Management of Diabetes Mellitus and Factors Associated with Poor Glycemic Control in an Urban Area

Nam, Hyun; Shin, Min Ho; Kweon, Sun Seong; Oh, Hyun Suk; Rhee, Jung Ae; Choi, Jin Su

Korean J Health Promot > Volume 12(3); 2012 > Article

Original Article

Korean Journal of Health Promotion 2012;12(3):115-122.

Management of Diabetes Mellitus and Factors Associated with Poor Glycemic Control in an Urban Area

Hyun Nam, Min Ho Ho Shin, Sun Seong Seong Kweon, Hyun Suk Suk Oh, Jung Ae Ae Rhee, Jin Su Su Choi

¹Gwangju Donggu Public Health Center, Gwangju, Korea.
²Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea. mhshinx@paran.com
³Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Korea.

Abstract

BACKGROUND
We evaluated the current status of diabetes management and the predictors for poor glycemic control in an urban area. METHODS: This study included 1,138 community-dwelling adults (> or =50 years) with diabetes, of which 584 participated in the diabetes care survey. Logistic regression was used to identify the factors predicting poor glycemic control (hemoglobin A1c[HbA1c]> or =7%) in the total sample and to evaluate the relationship between the history of diabetes management checkup and poor glycemic control in the diabetes care survey sample. RESULTS: Of the 1,138 patients, 53.2% had blood pressure less than 130/80 mmHg, 41.7% had fasting glucose between 70 and 130 mg/dL, 48.6% had HbA1c below 7.0%, 60.1% had triglycerides below 150 mg/dL, 41.4% had low density lipoprotein cholesterol below 100 mg/dL, and 59.1% had normoalbuminuria (urine albumin-to-creatinine ratio <30 mg/g creatinine). Of the 584 patients completing the diabetes care survey, 63.9% had one or more lipid tests, 32.0% had one or more HbA1c tests, 43.8% had one or more microalbuminuria tests, and 42.5% had one or more fundoscopic examinations annually. Female gender (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.23-2.36), duration of diabetes (OR, 1.07; 95% CI, 1.06-1.09), and alcohol use (OR, 1.40; 95% CI, 1.06-1.85) were associated with an increased risk for poor glycemic control while age (OR, 0.97; 95% CI, 0.96-0.99) and antihypertensive medication (OR, 0.64; 95% CI, 0.50-0.83) were associated with a decreased risk. CONCLUSIONS: This study shows that glycemic control is likely to be poor in urban areas. We need to develop appropriate community-based strategies to achieve optimal glycemic control and prevent diabetes complications.

Key Words: Diabetes mellitus, Factors, Management, Complications, Glycated hemoglobins, Community