Abstract
Strict glycaemic control early in the treatment process has been shown to reduce the occurrence of micro- and macro- vascular complications of diabetes in the long-term. Thus, treatment guidelines advise early intensification of treatment to achieve glycaemic control goals. However, evidence in Bangladesh suggests that, despite guideline recommendations, glycaemic control among patients with T2DM remains challenging. The objective of this study was to determinants of glycaemic control among individuals with type 2 diabetes mellitus patients in Bangladesh. A cross-sectional study was conducted during March to September 2017 at Endocrinology OPD in Lab Aid Specialized Hospital, Dhaka, Bangladesh. A total number of 213 patients with type 2 diabetes mellitus patients were enrolled. Information was gathered from patients by means of eye to eye meet, and their clinical records were explored. Numerous calculated relapse examinations were performed. Among the patients, 46.48% were male. Mean age was 49.20and standard deviation (±13.04). Mean of HbA1c was 8.71% and standard deviation was (±3.97). Low training level, rustic living arrangement, undesirable dietary patterns, insulin use rate follow up registration related with insufficient and exceptionally poor controls. Being female and smokeless tobacco buyer gave off an impression of being related with deficient control anyway psychological debilitation was related with poor control as it were. Commonness of insufficient glycaemic level was exceptionally high in Bangladesh. Having comprehended relatable way of life change variables, socioeconomics and co-morbidities among individuals with type 2 diabetes, human services suppliers related to patients should cooperate to address the glycaemic control.
Keywords: Glycaemic control, Endocrine OPD, Co-morbidities.
References
- Afroz A, Ali L, Karim MN, et al. Glycaemic Control for People with Type 2 Diabetes Mellitus in Bangladesh - An urgent need for optimization of management plan. Sci Rep. 2019;9(1): 10248. Published 2019 Jul 15. doi:10.1038/s41598-019-46766-9
- Akter, S., Rahman, M. M., Abe, S. K. & Sultana, P. Prevalence of diabetes and prediabetes and their risk factors among Bangladeshi adults: a nationwide survey. Bulletin of the World Health Organization92, 204–213A (2014).
- Control, D. & Group, C. T. R. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl j Med1993, 977–986 (1993).
- Group, U. P. D. S. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). The Lancet352, 837–853 (1998).
- Group, U. P. D. S. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). The Lancet352, 854–865 (1998).
- Stettler, C. et al. Glycemic control and macrovascular disease in types 1 and 2 diabetes mellitus: meta-analysis of randomized trials. American heart journal152, 27–38 (2006).
- Sanal, T., Nair, N. & Adhikari, P. Factors associated with poor control of type 2 diabetes mellitus: a systematic review and meta-analysis. Journal of diabetology3, 1–10 (2011).
- Selim, S., Pathan, F., Saifuddin, M., Latif, Z. &Karim, N. The challenge of proper glycaemic control among patients with type 2 diabetes in Bangladesh. Sri Lanka Journal of Diabetes Endocrinology and Metabolism6 (2016).
- Harris, P. A. et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of biomedical informatics 42, 377–381 (2009).
- American Diabetes Association. Diabetes Care 38(Suppl. 1), S33–S34, https://doi.org/10.2337/dc15-S009 (2015).
- Latif, Z., Jain, A. &Rahman, M. Evaluation of management, control, complications and psychosocial aspects of diabetics in Bangladesh: DiabCare Bangladesh 2008. Bangladesh Medical Research Council Bulletin37, 11–16 (2011).
- Sanal, T., Nair, N. &Adhikari, P. Factors associated with poor control of type 2 diabetes mellitus: a systematic review and meta-analysis. Journal of diabetology3, 1–10 (2011).
- Mendes, A. B. V., Fittipaldi, J. A. S., Neves, R. C. S., Chacra, A. R. & Moreira, E. D. Prevalence and correlates of inadequate glycaemic control: results from a nationwide survey in 6,671 adults with diabetes in Brazil. Actadiabetologica47, 137–145 (2010).
- Gupta, P. C. & Ray, C. S. Smokeless tobacco and health in India and South Asia. Respirology 8, 419–431 (2003).
Corresponding Author
Dr Indrajit Prasad
Associate Professor, Department of Endocrinology, Dhaka Medical College, Dhaka