Non-pharmaceutical factors for poor glycemic control in 13,970 Chinese women with drug-treated type 2 diabetes: A cross-sectional survey in 77 tertiary hospitals in four Chinese cities

Abstract

Background: Achieving good glycemic control improves clinical outcomes among patients with type 2 diabetes (T2D). This study aimed to explore non-pharmaceutical factors for poor glycemic control in Chinese women with T2D who used antidiabetic drug(s). Methods: A cross-sectional survey was conducted in March to June 2011 in 77 top tertiary hospitals in Beijing, Shanghai, Tianjin, and Guangzhou, People’s Republic of China (the coverage rates of the 3A hospitals: 74.4%, 76%, 55%, and 29.3%, respectively). Of 29,502 patients with T2D who used oral antidiabetic drugs (OADs) alone or combined with insulin, 13,970 were women and used in the analysis. Logistic regression analysis was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) of factors for hyperglycemia defined as HbA1c (glycated hemoglobin) ≥77 mmol/mol (7.0%). Results: The mean age was 60.3 (standard deviation 11.0) years, with a median of 4 (interquartile range 2–9) years of duration of diabetes, and 65.1% had hyperglycemia. In multivariable analysis, body height of ≥164 cm (OR 1.26, 95% CI 1.15–1.37) and obesity (OR 1.16, 95% CI 1.04–1.31) was associated with increased risk of hyperglycemia, while self-monitoring blood glucose (SMBG) decreased the risk of hyperglycemia (OR 0.78, 95% CI 0.73–0.84). Duration of diabetes ≥3 years (≥3 to ≥6 years, OR 1.46, 95% CI 1.32–1.62; ≥6 to ≥10 years, OR 1.65, 95% CI 1.44–1.89), especially ≥10 years (OR 1.95, 95% CI 1.73–2.19), was associated with higher risks of hyperglycemia. Conclusion: Body height ≥164 cm, obesity, and duration of diabetes ≥3 years increased while SMBG decreased risk of hyperglycemia in Chinese women with OAD-treated T2D.