Risk factors associated with poor glycemic control in patients with type two Diabetes mellitus in Zakho city
Risk factors associated with Type 2 Diabetes mellitus
Keywords:Risk factors, Diabetes mellitus, poor glycaemic control, Zakho city
Diabetes Mellitus (DM) is a chronic condition caused by relative lack of insulin due to impaired insulin secretion or insulin resistance. The aim of this study was to investigate the prevalence of poor glycemic control in Zakho city and to explore the modifiable risk factors that may help controlling the disease.
Materials and Methods
We recruited patients with known history of diabetes receiving oral anti-diabetic medications. Those patients were registered in Zakho Diabetes center with regular visits. The measurement of anthropometric indices was conducted by trained personnel. Plasma glucose was determined using colorimetric enzymatic method with glucose oxidase. HbA1c concentrations were measured in whole blood samples using high performance liquid chromatography.
In this study, 520 patients were recruited. The average age of the patients was 56.92Â±9.62. Among those, 190 were male. The blood sugar was controlled in 122 (23.4%) patients. We found a significant association between sex and HbA1C level (p=0.000; OR=0.4796; CI=0.3175-0.7243). In addition, waist circumference was significantly associated with HbA1C levels (p=0.018; OR=1.02; CI=1.0031-1.0373).
The vast majority of the patients had uncontrolled diabetes. We found that sex and waist circumference were risk factors for uncontrolled diabetes. Any diabetes controlling program should focus on those two factors.
2. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology. 2017;14:88.
3. Zimmet PZ. Diabetes and its drivers: the largest epidemic in human history? Clin Diabetes Endocrinol. 2017;3:1-.
4. Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of Diabetes. Diabetes Care. 2004;27(5):1047.
5. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice. 2018;138:271-81.
6. Haghighatpanah M, Nejad ASM, Haghighatpanah M, Thunga G, Mallayasamy S. Factors that Correlate with Poor Glycemic Control in Type 2 Diabetes Mellitus Patients with Complications. Osong Public Health Res Perspect. 2018;9(4):167-74.
7. Peng K, Chen G, Liu C, Mu Y, Ye Z, Shi L, et al. Association between smoking and glycemic control in diabetic patients: Results from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal (REACTION) study. Journal of Diabetes. 2018;10(5):408-18.
8. Zhu H-T, Yu M, Hu H, He Q-F, Pan J, Hu R-Y. Factors associated with glycemic control in community-dwelling elderly individuals with type 2 diabetes mellitus in Zhejiang, China: a cross-sectional study. BMC Endocr Disord. 2019;19(1):57-.
9. Black MH, Anderson A, Bell RA, Dabelea D, Pihoker C, Saydah S, et al. Prevalence of asthma and its association with glycemic control among youth with diabetes. Pediatrics. 2011;128(4):e839-e47.
10. Ogbonna SU, Ezeani IU, Okafor CI, Chinenye S. Association between glycemic status and thyroid dysfunction in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2019;12:1113-22.
11. Alzaheb RA, Altemani AH. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia. Diabetes Metab Syndr Obes. 2018;11:15-21.
12. Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, et al. Diabetes in Iran: Prospective Analysis from First Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (NPPCD-2016). Scientific Reports. 2017;7(1):13461.
13. Mansour AA, Alibrahim NTY, Alidrisi HA, Alhamza AH, Almomin AM, Zaboon IA, et al. Prevalence and correlation of glycemic control achievement in patients with type 2 diabetes in Iraq: A retrospective analysis of a tertiary care database over a 9-year period. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(3):265-72.
14. Selvin E, Coresh J, Golden SH, Boland LL, Brancati FL, Steffes MW. Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals With Diabetes. Diabetes Care. 2005;28(8):1965.
15. Kakade AA, Mohanty IR, Sandeep R. Assessment of factors associated with poor glycemic control among patients with type II diabetes mellitus. Integr Obes Diabetes. 2018;4(3).
16. Peng K, Chen G, Liu C, Mu Y, Ye Z, Shi L, et al. Association between smoking and glycemic control in diabetic patients: Results from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal (REACTION) study. Journal of Diabetes. 2018;10(5):408-18.
17. Zhu H-T, Yu M, Hu H, He Q-F, Pan J, Hu R-Y. Factors associated with glycemic control in community-dwelling elderly individuals with type 2 diabetes mellitus in Zhejiang, China: a cross-sectional study. BMC Endocr Disord. 2019;19(1):57.
18. Gomes MB, Tang F, Chen H, Cid-Ruzafa J, Fenici P, Khunti K, et al. 1279-P: Socioeconomic Factors Associated with Poor Glycemic Control in People with Type 2 Diabetes: The DISCOVER Study. Am Diabetes Assoc; 2019.
19. Alramadan MJ, Magliano DJ, Almigbal TH, Batais MA, Afroz A, Alramadhan HJ, et al. Glycaemic control for people with type 2 diabetes in Saudi Arabia - an urgent need for a review of management plan. BMC Endocr Disord. 2018;18(1):62-.
20. Kayar Y, Ilhan A, Kayar NB, Unver N, Coban G, Ekinci I, et al. Relationship between the poor glycemic control and risk factors, life style and complications. 2017.
21. Kamuhabwa AR, Charles E. Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam. Drug Healthc Patient Saf. 2014;6:155-65.
22. Omar SM, Musa IR, Osman OE, Adam I. Assessment of glycemic control in type 2 diabetes in the Eastern Sudan. BMC Research Notes. 2018;11(1):373.
23. Roy S, Sherman A, Monari-Sparks MJ, Schweiker O, Jain N, Sims E, et al. Association of Comorbid and Metabolic Factors with Optimal Control of Type 2 Diabetes Mellitus. N Am J Med Sci. 2016;8(1):31-9.
24. Rohit S, Rahul M. Diabetes Risk Diagnosis Using Obesity Markers and Glycemic Control in Indian Population. Journal of The Association of Physicians of India. 2019;67:22.
25. Goodpaster BH, Krishnaswami S, Resnick H, Kelley DE, Haggerty C, Harris TB, et al. Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes care. 2003;26(2):372-9.