Glycemic outcomes of people with diabetes mellitus in Brazilian primary health care

Abstract

Background: The capillary blood glucose monitoring program at home a challenge in primary health care. Therefore, it is fundamental to identify the glycemic control of people with diabetes mellitus through HBA1c and to analyze its associated factors.

Objective: To identify the glycemic profile of people with Diabetes Mellitus (DM) through HbA1c and analyze factors associated.

Materials & methods: Cross-sectional study developed in Ribeirão Preto, São Paulo, Brazil. Secondary data from the electronic health record of people registered in the Primary Health Care system were used. A sample of 3181 participants was obtained. People with HbA1c < 7.0% (53 mmol/mol) were considered to have adequate glycemic control. For people aged ≥ 55 years, a less stringent target, < 8.0% (64 mmol/mol), was also considered. The odds ratio was the measure of effect analyzed with their respective 95% Confidence Intervals (95% CI).

Results: Adequate glycemic control with HbA1c < 7.0% (53 mmol/mol) was found in 44.8% of people and, when using the less rigid target, HbA1c < 8.0% (64 mmol/mol) for people aged ≥ 55 years-old, 70.6% had adequate glycemic control. Age and drug therapy were associated with adequate glycemic control (p < 0.001), which was more frequent among older people and those who used only metformin.

Conclusion: The study shows that the achievement of adequate glycemic control is still a challenge, especially with regard to younger people and those who use insulin.

Keywords: Diabetes mellitus; Glycated hemoglobin A; Glycemic control; Primary health care.

Fig. 1

Graphical representation of data collection and analysis, Ribeirão Preto, SP, Brazil