Li Liu1,2,3, Daizhi Yang1,2,3, Yan Zhang1,2,3, Shuo Lin1,2,3, Xueying Zheng1,2,3, Shaoda Lin4, Lishu Chen5, Xiuwei Zhang6, Lu Li7, Ganxiong Liang8, Bin Yao1,2,3, Jinhua Yan1,2,3, Jianping Weng1,2,3. 1. Department of Endocrinology and Metabolic Disease, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 2. Guangdong Diabetes Center, Sun Yat-sen University, Guangzhou, China. 3. Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China. 4. Department of Endocrinology, the First Affiliated Hospital of Shantou University, Shantou, China. 5. Department of Endocrinology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, China. 6. Department of Endocrinology, Dongguan People's Hospital, Dongguan, China. 7. Department of Endocrinology, Shenzhen People's Hospital, Shenzhen, China. 8. Department of Endocrinology, Zhongshan People's Hospital, Zhongshan, China.
Abstract
BACKGROUND: Glycaemic control is a great challenge in the management of type 1 diabetes mellitus (T1DM). There is limited data concerning glycaemic control among adults with T1DM. We used data from the Guangdong T1DM Translational Medicine Study to evaluate glycaemic control and its associated factors in Chinese adults with T1DM. METHODS: This cross-sectional analysis included 827 participants who were 18 years of age or older and had been living with T1DM for at least 1 year. Participants with HbA1c levels <7% were compared against those with HbA1c levels ≥ 7%. A multivariate logistic regression model was used to examine factors associated with glycaemic control. RESULTS: Among the 827 participants, the mean age was 34.2 ± 12.1 years and the median (interquartile range) duration of diabetes was 6.1 (3.4, 10.4) years. The median HbA1c level was 8.5% (7.5%, 10.2%). Only one-fifth of participants had HbA1c levels <7%. Insufficient glycaemic control (HbA1c ≥ 7%) was strongly associated with infrequent self-monitoring of blood glucose (OR = 1.21, 95% CI 1.14 ~ 1.29, p = 0.000), high insulin dose (OR = 1.27, 95% CI 1.07 ~ 1.52, p = 0.006), smoking (OR = 3.11, 95% CI 1.44 ~ 6.72, p = 0.004), low-frequency clinical visits (OR = 2.74, 95% CI 1.47 ~ 5.10, p = 0.001), the presence of diabetic autoantibodies (OR = 1.63, 95% CI 1.07 ~ 2.48, p = 0.022) and low fasting C-peptide (FCP) levels (OR = 1.21, 95% CI 1.01 ~ 1.46, p = 0.049) after adjustment for age at disease onset, education level, household income and diet control. CONCLUSIONS: Most adult patients with T1DM did not achieve the HbA1c target. Identifying determinants for glycaemic control provides us valuable information to improve glycaemic control in these patients.
BACKGROUND: Glycaemic control is a great challenge in the management of type 1 diabetes mellitus (T1DM). There is limited data concerning glycaemic control among adults with T1DM. We used data from the Guangdong T1DM Translational Medicine Study to evaluate glycaemic control and its associated factors in Chinese adults with T1DM. METHODS: This cross-sectional analysis included 827 participants who were 18 years of age or older and had been living with T1DM for at least 1 year. Participants with HbA1c levels <7% were compared against those with HbA1c levels ≥ 7%. A multivariate logistic regression model was used to examine factors associated with glycaemic control. RESULTS: Among the 827 participants, the mean age was 34.2 ± 12.1 years and the median (interquartile range) duration of diabetes was 6.1 (3.4, 10.4) years. The median HbA1c level was 8.5% (7.5%, 10.2%). Only one-fifth of participants had HbA1c levels <7%. Insufficient glycaemic control (HbA1c ≥ 7%) was strongly associated with infrequent self-monitoring of blood glucose (OR = 1.21, 95% CI 1.14 ~ 1.29, p = 0.000), high insulin dose (OR = 1.27, 95% CI 1.07 ~ 1.52, p = 0.006), smoking (OR = 3.11, 95% CI 1.44 ~ 6.72, p = 0.004), low-frequency clinical visits (OR = 2.74, 95% CI 1.47 ~ 5.10, p = 0.001), the presence of diabetic autoantibodies (OR = 1.63, 95% CI 1.07 ~ 2.48, p = 0.022) and low fasting C-peptide (FCP) levels (OR = 1.21, 95% CI 1.01 ~ 1.46, p = 0.049) after adjustment for age at disease onset, education level, household income and diet control. CONCLUSIONS: Most adult patients with T1DM did not achieve the HbA1c target. Identifying determinants for glycaemic control provides us valuable information to improve glycaemic control in these patients.
Authors: Ahmed O Almobarak; Sufian K Noor; Wadie M Elmadhoun; Sarra O Bushara; Reham S Salim; Sittana A Forawi; Heitham Awadalla; Einas S Elwali; Mohamed H Ahmed Journal: J Family Med Prim Care Date: 2017 Apr-Jun
Authors: Lili Huo; Wei Deng; Jonathan E Shaw; Dianna J Magliano; Puhong Zhang; Helen C McGuire; Katarzyna Kissimova-Skarbek; David Whiting; Linong Ji Journal: J Diabetes Investig Date: 2020-05-30 Impact factor: 4.232