Prevalence and predictors of suboptimal glycemic control among patients with type 2 diabetes mellitus in northern Thailand: A hospital-based cross-sectional control study

Abstract

Background Suboptimal glycemic control among patients with type 2 diabetes mellitus (DM) is a significant public health problem, particularly among people living with poor education and economic statuses, including those with a unique dietary culture. This study aimed to estimate the prevalence and identify the factors associated with suboptimal glycemic control among patients with type 2 DM during the coronavirus disease-2019 (COVID-19) pandemic. Methods A hospital-based cross-sectional study was used to elicit information from DM patients attending six hospitals located in Chiang Rai Province, northern Thailand, between February and May 2021. A validated questionnaire and 5 mL blood specimens were used as the research tools. Glycated hemoglobin (HbA1c) greater than 7.0% among DM patients at least two years after diagnosis was defined as suboptimal glycemic control. Chi-square tests and logistic regression were used to identify the associations between variables at the significance level α = 0.05. Results A total of 967 patients were recruited for this study; 54.8% 530 had suboptimal glycemic control, 58.8% were female, 66.5% were aged 50-69 years, and 78.5% were married (78.5%). Six variables were found to be associated with suboptimal glycemic control in multivariable logistic regression. Participants aged <49, 50-59, and 60-69 years had 3.32 times (95% CI = 1.99-5.53), 2.61 times (95% CI = 1.67-4.08), and 1.93 times (95% CI = 1.26-2.95) greater odds of having suboptimal glycemic control, respectively, than those aged ≥70 years. Married individuals had 1.64 times (95% CI = 1.11-2.41) greater odds of having suboptimal glycemic control than those ever married. Participants who consumed sticky rice had 1.61 times (95% CI = 1.19-2.61) greater odds of having suboptimal glycemic control than those who did not consume sticky rice in daily life. Participants who had been diagnosed with DM for 11-20 years and ≥21 years had 1.98 times (95% CI = 1.37-2.86) and 2.46 times (1.50-4.04) greater odds of having suboptimal glycemic control, respectively, than those who had been diagnosed ≤ 10 years. Participants who had experienced forgetting to take their medication had 2.10 times (95% CI = 1.43-3.09) greater odds of having suboptimal glycemic control than those who did not, and those who had their medical expenses covered by the national scheme had 2.67 times (95% CI = 1.00-7.08) greater odds of suboptimal glycemic control than those who self-paid.