Uncontrolled glycemia and the associated factors in Iranian type 2 diabetic patients, North of Iran: Role of self-care and self-efficacy

Abstract

Background: Hyperglycemia caused by diabetes is closely related to long-term damage in organ functional disorders. The objective of the study was to determine the prevalence of uncontrolled glycemia and its associated factors in Iranian diabetic patients.

Methods: This cross-sectional study was conducted on 496 types 2 diabetic patients in the outpatient clinic of a referral hospital center affiliated with Babol University of Medical Sciences, North of Iran. The data of fasting blood sugar (FBS) and hemoglobin A1C were extracted from recent laboratory tests. The demographic, clinical data, and comorbidity were collected. The reliable and valid scales of self-care and self-efficacy were used to collect data through face-to-face interviews with patients.

Results: About half of the participants, 241(48.6%) patients had poor glycemic control (FBS≥152 mg/dl) and a higher proportion, 382 (79.6%) patients were found based on the criterion of HbA1C≥7%. There was no significant difference in poor glycemic control between genders. The adjusted OR for risk of poor glycemic control (FBS>152mg/dl) after controlling potential confounders was 2.37 (95%CI: 1.34, 4.12) for the duration of diabetes >15 years compared to 5 years or less. The higher level of self-efficacy prevented poor glycemic control (adjusted OR=0.50, 95%CI: 0.29, 0.87). While the high level of self-care tended to protect against poor glycemic control non-significantly (adjusted OR=0.65, 95%CI: 0.41, 1.11).

Conclusion: Our findings show that majority of diabetic patients have poor glycemic control. The high level of self-care and self-efficacy substantially reduced the risk of poor glycemic control.

Keywords: Fasting blood sugar; Hemoglobin A1C; Self-care; Self-efficacy; Uncontrolled diabetes.