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Multicenter Study
. 2025 Jul 14;25(1):178.
doi: 10.1186/s12902-025-01994-1.

Behavioral and demographic associations of optimal glycemic control among patients with type 2 diabetes mellitus in Sri Lanka: a multicenter study

Warsha De Zoysa  1 , Thilak Priyantha Weerarathna  2 , Ipitagama Liyana Arachchige Nuwan Darshana  3 , Udari Kaushalya Egodage  4 , Priyamali Jayasekara  5 , Vathulan Sujanitha  6 , Shehan Silva  7 , Chamila Mettananda  8 , Manoji Pathirage  9 , Udayangani Ramadasa  10 , Dhammika Randula Palangasinghe  2 , Keddagoda Gamage Piyumi Wasana  11 , Sahan Mendis  12
Affiliations
Multicenter Study

Behavioral and demographic associations of optimal glycemic control among patients with type 2 diabetes mellitus in Sri Lanka: a multicenter study

Warsha De Zoysa et al. BMC Endocr Disord. .

Abstract

Background: Type 2 diabetes mellitus (T2DM) is an escalating global public health concern. Effective management of T2DM needs a holistic approach, considering not only the medical interventions but also demographic and behavioral factors. This multicenter study aims to investigate the association between optimal glycemic control and demographic and behavioral factors among patients with T2DM followed up in outpatient clinics of tertiary care hospitals across Sri Lanka.

Methods: A cross-sectional study was carried out involving T2DM patients (n = 2013) visiting outpatient clinics at seven tertiary care facilities across five provinces in Sri Lanka. Information related to sociodemographic and behavioral factors was collected using an interviewer-administered questionnaire. HbA1C < 7% was considered as optimal glycemic control. Predictors for glycemic control were identified using multiple logistic regression at a 0.05 significance level.

Results: Out of the total sample, 99.1% were on pharmacological treatment for T2DM while the minority were solely on dietary management. The optimal glycemic control had been achieved by 43.4%. Female gender (aOR = 1.56, 95% CI 1.18-2.05), younger age group (aOR = 1.39, 95% CI 1.06-1.82), non-Sinhalese ethnicities (aOR = 1.34, 95% CI 1.02-1.77), inadequate adherence to antidiabetic medication (aOR = 1.71, 95% CI 1.31-2.24), longer disease duration (aOR = 1.51, 95% CI 1.13-2.02), being treated with insulin (aOR = 2.79, 95% CI 1.77-4.41), and daily alcohol use (aOR = 2.27, 95% CI 1.19-4.32) were identified as risk factors for inadequate glycemic control in multiple logistic regression.

Conclusion: Over 50% of individuals demonstrated suboptimal glycemic control. It is recommended to implement targeted interventions for specific subgroups to address distinct demographic and behavioral factors to achieve optimal glycemic control and clinical outcomes for diabetes patients in Sri Lanka.

Keywords: Behavioral factors; Demographic factors; Glycemic control; Sri Lanka; Type 2 diabetes mellitus.

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Conflict of interest statement

Declarations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Ethics approval: The ethical approval for the research was obtained by the Ethics Review Committee at Teaching Hospital Karapitiya, Sri Lanka (THK/ERC/23/12). Before starting the research, all participants provided their written informed consent. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
Nutritional status according to BMI in T2DM patients (n = 2013)
Fig. 2
Fig. 2
Management options among the T2DM patients (n = 2013). OHAs- oral hypoglycemic agents. aOR- Adjusted Odd Ratio
See this image and copyright information in PMC

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