Department of Statistics, Debre Markos University, Debre Markos, Ethiopia.
Sci Rep. 2022 Jun 8;12(1):9459. doi: 10.1038/s41598-022-13673-5.
Poor glycemic control is a main public health problem among type 2 diabetes mellitus (T2DM) patients and a significant cause of the development of diabetic complications. This study aimed to assess the glycemic control status and its associated factors among type 2 diabetes patients in Felege-Hiwot and Debre Markos Referral Hospitals. A retrospective cohort study was conducted at Felege-Hiwot and Debre Markos Referral Hospitals from December 2014 to December 2015. We have reviewed the chart of these patients until January 2020. Type 2 diabetic patients on follow-up at Felege-Hiwot and Debre Markos Referral Hospitals who fulfilled the inclusion criteria of the study were included. The primary outcome was the level of blood glucose during the study period. Good glycemic control was defined as patients whose average fasting blood glucose measurement for three consecutive visits was between 70 and 130 mg/dL. A generalized linear mixed autoregressive order one model was used to identify the determinants of glycemic control. A total of 191 patients with 1740 observations were included in the study. The overall prevalence of good glycemic control was 58.4% (95% CI: 57.159.7%). The factors associated with good glycemic control at 95% confidence level adjusted odds ratio were being residing in rural (CI: 0.454, 0.614), negative proteinuria (CI: 1.211, 1.546), diastolic blood pressure < 90 (CI: 1.101, 1.522), systolic blood pressure < 140 (CI: 1.352, 1.895), serum creatinine (CI: 0.415, 0.660), duration per visit (CI: 0.913, 0.987), duration since diagnosis (CI: 0.985, 0.998), weight ≥ 78 kg (CI: 0.603, 0.881). Age 38-50, 51-59 and 60-66 years (CI: 1.267, 1.776), (CI: 1.057, 1.476) and (CI: 1.004, 1.403), respectively. The overall prevalence of poor glycemic control was high at Debre Markos and Felege Hiwot Referral Hospital. Living in a rural area, older age (≥ 67 years), positive proteinuria, higher weight (≥ 78 kg), higher serum creatinine levels, higher duration per visit, higher time duration of T2DM since diagnosis, and developing hypertension (SBP ≥ 140, DBP ≥ 90) were the predictors of lower good glycemic control achievements of T2DM patients. In response to this finding, an aggressive intervention that targets improving glycemic control is required.
血糖控制不佳是 2 型糖尿病(T2DM)患者的主要公共卫生问题,也是糖尿病并发症发展的重要原因。本研究旨在评估 Felege-Hiwot 和 Debre Markos 转诊医院 2 型糖尿病患者的血糖控制状况及其相关因素。这是一项回顾性队列研究,于 2014 年 12 月至 2015 年 12 月在 Felege-Hiwot 和 Debre Markos 转诊医院进行。我们查阅了这些患者的病历,直到 2020 年 1 月。符合研究纳入标准的在 Felege-Hiwot 和 Debre Markos 转诊医院接受随访的 2 型糖尿病患者被纳入研究。主要结局是研究期间的血糖水平。血糖控制良好定义为连续三次就诊时平均空腹血糖测量值在 70 至 130mg/dL 之间。使用广义线性混合自回归一阶模型来确定血糖控制的决定因素。共有 191 名患者(1740 次就诊)纳入研究。总体上,血糖控制良好的比例为 58.4%(95%CI:57.159.7%)。在 95%置信水平下,与良好血糖控制相关的调整后比值比的因素包括居住在农村(CI:0.454,0.614)、蛋白尿阴性(CI:1.211,1.546)、舒张压<90(CI:1.101,1.522)、收缩压<140(CI:1.352,1.895)、血清肌酐(CI:0.415,0.660)、就诊时间间隔(CI:0.913,0.987)、诊断后时间间隔(CI:0.985,0.998)、体重≥78kg(CI:0.603,0.881)。年龄 38-50、51-59 和 60-66 岁(CI:1.267,1.776)、(CI:1.057,1.476)和(CI:1.004,1.403),分别。Debre Markos 和 Felege Hiwot 转诊医院的血糖控制不佳总体患病率较高。居住在农村地区、年龄较大(≥67 岁)、蛋白尿阳性、体重较高(≥78kg)、血清肌酐水平较高、就诊时间间隔较长、T2DM 诊断后时间间隔较长以及发生高血压(SBP≥140、DBP≥90)是 2 型糖尿病患者血糖控制不佳的预测因素。针对这一发现,需要采取积极的干预措施来改善血糖控制。