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BMC Public Health
Published in: BMC Public Health 1/2005

Open Access 01-12-2005 | Research article

Predictors of glycemic control among patients with Type 2 diabetes: A longitudinal study

Authors: Stephen R Benoit, Regina Fleming, Athena Philis-Tsimikas, Ming Ji

Published in: BMC Public Health | Issue 1/2005

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Abstract

Background

Diabetes is the sixth leading cause of death and results in significant morbidity. The purpose of this study is to determine what demographic, health status, treatment, access/quality of care, and behavioral factors are associated with poor glycemic control in a Type 2 diabetic, low-income, minority, San Diego population.

Methods

Longitudinal observational data was collected on patients with Type 2 diabetes from Project Dulce, a program in San Diego County designed to care for an underserved diabetic population. The study sample included 573 patients with a racial/ethnic mix of 53% Hispanic, 7% black, 18% Asian, 20% white, and 2% other. We utilized mixed effects models to determine the factors associated with poor glycemic control using hemoglobin A1C (A1C) as the outcome of interest. A multi-step model building process was used resulting in a final parsimonious model with main effects and interaction terms.

Results

Patients had a mean age of 55 years, 69% were female, the mean duration of diabetes was 7.1 years, 31% were treated with insulin, and 57% were obese. American Diabetes Association (ADA) recommendations for blood pressure and total cholesterol were met by 71% and 68%, respectively. Results of the mixed effects model showed that patients who were uninsured, had diabetes for a longer period of time, used insulin or multiple oral agents, or had high cholesterol had higher A1C values over time indicating poorer glycemic control. The younger subjects also had poorer control.

Conclusion

This study provides factors that predict glycemic control in a specific low-income, multiethnic, Type 2 diabetic population. With this information, subgroups with high risk of disease morbidity were identified. Barriers that prevent these patients from meeting their goals must be explored to improve health outcomes.
Appendix
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Metadata
Title
Predictors of glycemic control among patients with Type 2 diabetes: A longitudinal study
Authors
Stephen R Benoit
Regina Fleming
Athena Philis-Tsimikas
Ming Ji
Publication date
01-12-2005
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2005
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-5-36

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