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Determinants of Glycemic Control: Phase 2 Analysis From Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (Nppcd-2018) Publisher Pubmed



Esteghamati A1 ; Ismailbeigi F2 ; Khaloo P1 ; Moosaie F1 ; Alemi H1 ; Mansournia MA3 ; Afarideh M1 ; Janbabaei Molla G4 ; Ghadimi T5 ; Shadnoush M6 ; Kermanchi J7 ; Ghaemi F8
Authors
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Authors Affiliations
  1. 1. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Medicine, Biochemistry, Physiology and Biophysics, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, OH, United States
  3. 3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Deputy of Curative Affaires of Ministry of Health & Medical Education, Tehran, Iran
  5. 5. Department of Surgery, Iran Medical University, Tehran, Iran
  6. 6. Department of Clinical Nutrition, Shahid Beheshti University of Medical Science, Tehran, Iran
  7. 7. Disease Management Advisor-Curative Affair Deputy-Ministry of Health and Medical Education, Tehran, Iran
  8. 8. Department of Transplantation and Disease, Ministry of Health & Medical Education, Tehran, Iran

Source: Primary Care Diabetes Published:2020


Abstract

Background: Diabetes is one of the leading causes of morbidity and mortality worldwide, especially among middle and low income nations. Many diabetic complications and comorbidities are attributable to poor glycemic control. The aim of this study was to update and extend the national diabetes reports on the status of comorbidities, diabetes care and complications in Iran. Moreover, we investigated the risk factors of poor glycemic control in the Iranian population. Methods: National database of 99,651 patients with diabetes who attended university-affiliated clinics between April 1, 2017 and February 30, 2018 was used to carry out a cross-sectional study. Stepwise backward selection logistic regression model was used to examine the associated factors of glycemic control. Results: In this study 73.0% and 56.5% of the enrolled population with diabetes, had hypertension and hyperlipidemia, respectively. The prevalence of patients who received education for nutrition therapy or diabetes self-management was 16.3% and 23.3% respectively. Poor glycemic control was associated with male gender (OR = 1.06, p = 0.001), obesity (OR = 1.03, p = 0.05), duration of diabetes (OR = 1.018, p < 0.001), smoking (OR = 1.08, p = 0.041), hypertension (OR = 1.53, p < 0.001), hyperlipidemia (OR = 1.15, p < 0.001), insulin therapy (OR = 1.26, p < 0.001) and combination of insulin and oral anti-diabetic agents compared to oral anti-diabetic agents alone (OR = 2.36, p < 0.001). Conclusion: We demonstrated that the prevalence of diabetes comorbidities is high in Iranian population and that a great proportion of Iranian patients with diabetes had not reached the goal of glycemic control. Our findings provide a starting point from which to investigate the obstacles that prevent patients with diabetes from reaching metabolic targets. © 2019 Primary Care Diabetes Europe
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