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

Shariff-ghazali Sazlina; Ismail Mastura; Ai Theng Cheong; Adam Bujang Mohamad; Haniff Jamaiyah; Ping Yein Lee; Syed Abdul Rahman Syed Alwi; Boon How Chew

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

Author: Shariff-Ghazali SAZLINA ^{1
,

2} ; Ismail MASTURA ³ ; Ai Theng CHEONG ⁴ ; Adam Bujang MOHAMAD ⁵ ; Haniff JAMAIYAH ⁶ ; Ping Yein LEE ⁴ ; Syed Abdul Rahman Syed ALWI ⁷ ; Boon How CHEW ⁴
Author Information

1. Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
2. Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
3. Seremban 2 Health Clinic, Seremban, Negeri Sembilan, Malaysia.
4. Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
5. Biostatistics Unit, National Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
6. Clinical Epidemiology Unit, National Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
7. Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kuching, Sarawak, Malaysia.
Publication Type:Journal Article
Keywords: Malaysia; diabetes mellitus; glycaemic control; older patients; registry
MeSH: Aged; Aged, 80 and over; Asian Continental Ancestry Group; Blood Pressure; Cholesterol, LDL; blood; Comorbidity; Cross-Sectional Studies; Diabetes Mellitus, Type 2; blood; complications; ethnology; Female; Glycated Hemoglobin A; metabolism; Humans; Hyperglycemia; blood; Hypertension; complications; Hypoglycemic Agents; therapeutic use; Insulin; blood; Male; Middle Aged; Obesity; complications; Registries; Sex Factors; Singapore; Triglycerides; blood
From:Singapore medical journal 2015;56(5):284-290
CountrySingapore
Language:English
Abstract:
INTRODUCTIONWe assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia.
METHODSThis 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.
RESULTSPredictors 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.
CONCLUSIONYoung-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.