scholarly journals Identifying the Risk Factors and the Prevalence of Poor Glycemic Control among Diabetic Outpatients in a Rural Region in Saudi Arabia

Author(s):  
Ziyad S. Almalki ◽  
Nehad Jaser Ahmed ◽  
Abdullah K. Alahmari ◽  
Ahmed M. Alshehri ◽  
Sheikah Abdullah Alyahya ◽  
...  

Aim: This cross-sectional study aimed to assess the prevalence of poor glycemic control and risk factors associated with it among diabetic patients in the central rural region of Saudi Arabia. Methods: The study included a review of diabetic patients’ medical record in King Khaled Hospital in Al-Kharj from the beginning of January 2019 to the end of June 2019. Poor glycemic control was defined as the current use of diabetic-lowering medication associated with HbA1c levels ≥7%. Multivariate analysis was done to identify the associated factors of poor glycemic control. Results: Of 1,010 consecutive outpatients’ diabetic patients were involved in the study sample, poor glycemic control presented in 496 (49.1%). Individuals who were at risk to have poor glycemic control those between 45 and 65 years with odds ratio (OR) of 1.927 (95% CI: 1.143–3.248), obese 1.496 (95% CI: 1.085–2.063) and diagnosed with asthma 2.062 (95% CI: 1.637–3.504). Conclusion: The extent of poor glycemic control in the study sample was found high. Age, obesity, and having asthma are the most important factors of increased risk of poor glycemic control. Improving glycemic control would need rigorous efforts by addressing these factors.

2017 ◽  
Vol 2 (2) ◽  
pp. 155-159
Author(s):  
Zhian S. Ramzi ◽  
Mahfoodh A. Sulaiman

Microalbuminuria is the most leading cause for cardiovascular disease, diabetic nephropathy, end stage renal diseases, and death among diabetic patients. The study carried out                                                                                       to find out the prevalence of microalbuminuria in a sample of Sulaimani diabetics and to determine its relation to different associated risk factors. The first part of study was a cross-sectional study conducted through examination of records of diabetic patients registered in Sulaimani Diabetic Center from June 2010 to May 2012. The second part was a case- control study that conducted in the same center, including 50 cases of diabetics with positive microalbuminuria, and 50 controls with negative one, that were registered in the same center and matched by age and gender. A specially designed questionnaire was used by researcher to collect information from the records. SPSS version 21.0 was used for data analysis. Males accounts for half of cases and controls, highest proportion of sample was found among age group (60-69) years about 34%. The prevalence of microalbuminuria was 29%. The study showed a statistical significant association of microalbuminuria with obesity, smoking, hypertension, retinopathy, ischemic heart disease, poor glycemic control, and dyslipidemia.  In conclusion moderate prevalence of microalbuminuria was found among diabetic patients, the prevalence was more common in poor glycemic control, and hypertensive diabetics. There was significant relation between microalbuminuria and diabetic nephropathy.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Mohammad K. Hemadneh ◽  
Sohaib T. Khatib ◽  
Samer A. Hasan ◽  
Ihab N. Tahboub ◽  
Emad Khazneh ◽  
...  

Abstract Background Diabetes mellitus is the leading cause of end-stage renal disease. Monitoring and controlling normal blood sugar levels play a critical role in slowing the progression of micro- and macrovascular complications of diabetes. This study was conducted to measure glycaemic control and diabetes-related knowledge in diabetic patients on maintenance haemodialysis and to assess any relationship between these two variables. Methods This cross-sectional study was conducted at six dialysis centres in the north of the West Bank. Blood samples were collected to measure glycated haemoglobin (HbA1c) levels, while the Michigan Diabetic Knowledge Test (MDKT) was employed as a measure tool of diabetes-related knowledge. Patients were also asked to fill in a questionnaire in order to determine their sociodemographic characteristics. Finally, univariate analyses were used to measure the associations between the clinical and sociodemographic data, and diabetes knowledge and glycaemic control. Results A total of 147 haemodialysis patients with diabetes were included in this study. The mean age of the cohort was 60.12 (SD = 10.28). Males accounted for 51.7% of the cohort. The HbA1c levels (%) and MDKT scores were 6.89 ± 1.72 and 9.19 ± 1.7 (mean ± SD), respectively. 36.1% of the patients had poor glycemic control. The study showed that residency and household income were associated with diabetes knowledge (P < 0.05). However, the study did not show a significant association between diabetes-related knowledge and glycaemic control overall, nor did it show a significant association between the clinical and sociodemographic factors and glycaemic control (P > 0.05). Conclusions This study showed that patients living in refugee camps as well as those with low income had low diabetes-related knowledge and needed extra care. This study also revealed that a relatively high proportion of diabetic patients on maintenance haemodialysis suffered from poor glycemic control. Here, we recommend to put greater emphasis on better diabetes-related knowledge as a means to achieve better diabetes care with improved glycemic control for all haemodialysis patients


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251506
Author(s):  
Shambel Nigussie ◽  
Nigussie Birhan ◽  
Firehiwot Amare ◽  
Getnet Mengistu ◽  
Fuad Adem ◽  
...  

Objective To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. Result A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10–4.29). The odds of poor glycemic control in patients who did not understand the pharmacist’s instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10–3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13–2.55). Conclusion The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist’s advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hasan Mahmud Reza ◽  
Towhid Hasan ◽  
Marjia Sultana ◽  
Md. Omar Faruque

Purpose Diabetes mellitus is becoming a growing concern worldwide. Hence, the purpose of this study is to assess the magnitude of poor glycemic control and to identify the determinants of poor glycemic control among diabetic patients attending a tertiary care hospital in Bangladesh. Design/methodology/approach This cross-sectional study was conducted among 732 diabetes patients seeking care at the outpatient department of Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. Information, including glycemic status, was collected from patients’ medical records using a structured questionnaire. Findings About 87.6% of the patients were found to have poor glycemic control (glycosylated hemoglobin = 7%). Variables that were significant in bivariate analysis were put into a multivariate model where the factors associated with poor glycemic control were patients aged 41–60 years (odds ratio (OR)=2.26; 95% confidence interval (CI): 1.19–4.32, p = 0.013), suffering from diabetes for > 7 years (OR = 1.84; 95% CI: 1.12–2.99, p = 0.015), using insulin (OR = 2.34; 95% CI: 1.23–4.47; p = 0.010) or diet alone (OR = 0.20; 95% CI: 0.05–0.80, p = 0.023) as a type of diabetes treatment and proper use of medicine (OR = 0.37; 95% CI: 0.17–0.82, p = 0.015). Originality/value The high prevalence of poor glycemic control among diabetic patients is evident; therefore, strategic management and proper attention focusing on the predictors of poor glycemic control are necessary to reduce the long-term complications of diabetes.


Author(s):  
Omyma Abbas Banaga Salih ◽  
Ehab Hamed

Background: Diabetic patients are at increased risk of glaucoma compared to the general population. Risk factors for glaucoma that is specific to diabetic patients include increased IOP, retinopathy and neovascular changes and years since diagnosis of diabetes. This cross-sectional study aims to report on the prevalence of glaucoma in diabetic patients in community diabetes centre in Sudan and examine associations with previously reported risk factors.Methods: A cross-sectional study was carried out in Omdurman specialised diabetic healthcare centre in Sudan. A total of 300 patients consented to participation. All patients filled in a survey for both demographics and diabetic disease history then had an assessment for glaucoma by an ophthalmologist. The assessment included examination of the anterior segment, optic nerve assessment and fundus examination using a stereoscopic slit lamp, intraocular pressure (IOP) measurement using tonometry, peripheral anterior chamber configuration and depth assessments using gonioscopy and central visual field assessment using perimetry.Results: Prevalence of open-angle glaucoma diagnosis was 2.8% among diabetic patients who were included in this study. Family history for glaucoma was significantly associated with increased risk of open-angle glaucoma (OR 5.67, 95% CI 1.74-18.45). Retinopathy was also associated with an increased risk of developing the condition (OR 3.1, 95% CI 1.11-8.51). Gender, years since diabetes diagnosis and medications did not have significant associations.Conclusions: Patients with diabetes are at increased risk of developing open-angle glaucoma, but the prevalence among the diabetic population attending community diabetes centre in Sudan remains low. Among different clinical determinants, diabetic retinopathy and genetic determinants may explain the increased risk in the diabetic population.


Author(s):  
Hamed Taheri ◽  
Roya Rafaiee ◽  
Raheleh Rafaiee

Objective: Academic health services play an important role in the prevention and control of diabetes mellitus (DM) in Iran. This study aimed at determining the prevalence of DM-related complications and the associated risk factors among patients with DM in a university-affiliated outpatient diabetes clinic of a referral hospital in Southeast of Iran, Zahedan. Materials and Methods: This cross-sectional study was conducted from January to April 2019 in an academic diabetes clinic. A total of 334 patients with DM, whose characteristics (age, sex, family history of DM, and substance abuse), as well as laboratory and clinical information, were recorded in the baseline forms, were included. The relationship between variables were assessed by Pearson’s correlation coefficient at P-value< 0.05 and using SPSS version 20.0. Results: The mean age of the participants was 54.27 (±11.57) years. In these patients, DM type 2 was estimated at 99.1%, and the mean duration of the disease was 8.98 (±6.93) years. The findings showed that 77.2% of the patients had poor glycemic control. Also, 85.4% of the patients had fasting blood sugar (FBS) level >126 mg/dL. There was a significant relationship between insulin-dependent therapy and drug abuse (P-value <0.001). The prevalence of hyperlipidemia (68.9%), hypertension (50.6%), retinopathy (29.6%), nephropathy (11.7%), and neuropathy (12.3%) was also determined. Conclusion: The majority of the patients (77.2%) in this study had poor glycemic control, and 69.9% of them suffered from microvascular complications, macrovascular complications, or both. Therefore, frequent visits accompanied by patient education could help to better diabetes control


2018 ◽  
Vol 10 (1) ◽  
pp. 92
Author(s):  
Anita Natasya ◽  
Retnosari Andrajati ◽  
Rani Sauriasari

Objective: The present study aimed to evaluate the association between glycemic control and quality of life (QoL) in people with type 2 diabetesmellitus (T2DM) and identify that factors that influence glycemic control and QoL.Methods: This cross-sectional study was conducted at the general hospital in Depok City from October to December 2017. Respondents wereoutpatients diagnosed with T2DM, receiving routine care at the hospital. Glycemic control was assessed using glycated hemoglobin (HbA1c) levels,while QoL was measured using an Indonesian version of the validated 5-level EuroQol 5-Dimensional.Results: Among 108 participants, HbA1c levels were influenced by age, DM disease duration, DM treatment adherence, glycemic control, diet, andphysical activity suitable for patients with DM. The mean QoL value was 0.74±0.23 and the visual analog scale (VAS) score was 65.49±15.96. The QoLvalues of patients with DM were influenced by HbA1c levels, duration of DM, and physical activity, while the VAS score was significantly affected byHbA1c levels and duration of DM.Conclusion: The present study showed that the QoL of T2DM patients was significantly influenced by glycemic control and other factors.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Dykun ◽  
O Bayturan ◽  
J Carlo ◽  
S E Nissen ◽  
S J Nicholls ◽  
...  

Abstract Background Hemoglobin A1c (HbA1c) reflects long-term glycemic control and is associated with an increased risk of cardiovascular events among diabetic and non-diabetic patients. The specific impact of HbA1c upon atheroma progression and incident cardiovascular events relative to the presence of other cardiovascular risk factors remains uncertain. Purpose We tested the hypothesis that on-treatment HbA1c levels independently associate with coronary atheroma progression measured with serial intravascular ultrasonography (IVUS) and major adverse cardiovascular events (MACE: death, myocardial infarction, cerebrovascular accident, coronary revascularization, or hospitalization for unstable angina) rates. Methods We performed a post-hoc pooled analysis of data from eight prospective, randomized trials involving serial coronary IVUS. HbA1c was measured at baseline and the average of the follow-up values was taken. The percent atheroma volume (PAV) was calculated as the proportion of the entire vessel wall occupied by atherosclerotic plaque, throughout the segment of interest. Using multivariable mixed modeling, we determined the association of HbA1c with annualized change in PAV. Cox proportional hazard models were used to assess the association of HbA1c with incidence of MACE. Results Among 2,791 patients, mean age was 58.9±9 years and 29.1% were women. Mean on-treatment low-density lipoprotein (LDL)-cholesterol was 80.2±33.7 mg/dl and median on-treatment triglycerides (TG) were 125.5 (94.7, 170.2) mg/dl. Mean baseline and follow-up HbA1c was 6.2±1.2% and 6.3±1.2%, respectively. Overall, there was no net significant annualized change in PAV (0.15±0.21, p=0.47). In a fully adjusted multivariable analysis (following adjustment of age, sex, body mass index (BMI), systolic blood pressure, smoking, LDL- and high-density lipoprotein cholesterol, TG levels, peripheral artery disease, trial, region, and baseline PAV), higher on-treatment HbA1c levels were independently associated with annualized changes in PAV [beta-estimate (95% confidence interval): 0.13 (0.07, 0.19), p&lt;0.001]. On-treatment HbA1c levels were significantly and independently associated with incidence of MACE [hazard ratio (95% confidence interval): 1.17 (1.07, 1.28), p&lt;0.001]. Conclusions Independent of achieved cholesterol levels, vascular risk factors and BMI, greater HbA1c levels significantly associate with coronary atheroma progression and clinical outcomes. These results support the notion of a direct, specific effect of glycemic control upon the natural history of coronary atheroma and atherosclerotic events, supporting the rationale of therapies designed to directly modulate it. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Iryna Dykun was supported by the German Research Foundation


2021 ◽  
Vol 30 (3) ◽  
pp. 215-20
Author(s):  
Novi Sulistia Wati ◽  
Pokkate Wongsasuluk ◽  
Pradana Soewondo

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupts selfmanagement in diabetic patients in Indonesia. This study aimed to determine the telemedicine usage and factors contributing to glycemic control in type 2 diabetes mellitus (T2DM) patients during the pandemic. METHODS A cross-sectional study was conducted in T2DM patients aged 25–54 years. The questionnaire included general characteristics, diabetes conditions, consultation factors, and self-care management. Glycemic status was evaluated using glycated hemoglobin (HbA1c) levels, which was categorized into poor (HbA1c≥7%) and good glycemic control (HbA1c<7%). Data were analyzed using chi-square and binary logistic regression. RESULTS Of 264 patients, only 19.2% used telemedicine and 60.2% had poor glycemic control during the pandemic. Overweight or obesity (odds ratio [OR] = 5.740 [95% confidence interval [CI] = 2.554–12.899]; p<0.001), insulin injection (OR = 3.083 [95% CI = 1.238–7.677]; p = 0.016), and frequent fried food consumption (OR = 5.204 [95% CI = 1.631–16.606]; p = 0.005) were the factors contributing to poor glycemic control. The risk is lower if exercised regularly (OR = 0.036 [95% CI = 0.007–0.195]; p<0.001) and consulted with a doctor using telemedicine (OR = 0.193 [95% CI = 0.044–0.846]; p = 0.029) or in-person visits (OR = 0.065 [95% CI = 0.016–0.260]; p<0.001). CONCLUSIONS Glycemic control was not optimal during the COVID-19 pandemic. Therefore, keeping a healthy lifestyle and staying connected with a doctor are important to ensure optimal blood glucose control and reduce the risk of diabetesrelated complications.


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