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Factors associated with poor glycemic control or wide glycemic variability among diabetes patients in Hawaii,

Deborah Taira Juarez1, Tetine Sentell, Sheri Tokumaru

  • 1College of Pharmacy, University of Hawaii, 677 Ala Moana Blvd, Ste 1025, Honolulu, HI 96813, USA. dtjuarez@hawaii.edu

Preventing Chronic Disease
|September 29, 2012
PubMed

Insights

Diabetes duration, younger age, and more medications are linked to sustained poor glycemic control. High morbidity and certain insurance plans may improve control. Wide glycemic variability affects younger patients and those with heart disease.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Public Health

Background:

  • Glycemic control is crucial for preventing diabetes complications but remains challenging for many patients.
  • Identifying factors associated with poor glycemic control and variability is essential for effective diabetes management.

Purpose of the Study:

  • To investigate predictors of sustained poor glycemic control, some glycemic variability, and wide glycemic variability over three years in diabetes patients.
  • To inform targeted interventions for improving diabetes outcomes.

Main Methods:

  • Retrospective analysis of 2,970 diabetes patients with elevated hemoglobin A1c (>9%) in Hawaii.
  • Multivariable logistic regression used to identify factors associated with glycemic control and variability.
  • Evaluated variables included age, sex, insurance, morbidity, diabetes duration, cardiovascular disease history, and medication count.

Main Results:

  • Sustained poor glycemic control linked to longer diabetes duration, age under 35, and ≥15 medications.
  • Wider glycemic variability associated with age <50, longer diabetes duration, coronary artery disease, and 5-9 medications.
  • Lower likelihood of sustained poor control observed in PPO/Medicare enrollees and those with high morbidity.

Conclusions:

  • Diabetes duration, age, medication count, morbidity, and insurance type are key risk factors for sustained poor glycemic control.
  • Patients with specific risk factors require enhanced therapies and interventions.
  • Younger patients (<50) and those with coronary artery disease history need awareness regarding risks of wide glycemic variability.
Abstract

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