糖尿病合併症と医学のジャーナル

Socio-demographic Determinants of Poor Glycaemic Control among Type 2 Diabetes Mellitus (T2DM) Patients Attending Clinics at the Three Selected Health Facilities in Suva, Fiji in 2011-2016

Abstract

Pablo CR, Masoud Mohammadnezhad , Donald Wilson and Sabiha Khan

Introduction and Aim: Diabetes is one of the largest health emergencies in the 21st century. In Fiji, type 2 diabetes mellitus (T2DM) is the number one cause of premature deaths and disability. The aim of this study was to determine the socio-demographic determinants of poor glycemic control among T2DM patients attending clinics at the three selected health facilities in Suva, Fiji.
Methods: This facility based 5-year retrospective folder audit among 338 randomly selected T2DM patient records registered between August 1, 2011 to August 1, 2016 from three selected health facilities in Suva, Fiji through proportionate sampling method and met the following inclusion criteria: T2DM adults >18 years; on treatment for >1 year; had >4 clinic visits and; had recent HbA1c result in 2017. Glycemic level was assessed using the most recent HbA1c level and poor glycemic control was defined as HbA1c of >7%. Data analysis included both descriptive and inferential statistics using SPSS v. 22 to assess the independent variable’s association with glycemic control. P value <0.05 was considered significant.
Results: The 338 T2DM patients had a mean age of 56.5 years (SD=+9.9), 62.1% were <60 years old, 62.1% were females and 63.9% were of Fijian of Indian Descent (FID). The prevalence of poor glycemic control was 77.2%. Mean HbA1c was 8.6% (SD=+2.04). In logistic regression analysis, T2DM patients <60 years had twice the chances of having poor glycemic control than their younger counterparts: odds ratio (OR) =2.29; 95% confidence interval (CI): 1.32, 3.9; p=0.003. Those attending Suva diabetes Centre were found to be three times more likely to have poor glycemic control than those attending other diabetes clinics: OR =3.32; 95% CI: 1.22, 9.04; p=0.019.
Conclusion: This study found a significantly high proportion of poorly controlled T2DM patients. Younger patients and those attending Suva Diabetes Centre were significant socio-demographic determinants of poor glycemic control. Health care workers dealing with T2DM patients should consider socio-demographic factors associated with glycemic control for a more patient-centered diabetes care.