The Outcome of Diabetes Care and Factors Associated With Poor Glycemic Control among Type 2 Diabetic Patients in Saimun Hospital

Abstract

Background and Objective: Diabetes mellitus is a major cause of morbidity and mortality. Poor and inadequate glycemic control among  patients with diabetes constitutes a major public health in Thailand. In clinical practice, optimal glycemic control is difficult to obtain on a long-term basis because the reasons for poor glycemic control in diabetes are complex. The aim of this study was to assess whether the quality of diabetes care and determine factors associated with poor glycemic control among patients with Type 2 diabetes in Saimun hospital.

Methods: This study was a cross-sectional descriptive design. The patients were interviewed, and the medical records were reviewed for demographic data, management practice, diabetes control, its complications, self-care management behaviors, and attitude towards diabetes. Poor glycemic control was defined as HbA1c ≥ 7%

Results: Of the total 310 patients, 26.8% had HbA1c < 7%, 61.6% of patients had adequate blood

pressure control (<130/85 mm Hg), 34.6% had total cholesterol levels ≤ 170 mg/dl, and 46.3% had triglyceride levels ≤ 150 mg/dl. In the multinominal  logistic regression analysis, increased duration of diabetes, increased treatment modalities, treated at  Saimun hospital (compared to  treated at Sub District Health Promoting Hospital), poor medication adherence, and missed doctor’s appointment were significantly associated with increased odds of poor glycemic control. ( p-value < 0.05)

Conclusion: Only small numbers of patients achieve established targets of diabetes control. Reengineering the diabetes management system focusing on early and intensive treatment, and adherence to medication may be necessary to substantially improve care.

Keywords: Type 2 diabetes mellitus, diabetes control, HbA_1C