Korean Journal of Health Education and Promotion (보건교육건강증진학회지)

Korean Society for Health Education and Promotion (한국보건교육건강증진학회)
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Factors Related to Blood Glucose Control in Patients with Diabetes

당뇨병 유병자의 혈당 조절 관련 요인

  • Received : 2012.06.28
  • Accepted : 2012.09.17
  • Published : 2012.09.30
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Abstract

Objectives: This study was conducted to determine factors related to glycemic control among Korean patients with diabetes. Methods: Data was collected from the Fourth (2007-2009) Korea National Health and Nutrition Examination Survey (KNHANES) which was a nationwide, cross-sectional survey. The study participants who are available for hemoglobin A1c (HbA1c) were 1,441 patients with diabetes aged 30 years and older. Poor glycemic control was defined as $HbA1c{\geq}7.0%$. Data were analysed using logistic regression. Results: The proportion of patients with the poor glycemic control ($HbA1c{\geq}7.0%$) was 49.5%. After adjusting for confounding factors, younger aged persons (30-49 years) were less likely to control the blood glucose than older aged persons (60-69 years) (Adjusted OR=0.533, 95% CI [0.295-0.960]) and longer duration of diabetes was positively related to poor glycemic control (Adjusted OR=2.018, 95% CI [1.418-2.873]). Conclusions: Age and duration of diabetes were significantly related to blood glucose control. Therefore, considering these factors is helpful for developing a strategy to improve blood glucose control in diabetes.

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References

  1. American Diabetes Association. (2010). Standards of medical care in diabetes - 2010. Diabetes Care, 33(1), S11-S69. https://doi.org/10.2337/dc09-1554
  2. Benoit, S. R., Fleming, R., Tsimikas, A. P., & Ming, J. I. (2005). Predictors of glycemic control among patients with type 2 diabetes: A longitudinal study. BMC Public Health, 5, 36-45. https://doi.org/10.1186/1471-2458-5-36
  3. Centers for Disease Control and Prevention. (2011). National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
  4. Cowie, C. C., Rust, K. F., Byrd-Holt, D. D., Eberhardt, M. S., Flegal, K. M., Engelgau, M. M., . . . Gregg E. W. (2006). Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999-2002. Diabetes Care, 29(6), 1263-1268. https://doi.org/10.2337/dc06-0062
  5. Diabetes Control and Complications Trial Research Group. (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine, 329, 977-986. https://doi.org/10.1056/NEJM199309303291401
  6. El-Kebbi, I. M., Cook, C. B., Ziemer, D. C., Millier, C. D., Gallina, D. L., & Phillips, L. S. (2003). Association of younger age with poor glycemic control and obesity in urban African Americans with type 2 diabetes. Archives of International Medicine, 163, 69-75. https://doi.org/10.1001/archinte.163.1.69
  7. Gress, T. W., Nieto, F. J., Shahar, E., Wofford, M. R., & Brancati, F. L. (2000). Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. New England Journal of Medicine, 342(13), 905-912. https://doi.org/10.1056/NEJM200003303421301
  8. Hong, M. H., Yoo, J. W., Gu, M. O., Kim, S. A., Lee, J. R., Gu, M. J., . . . Eum, J. H. (2009). A study on effects and their continuity of the self regulation education program in patients with type 2 diabetes. Korean Clinical Diabetes Journal, 10, 187-195.
  9. Karter, A. J., Moffet, H. H., Liu, J., Parker M. M., Ahmed A. T., Ferrara A., & Selby J. V. (2005). Achieving good glycemic control: Initiation of new antihyperglycemic therapies in patients with Type 2 diabetes from the Kaiser Permanente Northern California diabetes registry. American Journal of Managed Care, 11(4), 262-270.
  10. Khattab, M., Khader, Y. S., Al-Khawaldeh, A. A., & Ajlouni, K. (2010). Factors associated with poor glycemic control among patients with type 2 diabetes. Journal of Diabetes and Its Complications, 24, 84-89. https://doi.org/10.1016/j.jdiacomp.2008.12.008
  11. Kim, H. S., Yoon, K. H., Yoo, Y. S., Oh, J. A., Song, M. S., Shin, M. O., . . . Song, B. R. (2000). Effects of critical pathway for patients with type 2 diabetes mellitus on glycemic control, the knowledge on the disease, and the length of hospital stay. Diabetes & Metabolism Journal, 3(1), 76-86.
  12. Korea Centers for Disease Control and Prevention. (2011). Korea health statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1). Chungcheongbuk-do, Korea: Author.
  13. Korean Diabetes Association. (2011). Treatment guideline for diabetes 2011. The Journal of Korean Diabetes Association, 12(1), 4-49.
  14. Ministry of Health and Welfare. (2011). Ministry of Health and Welfare Year Book 2011. Retrieved from http://stat.mw.go.kr/stat
  15. National Health Insurance Corporation. (2010). Health insurance statistical yearbook 2010. Retrieved from http://www.nhic.or.kr/portal/site/main/menuitem
  16. Nichols, G. A., Hillier, T. A., Javor, K., & Brown, J. B. (2000). Predictors of glycemic control in insulin using adult with type 2 diabetes. Diabetes Care, 23(3), 273-277. https://doi.org/10.2337/diacare.23.3.273
  17. Oh, H. G., Rhee, E. J., Kim, T. W., Lee, K. B., Park, J. H., Yang, K. I., . . . Park, H. K. (2011). Higher glycated hemoglobin level is associated with increased risk for ischemic stroke in non-diabetic Korean male adults. Diabetes & Metabolism Journal, 35, 551-557. https://doi.org/10.4093/dmj.2011.35.5.551
  18. Park, S. W., Kim, D. J. Min, K. W., Baik, S. H., Choi, K. M., Park, I. B., . . . Kim, H. Y. (2007). Current Status of Diabetes Management in Korea Using National Health Insurance Database. Diabetes & Metabolism Journal, 31(4), 362-367.
  19. Rohlfing, C. L., Wiedmeyer, H. M., Little, R. R., England, J. D., Tennill, A., & Goldstein, D. E. (2002). Defining the relationship between plasma glucose and HbA[1c]: analysis of glucose profiles and HbA[1c] in the Diabetes Control and Complications Trial. Diabetes Care, 25, 275-278. https://doi.org/10.2337/diacare.25.2.275
  20. Rothenbacher, D., Ruter, G., Saam, S., & Brenner, H. (2003). Younger patients with type 2 diabetes need better glycemic control: Results of a community-based study describing factors associated with a high HbA1c value. British Journal of General Practice, 53, 389-391.
  21. Sargeant, L. A., Khaw, K. T., Bingham, S., Day, N. E., Luben, R. N., Oakes, S., . . .Wareham, N. J. (2001). Cigarette smoking and glycaemia: the EPIC-Norfolk Study. European Prospective Investigation into Cancer. International Journal of Epidemiology, 30, 547-554. https://doi.org/10.1093/ije/30.3.547
  22. Targher, G., Alberiche, M., Zenere, M. B., Bonadonna, R. C., Muggeo, M, & Bonora, E. (1997). Cigarette smoking and insulin resistance in patients with non insulin-dependent diabetes mellitus. The Journal of Clinical Endocrinology & Metabolism, 82, 3619-3624. https://doi.org/10.1210/jc.82.11.3619
  23. UK Prospective Diabetes Study [UKPDS] Group. (1995). Overview of 6 years' therapy of type 2 diabetes: a progressive disease. Diabetes 44, 1249-1258. https://doi.org/10.2337/diabetes.44.11.1249
  24. UK Prospective Diabetes Study [UKPDS] Group. (1998). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes [UKPDS 33]. Lancet, 352, 837-853. https://doi.org/10.1016/S0140-6736(98)07019-6
  25. Valle, T., Koivisto, A., Reunanen, A., Kangas, T., & Rissanen, A. (1999). Glycemic control in patients with diabetes in Finland. Diabetes Care, 22(4), 575-579. https://doi.org/10.2337/diacare.22.4.575
  26. Verma, M., Paneri, S., Badi, P., & Raman, G. (2006). Effects of increasing duration of diabetes mellitus Type 2 on glycated hemoglobin and insulin sensitivity. Indian Journal of Clinical Biochemistry, 21(1), 142-146. https://doi.org/10.1007/BF02913083