CORRELATES OF INADEQUATE GLYCEMIC CONTROL AMONG OUTPATIENTS WITH TYPE 2 DIABETES IN BRAZIL
METHODS: Cross-sectional study in a consecutive sample of outpatients aged 18 years or older with DM2, in ten large cities in Brazil. Information about diabetes, current medications, related co-morbidities, complications, and dietary habits were obtained by trained interviewers, using a standardized questionnaire. A blood peripheral sample was collected for the measurement of HbA1C by high-performance liquid chromatography in a central laboratory. Patients with HbA1C>7 were considered to have inadequate glycemic control. Correlates of glycemic control were evaluated with multiple linear regression analyses using HbA1c as a dependent variable. Variables were included in forward stepwise analyses if there was a significant association in univariate analysis (p<0.05), or if they were likely to be a confounder.
RESULTS: Overall 5,692 patients with DM2 were surveyed (mean age, 61 yr; female 66.5%). The prevalence of inadequate glycemic control was 73%. Poor glycemic control was associated with younger age, black or mixed race, living in the South/Northeast region, and longer diabetes duration. Whereas higher educational achievement, health care delivered by a multi professional team, participation in a diabetes health education program, and adherence to diabetes treatment were associated with improved glycemic control.
CONCLUSIONS: The majority of patients with DM2 in Brazil had inadequate glycemic control and is at risk for the development of chronic complications. This may contribute to increased rates of diabetic complications and impact health care costs. Our data provide important information for the development of public health programs to improve glycemic control in this population.