Predictors of poor glycaemic control in older patients with type 2 diabetes mellitus

• Main Authors: Shariff Ghazali, Sazlina, Ismail, Mastura, Cheong, Ai Theng, Bujang, Mohamad Adam, Haniff, Jamaiyah, Lee, Ping Yein, Syed Abdul Rahman, Syed Alwi, Chew, Boon How
• Format: Article
• Language: English
• Published: Singapore Medical Association 2015
• Online Access: http://psasir.upm.edu.my/id/eprint/45941/1/Predictors%20of%20poor%20glycaemic%20control%20in%20older%20patients%20with%20type%202%20diabetes%20mellitus.pdf; http://psasir.upm.edu.my/id/eprint/45941/; http://www.smj.org.sg/article/predictors-poor-glycaemic-control-older-patients-type-2-diabetes-mellitus
• Institution: Universiti Putra Malaysia

Introduction:We assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia. Methods:This cross-sectional study used the data of 21,336 patients aged ≥ 60 years with T2DM from the Adult Diabetes Control and Management Registry 2008-2009. Results:Predictors of poor glycaemic control were: age groups 60-69 years (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.66-2.33) and 70-79 years (OR 1.43, 95% CI 1.20-1.71); Malay (OR 1.53, 95% CI 1.41-1.66) and Indian (OR 1.32, 95% CI 1.19-1.46) ethnicities; T2DM durations of 5-10 years (OR 1.46, 95% CI 1.35-1.58) and > 10 years (OR 1.75, 95% CI 1.59-1.91); the use of oral antidiabetic agents only (OR 5.86, 95% CI 3.32-10.34), insulin only (OR 17.93, 95% CI 9.91-32.43), and oral antidiabetic agents and insulin (OR 29.42, 95% CI 16.47-52.53); and elevated blood pressure (OR 1.10, 95% CI 1.01-1.20), low-density lipoprotein cholesterol (OR 1.48, 95% CI 1.38-1.59) and triglycerides (OR 1.61, 95% CI 1.51-1.73). Hypertension (OR 0.71, 95% CI 0.64-0.80), hypertension and dyslipidaemia (OR 0.68, 95% CI 0.61-0.75), pre-obesity (OR 0.89, 95% CI 0.82-0.98) and obesity (OR 0.76, 95% CI 0.70-0.84) were less likely to be associated with poor glycaemic control. Conclusion:Young-old and middle-old age groups (i.e. < 80 years), Malay and Indian ethnicities, longer T2DM duration, the use of pharmacological agents, and elevated blood pressure and lipid levels were associated with poor glycaemic control. The presence of comorbidities, pre-obesity and obesity were less likely to be associated with poor glycaemic control.