Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes in the Southeast Region of Brazil

Abstract

Background: Brazil is an upper middle-income country with the fourth higher prevalence of diabetes and the fifth in diabetes-related health expenditure. By monitoring the factors related to glycemic control is critical to design and implement policies to reduce the morbidity and mortality of the disease. The aim of this study was to investigate the status of glycemic control and the factors associated with poor glycemic control among diabetics from the Southeast of Brazil. Methods: Data from 656 patients with diabetes attending public and private Endocrinology units were analyzed after reviewing medical records for sociodemographic, clinical and biochemical features in the northwest region of Minas Gerais, Brazil. We also investigated the factors associated with poor glycemic control among patients with type 2 diabetes (T2D). Results: Most patients were female with T2D, median age of 55.1 years and a median time since diabetes diagnosis of less than 5 years. Over 60% of patients had glycosylated hemoglobin (HbA1c) levels over 7%. Factors associated with poor glycemic control among patients with T2D were schooling for less than 4 years, longer time since diabetes diagnosis, treatment with insulin and less frequent follow-up with endocrinologists and dietitians. Conclusion: Our findings confirm data from previous studies indicating that educational level, duration of diabetes, and less frequent follow-up by endocrinologists and dietitians may negatively affect glycemic control. It is therefore possible that health policies focusing patients with these features might favorably affect glycemic control among patients with T2D.