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Factors Associated with Glycemic Control among Syrian Patients With Type 2 Diabetes Mellitus


Affiliations
1 Master Student in Pharmacology Department, Faculty of Pharmacy, Tishreen University, Latakia,, Syrian Arab Republic
2 Doctor in Pharmaceutics and Pharmaceutical Technology Department, Faculty of Pharmacy, Tishreen University, Latakia,, Syrian Arab Republic
     

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Glycemic control is the main therapeutic objective in diabetes management. The aim of this study was to determine factors associated with poor glycemic control among Syrian patients with Type 2 diabetes mellitus (T2DM) in Latakia city. A random sample of 214 patients was selected from T2DM patients seen in the national center for diabetes in latakia over a period of 10 months in 2018/2019. Each patient was interviewed according to a validated questionnaire. Glycosylated hemoglobin (HbA1c) was measured for all patients using fast ion-exchange resin separation method. The SPSS 26.0 program was used for the statistical analysis. Probability (P) value less than 0.05 was considered statistically significant. Uncontrolled HbA1c (>7%) was seen in 70.6% of T2DM patients. There was no relationship of glycemic control, neither as HbA1c value, nor as percentage of patients with uncontrolled HbA1c, with age, gender, family history, education, duration of diabetes, diet or physical activity. Smokers and divorced patients, were more likely to have poor glycemic control. Elevated total cholesterol was significantly correlated with poorer glycemic control. Moreover, high levels of HbA1c were associated with the presence of diabetes complications and insulin therapy. Our findings suggests that poor glycemic control is common in T2DM Syrian patients in Latakia. Diabetic patients should routinely perform HbA1c and lipid profile analysis. There is a great need to educate patients about strategies to help them manage their diabetes and live a healthier life.

Keywords

Type 2 Diabetes Mellitus, Glycosylated Hemoglobin (HbA1c), Glycemic control, Diabetes risk factors.
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  • Diabetes care. A.D.A.J.D. Diagnosis and classification of diabetes mellitus. 2009; 32(1): S62-S67. Care 2009 Jan; 32(Supplement 1): S62-S67. https://doi.org/10.2337/dc09-S062.

  • Samidha K. Vrushali K. Management of Diabetes: A Review. Research J. Pharm. and Tech. 2014; 7: 1065-1072. DOI: 10.5958/0974-360X.

  • Hazaratali P. Vegunarani M. Study on Complications of Diabetes Mellitus among the Diabetic Patients. Asian J. Nur. Edu. and Research. 2016; 6: 171-182. doi: 10.5958/2349-2996.2016.00032.X.

  • Ogurtsova K . Rocha Fernandes J D da. Huang Y. Linnenkamp U. Guariguata L. N H Cho . Cavan D. J E. Makaroff L E. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. 2017; 128: 40-50. doi: 10.1016/j.diabres.2017.03.024.

  • Organization, W.H. Diabetes. World Health Organization. 2020. https://www.who.int/health-topics/diabetes#tab=tab_1.

  • Marcovecchio.L. Complications of acute and chronic hyperglycemia. US Endocrinology. 2017; 13(1):17–21. https://doi.org/10.17925/USE.2017.13.01.17.

  • Haidari F. Mansoori E. Zakerkish M. Haghighizadeh M. The Relationship between Metabolic Factors and Quality of Life Aspects in Type 2 Diabetes Patients. Research Journal of Pharmacy and Technology, 2017; 10(5): 1491. 10.5958/0974-360X.2017.00263.3.

  • Sujatha Kumari M. Babu K M. Sulthana R. Srinivas M. Prasanthi Ch P. Diabetes Mellitus: Present status and Drug therapy Updates. Research J. Pharm. and Tech. 2014; 7: 84-94. 10.5958/0974-360X.

  • Dailey G. Assessing glycemic control with self-monitoring of blood glucose and hemoglobin A1c measurements. in Mayo Clinic Proceedings. 2007; 82(2):229-35. doi: 10.4065/82.2.229.

  • lancet. U.P.D.S.G.J.T. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). 1998; 352(9131): 837-853.

  • Diabetes care. A.D.A.J.D. Standards of medical care for patients with diabetes mellitus. 2003; 26(suppl 1): s33-s50. abetes Care. 2003; 26(1): s33-s50. https://doi.org/10.2337/diacare.26.2007.S33

  • Daly J.M. Hartz J A. Xu Y. Levy T B. James A P. Merchant L M. Garrett E R. An assessment of attitudes, behaviors, and outcomes of patients with type 2 diabetes. 2009; 22(3): 280-290. doi: 10.3122/jabfm.2009.03.080114.

  • Badedi, M. Solan Y. Darraj H. Sabai A. Mahfouz M. Alamodi S. and Alsabaani A. Factors Associated with Long-Term Control of Type 2 Diabetes Mellitus. J Diabetes Res. 2016; 2016: 2109542. https://doi.org/10.1155/2016/2109542.

  • Organization, W.H. body Mass Index - BMI.” World Health Organization, World Health Organization, www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. 2020.

  • Cohen M P. Witt J. Wu Y V. Purified haemoglobin preparations in the evaluation of HbA1c determination by ion exchange chromatography. Ann Clin Biochem. 1993; 30 (3): 265-71. 10.1177/000456329303000307.

  • DIABETES care A.D.A.J.D. Glycemic targets: standards of medical care in diabetes—2020. 2020; 43(1): S66-S76. https://doi.org/10.2337/dc20-S006.

  • Lachin L M. White H N. Hainsworth D, Sun W. Cleary A P. Nathan N D. Effect of intensive diabetes therapy on the progression of diabetic retinopathy in patients with type 1 diabetes: 18 years of follow-up in the DCCT/EDIC. 2015; 64(2): 631-642. 10.2337/db14-0930.

  • Moreira Jr. Silva Neves C R. Nunes Z O. Chagas de Almeida C M. Valverde Mendes B A. Saraiva Fittipaldi J A. Ablan F. Venezuelan Diabetes Investigators' Group. Glycemic control and its correlates in patients with diabetes in Venezuela: results from a nationwide survey. 2010. 87(3): 407-414. doi: 10.1016/j.diabres.2009.12.014. Epub 2010 Jan 8.

  • Kakade A A. Assessment of Factors Associated with Poor Glycemic Control among Patients with Type II Diabetes Mellitus. Integrative Obesity and Diabetes. 2018; 4(3): 1-6. doi: 10.15761/IOD.1000209 Volume 4.

  • Pablo CR. Masoud M., Donald W. Sabiha K. 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. 2018; 3(1). DOI: 10.4172/2475-3211.1000120.

  • El-Kebbi, I.M. Cook B C. Ziemer C D. Miller D C. Gallina L D. Phillips S L. Association of younger age with poor glycemic control and obesity in urban African Americans with type 2 diabetes. 2003; 163(1): 69-75. doi:10.1001/archinte.163.1.69.

  • Ahmad N S. Islahudin F. Paraidathathu T. Factors associated with good glycemic control among patients with type 2 diabetes mellitus. 2014; 5(5): 563-569. doi: 10.1111/jdi.12175.

  • Haghighatpanah M. et al. Factors that correlate with poor glycemic control in type 2 diabetes mellitus patients with complications. 2018; 9(4): 167. doi: 10.24171/j.phrp.2018.9.4.05.

  • Kamuhabwa A R. E J D. Charles. healthcare p safety. Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam. 2014; 6: 155. DOI https://doi.org/10.2147/DHPS.S68786.

  • Mamo Y. Bekele F. Nigussie T. Zewudie A. Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus in Jimma University Medical Center, Jimma zone, south west Ethiopia: a case control study. 2019. 19(1): 1-11. 10.1186/s12902-019-0421-0 .

  • Eliasson B. Cigarette smoking and diabetes. 2003; 45(5): 405-413. DOI: 10.1053/pcad.2003.00103.

  • Rönnemaa T. Rönnemaa M E. Puukka P. Pyörälä K. Laaksoet M. Smoking is independently associated with high plasma insulin levels in nondiabetic men. 1996; 19(11): 1229-1232. DOI: 10.2337/diacare.19.11.1229.

  • Targher, G. Alberiche M. Zenere B M. Bonadonna C R. Muggeo M. Bonoraal E. Cigarette smoking and insulin resistance in patients with noninsulin-dependent diabetes mellitus. 1997; 82(11): 3619-3624. DOI: 10.1210/jcem.82.11.4351.

  • Bergman B C. Perreault L. Hunerdosse D. Kerege A. Playdon M. Samek M A. Eckel H A. Novel and reversible mechanisms of smoking-induced insulin resistance in humans. 2012; 61(12): 3156-3166. doi: 10.2337/db12-0418.

  • Al-qahtani M A A. Kan A N. Alakhali K M. Alavudeen S. S. Impact of Family History in Glycemic Control Among Type 2 Diabetes Mellitus Patients in Aseer Diabetic Center. 2015; 6(3): 191-194.

  • Gong L. Kao H W. Frederick L. Brancati. Batts-Turner M. Gary L T. Association between parental history of type 2 diabetes and glycemic control in urban African Americans. 2008; 31(9): 1773-1776. https://doi.org/10.2337/dc08-0618.

  • Sanal T. N. Nair. Adhikari P. Factors associated with poor control of type 2 diabetes mellitus: a systematic review and meta-analysis. 2011; 3(1): 1-10.

  • Vanmathi S M. M. Monitha Star. Jishala M I. Shanmuga Sundaram R. A Pathophysiological Approach of Macrovascular Complication in Diabetes Mellitus with Hypertension: A Systematic Review. Research Journal of Pharmacy and Technology, 2019. 12(2): p. 901., 2019; 12: 901. DOI: 10.5958/0974-360X.2019.00154.9.

  • Goudswaard A N. Stolk P R. Zuithoff P. Rutten M G. Patient characteristics do not predict poor glycaemic control in type 2 diabetes patients treated in primary care. 2004; 19(6): 541-545. doi: 10.1023/b:ejep.0000032351.42772.e7.

  • Khan A H. Sobki H S. Khan A S. Association between glycaemic control and serum lipid profile in type 2 diabetic patients: Glycated haemoglobin as a dual biomarker. 2011; 7(1):24-9. DOI: 10.1007/s10238-007-0121-3.

  • Goldberg I J. Diabetic dyslipidemia: causes and consequences. 2001. 86(3): 965-971. DOI: 10.1210/jcem.86.3.7304.

  • Feuerstein B L. Weinstock J N. Diet and exercise in type 2 diabetes mellitus. 1997. 13(2): 95-99. doi: 10.1016/s0899-9007(96)00398-x.

  • Abinaya S K. Vijey A M. An Improvement in Patient Compliance in Diabetes Mellitus. Research Journal of Pharmacy and Technology, 2018; 11(2): 587. 10.5958/0974-360X.2018.00108.7.

  • Kassahun T. Eshetie T. Gesesew H. Factors associated with glycemic control among adult patients with type 2 diabetes mellitus: a cross-sectional survey in Ethiopia. 2016; 9(1): 1-6. 10.1186/s13104-016-1896-7.

  • SM Bhanushali.IS Anand. CN Patel. JB Dave. Novel Approaches for Diabetes Mellitus: . Research J. Pharmacology and Pharmacodynamics. 2010; 2: 141-147.

  • Chiu. C.J. Wray A L. Peer reviewed: factors predicting glycemic control in middle-aged and older adults with type 2 diabetes. 2010; 7(1).

  • Preethikaa S. Brundha M P. Awareness of diabetes mellitus among general population. Research Journal of Pharmacy and Technology. 2018; 11: 1825. 10.5958/0974-360X.2018.00339.6.


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  • Factors Associated with Glycemic Control among Syrian Patients With Type 2 Diabetes Mellitus

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Authors

Khadija Khalil
Master Student in Pharmacology Department, Faculty of Pharmacy, Tishreen University, Latakia,, Syrian Arab Republic
Afraa Zrieki
Doctor in Pharmaceutics and Pharmaceutical Technology Department, Faculty of Pharmacy, Tishreen University, Latakia,, Syrian Arab Republic

Abstract


Glycemic control is the main therapeutic objective in diabetes management. The aim of this study was to determine factors associated with poor glycemic control among Syrian patients with Type 2 diabetes mellitus (T2DM) in Latakia city. A random sample of 214 patients was selected from T2DM patients seen in the national center for diabetes in latakia over a period of 10 months in 2018/2019. Each patient was interviewed according to a validated questionnaire. Glycosylated hemoglobin (HbA1c) was measured for all patients using fast ion-exchange resin separation method. The SPSS 26.0 program was used for the statistical analysis. Probability (P) value less than 0.05 was considered statistically significant. Uncontrolled HbA1c (>7%) was seen in 70.6% of T2DM patients. There was no relationship of glycemic control, neither as HbA1c value, nor as percentage of patients with uncontrolled HbA1c, with age, gender, family history, education, duration of diabetes, diet or physical activity. Smokers and divorced patients, were more likely to have poor glycemic control. Elevated total cholesterol was significantly correlated with poorer glycemic control. Moreover, high levels of HbA1c were associated with the presence of diabetes complications and insulin therapy. Our findings suggests that poor glycemic control is common in T2DM Syrian patients in Latakia. Diabetic patients should routinely perform HbA1c and lipid profile analysis. There is a great need to educate patients about strategies to help them manage their diabetes and live a healthier life.

Keywords


Type 2 Diabetes Mellitus, Glycosylated Hemoglobin (HbA1c), Glycemic control, Diabetes risk factors.

References