Predictive factors of glycemic control in patients with type 2 diabetes mellitus in primary health care |
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Authors: | Ben Abdelaziz A Soltane I Gaha K Thabet H Tlili H Ghannem H |
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Institution: | Service d'Epidémiologie et Statistiques Médicales, CHU Farhat-Hached, Sousse 4000, Tunisia. ahmed_epidemio@yahoo.fr |
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Abstract: | PURPOSE: To determine the factors associated with poor glycemic control in type 2 diabetic patients followed in primary care units in Sousse, Tunisia. METHODS: A cross-sectional study was conducted on a representative sample of type 2 diabetic patients followed at least two years in primary health care units in Sousse, Tunisia. Data were gathered from three sources: a self-administrated questionnaire, analysis of patient files and HbA1c level. HbA1c level was measured with turbidimetric immunoinhibition assay. Patients were considered well-controlled if glycated hemoglobin (HbA1c) was less than 7%, according to the American Diabetics Association (ADA) recommendations. RESULTS: The study enrolled 404 type 2 diabetic patients. The mean age was 60.5+/-10.89 years, sex-ratio was 0.5, and mean disease duration 8.7+/-6.1 years. ADA recommendations were met by 16.7% of patients. Multivariate analysis using variables in relation with the patient, his/her family, the disease, the treatment and the health care unit, showed that only poor geographic access to the care center (adjusted OR: 1.89, p=0.009) and Body Mass Index (BMI) less than 30 kg/m2 (adjusted OR: 2.21, p=0.034) were significantly and independently associated with poor glycemic control. CONCLUSION: Glycemic control in type 2 diabetic patients is poor. It depends strongly on geographic access to health care. Type 2 diabetic patients should be referred, as much as possible, to the nearest health care unit. |
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