    CrossrefPubMedSearch in Google Scholar
  • 31 Toh MPHS, Wu CX, Leong HSS. Association of younger age with poor glycemic and cholesterol control in Asians with type 2 diabetes mellitus in Singapore. J Endocrinol Metab 2011; 1 (01) 27-37
    Search in Google Scholar
  • 32 Shamshirgaran SM, Mamaghanian A, Aliasgarzadeh A, Aiminisani N, Iranparvar-Alamdari M, Ataie J. Age differences in diabetes-related complications and glycemic control. BMC Endocr Disord 2017; 17 (01) 25
    CrossrefPubMedSearch in Google Scholar
  • 33 Juarez DT, Sentell T, Tokumaru S, Goo R, Davis JW, Mau MM. Factors associated with poor glycemic control or wide glycemic variability among diabetes patients in Hawaii, 2006-2009. Prev Chronic Dis 2012; 9: 120065
    CrossrefPubMedSearch in Google Scholar
  • 34 Yurgin N, Secnik K, Lage MJ. Antidiabetic prescriptions and glycemic control in German patients with type 2 diabetes mellitus: a retrospective database study. Clin Ther 2007; 29 (02) 316-325
    CrossrefPubMedSearch in Google Scholar
  • 35 Kassahun T, Eshetie T, Gesesew H. Factors associated with glycemic control among adult patients with type 2 diabetes mellitus: a cross-sectional survey in Ethiopia. BMC Res Notes 2016; 9 (01) 78
    CrossrefPubMedSearch in Google Scholar
  • 36 Wang S, Ji X, Zhang Z, Xue F. Relationship between lipid profiles and glycemic control among patients with type 2 diabetes in Qingdao, China. Int J Environ Res Public Health 2020; 17 (15) 5317
    CrossrefPubMedSearch in Google Scholar
  • 37 Mahato RV, Gyawali P, Raut PP. et al. Association between glycaemic control and serum lipid profile in type 2 diabetic patients: glycated haemoglobin as a dual biomarker. Biomed Res 2011; 22 (03) 375-380
    Search in Google Scholar
  • 38 Klisic A, Kavaric N, Jovanovic M. et al. Association between unfavorable lipid profile and glycemic control in patients with type 2 diabetes mellitus. J Res Med Sci 2017; 22: 122
    CrossrefPubMedSearch in Google Scholar
  • 39 Mullugeta Y, Chawla R, Kebede T, Worku Y. Dyslipidemia associated with poor glycemic control in type 2 diabetes mellitus and the protective effect of metformin supplementation. Indian J Clin Biochem 2012; 27 (04) 363-369
    CrossrefPubMedSearch in Google Scholar
  • 40 Zheng D, Dou J, Liu G. et al. Association between triglyceride level and glycemic control among insulin-treated patients with type 2 diabetes. J Clin Endocrinol Metab 2019; 104 (04) 1211-1220
    CrossrefPubMedSearch in Google Scholar