scholarly journals Glycaemic control in type 2 diabetes patients and its predictors: a retrospective database study at a tertiary care diabetes centre in Ningbo, China

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019697 ◽  
Author(s):  
Jialin Li ◽  
Kaushik Chattopadhyay ◽  
Miao Xu ◽  
Yanshu Chen ◽  
Fangfang Hu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Rural Areas ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Information Management System ◽  
Cross Sectional ◽  
Poor Glycaemic Control

ObjectivesThe objectives of the study were to assess glycaemic control in patients with type 2 diabetes (T2DM) at a tertiary care diabetes centre in Ningbo, China and to determine factors that independently predict their glycaemic control.DesignRetrospective cross-sectional study using an existing database, the Diabetes Information Management System.SettingTertiary care diabetes centre in Ningbo, China.ParticipantsThe study included adult patients with T2DM, registered and received treatment at the diabetes centre for at least six consecutive months. The study inclusion criteria were satisfied by 1387 patients, from 1 July 2012 to 30 June 2017.Primary outcome measureGlycaemic control (poor was defined as glycated haemoglobin (HbA1c)>=7% or fasting blood glucose (FBG)>7.0 mmol/L).ResultsIn terms of HbA1c and FBG, the 5-year period prevalence of poor glycaemic control was 50.3% and 57.3%, respectively. In terms of HbA1c and FBG, the odds of poor glycaemic control increased with the duration of T2DM (>1 to 2 years: OR 1.84, 95% CI 1.06 to 3.19; >2 to 4 years: 3.32, 1.88 to 5.85 and >4 years: 5.98, 4.09 to 8.75 and >1 to 2 years: 2.10, 1.22 to 3.62; >2 to 4 years: 2.48, 1.42 to 4.34 and >4 years: 3.34, 2.32 to 4.80) and were higher in patients residing in rural areas (1.68, 1.24 to 2.28 and 1.42, 1.06 to 1.91), with hyperlipidaemia (1.57, 1.12 to 2.19 and 1.68, 1.21 to 2.33), on diet, physical activity and oral hypoglycaemic drug (OHD) as part of their T2DM therapeutic regimen (1.80, 1.01 to 3.23 and 2.40, 1.36 to 4.26) and on diet, physical activity, OHD and insulin (2.47, 1.38 to 4.41 and 2.78, 1.58 to 4.92), respectively.ConclusionsMore than half of patients with T2DM at the diabetes centre in Ningbo, China have poor glycaemic control, and the predictors of glycaemic control were identified. The study findings could be taken into consideration in future interventional studies aimed at improving glycaemic control in these patients.

scholarly journals Muscle Strength and Glycaemic Control among Patients with Type 2 Diabetes

2020 ◽  
Author(s):  
Haya Abduhijleh ◽  
Joud Alalwani ◽  
Dana Alkhatib ◽  
Hiba Bawadi
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Muscle Strength ◽  
Glycaemic Control ◽  
Handgrip Strength ◽  
Poor Glycaemic Control ◽  
Patients With Diabetes ◽  
Insulin Use

Background: The prevalence of diabetes has been rising sharply since 1980, reaching 422 million cases worldwide in 2014. Physical activity and handgrip strength may be associated with good glycaemic control among patients with diabetes Objective: We tested the association between handgrip strength and glycemic control in type 2 diabetes patients, from National Health and Nutritional Examination Survey NHANES 2011-2014 and the contribution of the study covariates to this association. Hypothesis: Muscle strength is positively associated with glycemic control in type two diabetes. Methodology: This cross-sectional study examined the association between handgrip strength and glycaemic control among patients with diabetes. Data on 1058 participants aged 40 and older were collected from the NHANES. Muscle strength was assessed using a handgrip dynamometer, and blood samples were obtained to observe the glycaemic control values. Height, body weight, physical activity, insulin use, smoking status, alcohol use, participant demographics, and income-to-poverty ratio were all considered in the study. Results: logistic regression analysis was used to assess the association between handgrip strength and poor glycaemic control among participants with diabetes. Three models were used, each model adjusted to include different variables. OR values revealed no association between handgrip strength and glycaemic control. However, model 2, which was adjusted for sedentary activity, income-topoverty ratio, education, and smoking, shows a trend towards an association. Patients in quartile 4 of handgrip had 0.59 odds of poor glycaemic control, OR = 0.59 (95% CI: 0.34–1.02). However, in model 3 this effect was diluted when further adjusted for insulin use, OR = 0.81 (95% CI: 0.47– 1.38). Further analysis was performed to examine the mean decline in handgrip strength among non-insulin and insulin users. Non-insulin users, both men and women, have higher handgrip strength as compared to insulin users. Conclusion: There was no association found between handgrip and glycaemic control among patients with diabetes.

scholarly journals Barriers to Exercise in Type 2 DM Patients: An Institutional Cross-Sectional Descriptive Study

2019 ◽  
pp. 1-6
Author(s):  
S. Majumdar ◽  
K.K. Gangopadhyay ◽  
N. Chowdhuri ◽  
A. Majumder ◽  
B. Ghoshdastidar ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Tertiary Care ◽  
International Standards ◽  
Moderate Intensity ◽  
Care Providers ◽  
Cross Sectional ◽  
Medical Reason ◽  
Barriers To Exercise

Background: The benefits of regular exercise are well recognized in type 2 diabetes subjects. However, a substantial proportion of patients don’t exercise at all. We aimed to enumerate the barriers to exercise in Type 2 Diabetes Mellitus (T2DM) patients and factors associated with these barriers. Methodology: We conducted a cross-sectional study of successive type 2 diabetes patients attending routine out-patient diabetes clinics in five tertiary care hospitals in Kolkata, India from 1st April,2017 to 31st March 2018. All patients who matched our study eligibility criteria were interviewed by diabetes care providers using a structured questionnaire modeled after a systematic review of similar studies but tuned to regional preferences. Besides demographic details, patient particulars and laboratory investigations, the questionnaire included 2 direct questions on possible barriers to exercise. The questions were grouped into five categories viz. environmental (4 questions), behavioral (9 questions), occupational (2 questions), physical inability (7 questions) and medical reason (1 question). Patients’ who didn’t meet the ADA-EASD recommended exercise (at least 150 minutes moderate intensity aerobic physical activity viz. brisk walking at 3-4 km-hr) were classified as non-exercisers. Results: The present study included a total of 1061 patients of which 617 were males versus 444 females. 636 (59.9%) were not doing physical activity as per current international standards. A substantial higher proportion of females (68.9%) did not exercised as compared to males (53.5%), which is statistically significantly higher, p<0.001. Insulin usage was found to be significantly associated to hamper exercise (p=0.017), physical activity being 8% lower (34.5% in insulin users versus 42.5% in non-insulin users). Male gender (OR-1.877, 95% CI=1.217-2.894, p=0.004) and doctor’s prior advice for exercise (OR-3.397, 95% CI=2.035-5.671, p<0.001) were found as significant predictors for increased physical activity. Conclusion: This study elaborates the need for awareness regarding possible barriers when counseling T2DM patients. Exercise remains one of the cheapest pillars of DM management, the benefits of which extend beyond glycemic control. However, as this study illustrates about 60% of patients with T2DM do not carry out the recommended exercise. This study also highlights the importance of physician advice regarding exercise. Behavioural causes seem to be the commonest barrier to exercise and hence strategies to target the same needs to be thought of.

scholarly journals Assessment of glycaemic control in patients with type 2 diabetes: a clinic-based study in a slum of Kolkata

2018 ◽  
Vol 5 (11) ◽  
pp. 4768
Author(s):  
Tania Pan ◽  
Aparajita Dasgupta ◽  
Sweta Suman ◽  
Bobby Paul ◽  
Rajarshi Banerjee ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Urban Health ◽  
Health Centre ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Poor Glycaemic Control ◽  
Duration Of Diabetes ◽  
Urban Health Centre

Background: Although diabetes is a chronic condition, it can be controlled and managed to prevent complications. Long-standing diabetes with poor glycaemic control leads to many complications. This study aims to assess the glycaemic control status and its associated factors among type 2 diabetes patients attending Urban Health Centre in a slum of Kolkata, West Bengal.Methods: A clinic-based cross-sectional study was conducted among 184 diabetic patients attending clinic at Urban Health Centre, Chetla from October-December 2017. Each respondent was interviewed using a structured schedule to collect data on sociodemographic characteristics, physical activity, disease profile and self-care activities. Height and weight were measured. Individuals with PPBS ≥160 mg/dl were said to have poor glycaemic control. Data entry and analysis was done using SPSS version 16.0.Results: Out of 184 participants, 37.5% had poor glycaemic control. Mean (±SD) age of the participants was 51.64 (9.64) years. Median duration of diabetes was 4 years. 104 (56.5%) had overweight/ obesity. Only 26.6% had satisfactory dietary practice. Test results revealed ≥4 years duration of diabetes, overweight/ obesity, smoking, unsatisfactory diet and non-adherence to medications as significant predictors of poor glycaemic control, explaining 31.6% of the variance of glycaemic control with non-significant Hosmer–Lemeshow statistics.Conclusions: The study has identified factors associated with poor glycaemic control among the study participants. Emphasis on promoting a healthy lifestyle which includes a healthful eating plan, cessation of smoking, maintaining optimum body weight and strictly adhering of prescribed medications would go a long way in maintaining good glycaemic control.

scholarly journals Prevalence and determinants of poor glycaemic control: a cross-sectional study among Moroccan type 2 diabetes patients

2020 ◽  
Author(s):  
Ahmed Chetoui ◽  
Kamal Kaoutar ◽  
Soufiane Elmoussaoui ◽  
Kaltoum Boutahar ◽  
Abdesslam El Kardoudi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Hba1c Level ◽  
Associated Factors ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Poor Glycaemic Control ◽  
Duration Of Diabetes ◽  
Diabetes Patients

Abstract Background Diabetes remains poorly controlled in a high proportion of diabetes patients. This study examines the prevalence of poor glycaemic control and associated factors in type 2 diabetes patients in the Beni-Mellal Khenifra region in Morocco. Methods A cross-sectional survey was conducted in 2017 among 1456 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews using structured and pre-tested questionnaires. Anthropometric measurements, including body weight, height and waist circumference were taken using standardized techniques and calibrated equipment. Glycaemic control was assessed in terms of the glycated haemoglobin (HbA1c) level and poor glycaemic control was defined as HbA1c ≥7% and a level &lt;7% reflects good glycaemic control. Results Of the total participants, 66.3% had poor glycaemic control. Bivariate analysis showed that sex (p=0.010), education level (p=0.013), body mass index (p=0.048), duration of diabetes (p&lt;0.0001) and type of therapeutic regimen (p&lt;0.0001) were significantly associated with HbA1c level. However, multiple logistic regression analyses revealed that only a longer duration of diabetes (OR 1.525 [95% confidence interval {CI} 1.183–1.967], p=0.001) and receiving insulin therapy alone (OR 1.589 [95% CI 1.157–2.183], p=0.004) or a combination of oral antidiabetics with insulin (OR 2.554 [95% CI 1.786–3.653], p&lt;0.001) were significantly associated with inadequate glycaemic control. Conclusions Despite the particularities of the region, the findings about glycaemic control and its cross-sectionally associated factors are in line with findings from other regions of Morocco. In this subgroup, the longer duration of diabetes and insulin treatment could constitute a cause leading to poor glycaemic control. However, inverse causality cannot be excluded.

scholarly journals Poor glycaemic control in Brazilian patients with type 2 diabetes attending the public healthcare system: a cross-sectional study

BMJ Open ◽  
2013 ◽  
Vol 3 (9) ◽  
pp. e003336 ◽  
Author(s):  
Luciana V Viana ◽  
Cristiane B Leitão ◽  
Caroline K Kramer ◽  
Alessandra T N Zucatti ◽  
Deborah L Jezini ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Cross Sectional Study ◽  
Public Healthcare ◽  
Sectional Study ◽  
Cross Sectional ◽  
Poor Glycaemic Control ◽  
The Public ◽  
System A

scholarly journals Prevalence of comorbidities and their associated factors in patients with type 2 diabetes at a tertiary care department in Ningbo, China: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040532
Author(s):  
Xueyu Li ◽  
Kaushik Chattopadhyay ◽  
Shengnan Xu ◽  
Yanshu Chen ◽  
Miao Xu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Rural Areas ◽  
Disease Duration ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Department

ObjectivesTo determine the prevalence of comorbidities in patients with type 2 diabetes mellitus (T2DM) and identify the factors independently associated with comorbidities in a tertiary care department in Ningbo, China.DesignA computerised medical records database was used to conduct a cross-sectional study.SettingThe study was conducted in a tertiary care department in Ningbo, China.ParticipantsThe study was conducted on adult patients with T2DM, and it included 8 years of data, from 1 January 2012 to 31 December 2019.The primary outcome measureComorbidity was defined as the coexistence of at least one other chronic condition, that is, either a physical non-communicable disease (duration ≥3 months), a mental health condition (duration ≥3 months) or an infectious disease (duration ≥3 months).ResultsIn total, 4777 patients with T2DM satisfied the eligibility criteria. Over 8 years, the prevalence of comorbidities was 93.7%. The odds of comorbidities increased with the age of patients (18 to 39 years: 1; 40 to 59 years: OR 2.80, 95% CI 1.98 to 3.96; 60 to 69 years: OR 4.43, 95% CI 3.04 to 6.44; and ≥70 years: OR 10.97, 95% CI 7.17 to 16.77). The odds were lower in female patients (OR 0.66, 95% CI 0.51 to 0.84), patients residing in rural areas (OR 0.75, 95% CI 0.59 to 0.95) and patients without health insurance (OR 0.62, 95% CI 0.46 to 0.83). The odds were higher in single/divorced/widowed patients compared with those in married patients (OR 1.95, 95% CI 1.21 to 3.12).ConclusionsA large percentage of patients with T2DM in the tertiary care department in Ningbo, China, had comorbidities, and the factors associated with comorbidities were identified. The findings could be used in developing, evaluating and implementing interventions aimed at improving outcomes in patients with T2DM with comorbidities.

scholarly journals Physical Activity Patterns and Risk of Type 2 Diabetes and Metabolic Syndrome in Middle-Aged and Elderly Northern Chinese Adults

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Qian Wang ◽  
Xu Zhang ◽  
Li Fang ◽  
Qingbo Guan ◽  
Ling Gao ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Rural Areas ◽  
Physical Activities ◽  
Activity Level ◽  
Cross Sectional ◽  
The Impact ◽  
Over 40 Years

The main aim of this study is to quantitatively describe the status of physical activity and evaluate its levels in a rural population and to investigate the association between the quantifiable physical activity and type 2 diabetes and metabolic syndrome. In total, 2076 participants aged over 40 years were included in a cross-sectional analysis. Physical activity status and the contributions of different types of activity were evaluated. The association between social behaviors and physical activities was analyzed. In addition, the impact of physical activities on type 2 diabetes mellitus and metabolic syndrome was also analyzed by logistic regression. Approximately half of the total activity in rural areas consisted of work-related activity (49.3%) followed by commuting (30.2%) and recreational activity (20.5%). In rural areas, the prevalence of physical activity levels was 28.6% for low levels, 47.3% for moderate levels, and 24.1% for high levels. Educational level showed a significant negative association with the physical activity level. Lower physical activity shows a strong and significant association with type 2 diabetes and metabolic syndrome. In conclusion, insufficient physical activity among rural people over 40 years old increases the risk of type 2 diabetes and metabolic syndrome. Population-wide and individualized guidelines for physical activities especially recreational physical activities should be developed.

scholarly journals Extent and Predictors of Poor Glycaemic Control among Elderly Pakistani Patients with Type 2 Diabetes Mellitus: A Multi-Centre Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 21
Author(s):  
Muhammad Atif ◽  
Quratulain Saleem ◽  
Saima Asghar ◽  
Iram Malik ◽  
Nafees Ahmad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Self Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Poor Glycaemic Control

Objectives: This study aimed to explore the relationship between glycaemic control and factors that may influence this among elderly type 2 diabetes mellitus (T2DM) patients in Lahore, Pakistan. Methods: This descriptive, cross-sectional study was conducted at the Jinnah and Sir Ganga Ram Hospitals, Lahore using convenience sampling techniques between 1 December 2015 and 28 February 2016. The sample consisted of elderly (>65 years) T2DM patients. Glycaemic values and patient characteristics were obtained from medical charts. Consenting patients were interviewed to complete the Barthel Index, Lawton Instrumental Activities of Daily Living Scale, Clinical Frailty Scale, Iowa Pain Thermometer Scale, Geriatric Depression Scale, Montreal Cognitive Assessment tool, Mini Nutritional Assessment Scale—Short Form and Self Care Inventory—Revised Version. Multiple logistic regression analysis was carried out to determine the predictors of poor glycaemic control. Results: A total of 490 patients were approached and 400 agreed to participate. Overall, nearly one-third (32.2%, n = 129) of patients had glycated haemoglobin (HbA1c) at the target level. Fasting and random plasma glucose levels were within the target range to much the same extent; (36.8%, n = 147) and (27%, n = 108), respectively. HbA1c levels were also higher in patients with co-morbidities (67.4%, n = 229) with diabetes-related complications (73.5%, n = 227). Significant predictors of impaired glycaemic control (HbA1c) included poor diabetes self-care (adjusted odds ratio (AOR) 0.96; 95% confidence interval (CI) 0.95, 0.98), not being prescribed oral hypoglycaemic agents (OHA) (AOR 6.22; 95% CI 2.09, 18.46), regular hypoglycaemic attacks (AOR 2.53; 95% CI 1.34, 4.81) and falling tendency (AOR 0.19; 95% CI 0.10, 0.36). Conclusions: Poor glycaemic control prevailed among the majority of elderly Pakistani diabetic patients in this study. Triggering factors of poor glycaemic control should be taken into consideration by the healthcare professionals in targeting multifaceted interventions to achieve good glycaemic control.

scholarly journals Dietary patterns and glycaemic control among Qatari adults with type 2 diabetes

2020 ◽  
pp. 1-8
Author(s):  
Marwa Alaradi ◽  
Asma Ouagueni ◽  
Rim Khatib ◽  
Grace Attieh ◽  
Hiba Bawadi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Fast Food ◽  
Self Report ◽  
Cross Sectional ◽  
Poor Glycaemic Control ◽  
Diabetes Medication

Abstract Objective: To assess the association between dietary patterns and glycaemic control among Qatari adults with type 2 diabetes (T2DM). Design: Cross-sectional analysis using data from the Qatar Biobank Study. Poor glycaemic control was defined as HbA1c ≥7·0 %. Dietary patterns were constructed using factor analysis based on habitual food intake assessed by a FFQ. Medication use was based on self-report. Multivariable logistic regression was used to assess the association. Setting: Qatar. Participants: Adults aged ≥18 years (n 1000) with known diabetes. Result: The mean age of the participants was 52·3 (sd 11·5) years. Overall, the prevalence of poor glycaemic control was 57·6 %, and 27·7 % of the participants were insulin users. Three dietary patterns were identified. The modern dietary pattern (high intake of fast food, croissants, white bread and cheese) was inversely associated with poor glycaemic control. The sd increments of the modern pattern had OR for poor glycaemic control of 0·86 (95 % CI 0·68, 1·08) in men and 0·76 (95 % CI 0·61, 0·95) in women. There was a significant interaction between the modern pattern and diabetes medication in men but not in women. In men without diabetes medication, the modern pattern was positively associated with poor glycaemic control with an OR of 2·35 (95 % CI 1·13, 4·87). Conclusions: Male diabetes patients took medication to control diabetes but ate more unhealthy food. In men who were not taking diabetes medication, modern dietary pattern was associated with poor glycaemic control. Promoting healthy eating should be encouraged especially among those under diabetes medication.

scholarly journals Modifiable Factors Associated with Uncontrolled Type 2 Diabetes Mellitus: Experience in a Tertiary Care Hospital of Bangladesh

2018 ◽  
Vol 8 (3) ◽  
pp. 229-234
Author(s):  
Mohammad Mehfuz E Khoda ◽  
Ishrat Jahan Shimu ◽  
Palash Mitra ◽  
Md Jakir Hossain ◽  
MA Sattar Sarkar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Tertiary Care ◽  
Poor Glycaemic Control ◽  
Specialist Physician ◽  
Modifiable Factors ◽  
Group 2 ◽  
Group 1

Background: Diabetes mellitus is a non-communicable disease with increasing prevalence worldwide. The present study was done to identify the modifiable factors that were associated with the poor glycemic control in Bangladeshi type 2 diabetic patients attending in a tertiary care hospital.Methods: This cross-sectional study was conducted in the Department of Medicine, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka from July 2014 to June 2015. A total of 140 adult type 2 diabetes mellitus patients were included in this study. Of them 70 patients had uncontrolled diabetes mellitus with glycated haemoglobin ³ 7% (group 1) and 70 patients with controlled diabetes mellitus (HbA1c< 7%) (group 2).Results: The present study demonstrated statistically significant difference regarding the mean age of both group 1 and group 2 [59.26±12.88 years and 55.24±11.52 years respectively (p <0.05)] and mean duration of diabetes [10.44±8.46 years and 5.96±6.39 years (p=0.0006) respectively]. Moderate physical activity was significantly (p=0.018) associated with good glycaemic control (group 1= 15.7% and group 2= 32.9%). Mean body mass index (BMI) of both group 1 and group 2 were almost equal (23.73±4.72 Kg/ m2 and 23.87±4.86 Kg/ m2 respectively) with no statistical significance and waist hip ratio was 0.98±0.07 and 0.95±0.09 respectively which was statistically significant (p=0.013). Poor economic conditions were significantly associated with uncontrolled blood glucose (p <0.05). Poor glycemic control was also significantly associated with smoking (p=0.00038) and frequent visit with specialist physician (p=0.011). Proper counseling was frequently associated with poor glycaemic control. Most of the patients in group 1 were irregular in dietary habit (58.6%) and exercise (67.1%) and intake of refined sugar (60%) were major contributory factors of poor glycaemic control.Conclusions: Low socioeconomic condition, smoking and intake of refined sugar were the significant modifiable factors that contributed to poor glycaemic control of diabetes. Irregular dietary habits and exercise and proper follow up with specialist physician were more frequent with poor blood glucose control. Proper counseling about diabetes and its management was another modifiable factor. Central obesity and longer duration of diabetes were predisposed to uncontrolled diabetes.Birdem Med J 2018; 8(3): 229-234

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