De Zoysa Warsha, Weerarathna Thilak Priyantha, Darshana Ipitagama Liyana Arachchige Nuwan, Egodage Udari Kaushalya, Jayasekara Priyamali, Sujanitha Vathulan, Silva Shehan, Mettananda Chamila, Pathirage Manoji, Ramadasa Udayangani, Palangasinghe Dhammika Randula, Wasana Keddagoda Gamage Piyumi, Mendis Sahan
Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
BMC Endocr Disord. 2025 Jul 14;25(1):178. doi: 10.1186/s12902-025-01994-1.
Type 2 diabetes mellitus (T2DM) is an escalating global public health concern. Effective management of T2DM needs a holistic approach, considering not only the medical interventions but also demographic and behavioral factors. This multicenter study aims to investigate the association between optimal glycemic control and demographic and behavioral factors among patients with T2DM followed up in outpatient clinics of tertiary care hospitals across Sri Lanka.
A cross-sectional study was carried out involving T2DM patients (n = 2013) visiting outpatient clinics at seven tertiary care facilities across five provinces in Sri Lanka. Information related to sociodemographic and behavioral factors was collected using an interviewer-administered questionnaire. HbA < 7% was considered as optimal glycemic control. Predictors for glycemic control were identified using multiple logistic regression at a 0.05 significance level.
Out of the total sample, 99.1% were on pharmacological treatment for T2DM while the minority were solely on dietary management. The optimal glycemic control had been achieved by 43.4%. Female gender (aOR = 1.56, 95% CI 1.18-2.05), younger age group (aOR = 1.39, 95% CI 1.06-1.82), non-Sinhalese ethnicities (aOR = 1.34, 95% CI 1.02-1.77), inadequate adherence to antidiabetic medication (aOR = 1.71, 95% CI 1.31-2.24), longer disease duration (aOR = 1.51, 95% CI 1.13-2.02), being treated with insulin (aOR = 2.79, 95% CI 1.77-4.41), and daily alcohol use (aOR = 2.27, 95% CI 1.19-4.32) were identified as risk factors for inadequate glycemic control in multiple logistic regression.
Over 50% of individuals demonstrated suboptimal glycemic control. It is recommended to implement targeted interventions for specific subgroups to address distinct demographic and behavioral factors to achieve optimal glycemic control and clinical outcomes for diabetes patients in Sri Lanka.
2型糖尿病（T2DM）是一个日益严重的全球公共卫生问题。T2DM的有效管理需要一种整体方法，不仅要考虑医学干预措施，还要考虑人口统计学和行为因素。这项多中心研究旨在调查在斯里兰卡三级医院门诊随访的T2DM患者中，最佳血糖控制与人口统计学和行为因素之间的关联。
开展了一项横断面研究，纳入了在斯里兰卡五个省份的七家三级医疗机构门诊就诊的T2DM患者（n = 2013）。使用访谈式问卷收集与社会人口统计学和行为因素相关的信息。HbA＜7%被视为最佳血糖控制。在0.05的显著性水平下，使用多元逻辑回归确定血糖控制的预测因素。
在总样本中，99.1%的患者正在接受T2DM的药物治疗，少数患者仅采用饮食管理。43.4%的患者实现了最佳血糖控制。在多元逻辑回归中，女性（调整后比值比[aOR]=1.56，95%置信区间[CI]1.18 - 2.05）、较年轻年龄组（aOR = 1.39，95%CI 1.06 - 1.82）、非僧伽罗族裔（aOR = 1.34，95%CI 1.02 - 1.77）、抗糖尿病药物依从性不足（aOR = 1.71，95%CI 1.31 - 2.24）、病程较长（aOR = 1.51，95%CI 1.13 - 2.02）、接受胰岛素治疗（aOR = 2.79，95%CI 1.77 - 4.41）以及每日饮酒（aOR = 2.27，95%CI 1.19 - 4.32）被确定为血糖控制不佳的危险因素。
超过50%的个体血糖控制不理想。建议针对特定亚组实施有针对性的干预措施，以解决不同的人口统计学和行为因素，从而为斯里兰卡的糖尿病患者实现最佳血糖控制和临床结局。
Zotero 插件