INTRODUCTION: Glycemic control in the Philippines has increased from 15% in 2008 to 47.4% in 2020. This study aims to identify the determinants of glycemic control in the Philippines. METHODOLOGY: This study included patients with type 2 diabetes mellitus. Current glycated hemoglobin (HbA1c) levels, medication compliance and adherence, and the clinico-socio-demographic profile of diabetics in the Philippines were recorded. RESULTS: There was no significant association between glycemic control and clinico-socio-demographic characteristics or medication compliance. However, the absence of complications showed a statistically significant positive association (odds ratio [OR], 1.65; p=0.02). While intensification of management provided a statistically significant reduction in HbA1c levels, no statistically significant association was observed. There was a statistically significant positive association with a diabetes duration of < 7 years (OR, 2.692; p < 0.0001). Observing a significant positive association would take 9 months of treatment (OR, 1.978; p=0.02). DISCUSSION Diabetes duration of < 7 years and absence of complications had a statistically significant impact on improving glycemic control. Although intensifying management led to a notable reduction in HbA1c levels, no statistically significant correlation was observed. The duration of management exhibited a curvilinear relationship with glycemic control, showing optimal glycemic control beginning at 9 months of duration, peaking at 1 year, and declining at 4 years of management.
Human ; Blood glucose ; Philippines

Background: Worldwide, diabetes mellitus (DM) is a serious health issue with a global prevalence of 9.8% in 2021. According to the latest 2018 Expanded National Health and Nutrition survey done by the DOST-FNRI, the prevalence of diabetes in the Philippines have more than doubled from 3.4% in 2003 to 7.9% in 2018. The latest research conducted regarding diabetes care in the Philippines was in 2008 which showed that 85% of patients with diabetes failed to achieve the HbA1c general target of <7%. Objectives: A population-based cross-sectional study to update the current status of diabetes care in the Philippines, specifically to determine glycemic control, trends in DM management, prevalence of complications and lastly their clinico-socio demographic profile. Methods: 340 patients with diabetes were included from the clinics of the Institute for Studies on Diabetes Foundation, Inc. physicians. The following data were collected: clinico-socio demographic profile, HbA1C-based glycemic control, trend in the use of glucose lowering agents, and prevalence of diabetes complications. Results: The mean age of the 340 patients with diabetes in this study was 62 years old. Almost sixty-seven percent (66.8%) were females. The mean body mass index was 26 kg/m2. The mean duration of diabetes was 12.63 years. Close to sixty- eight percent (67.6%) had tertiary education, 58.8% were unemployed and 65% had above minimum income. The most commonly used single oral agent was biguanide (72.9%), followed by dipeptidyl peptidase-4 inhibitors (64.3%). The most common dual therapy combinations were biguanide plus dipeptidyl peptidase-4 inhibitors (43.2%), biguanide plus sulfonylureas (27.2%), and biguanide plus sodium-glucose co-transporter-2 inhibitors (11.1%). Basal insulin was the most commonly used injectable agent. The present study showed that 47.4% of patients achieved an HbA1c of <7%. For the microvascular complication group alone, most had neuropathy (30.4%) followed by nephropathy (17.3%) and by retinopathy (5.4%). For the macrovascular complication group, the most common was coronary artery disease (82%) followed by peripheral artery disease and DM foot (27%). Overall, the most frequent DM complication identified was neuropathy (30.4%) , nephropathy (17.3%) and coronary heart disease (16.1%). Discussion Compared to the 2008 study, oral glucose lowering agents’ usage shifted from sulfonylureas to more use of dipeptidyl peptidase-4 inhibitors. There was a decline in the use of thiazolidinediones, α-glucosidase inhibitors and non-use of meglitinides. For insulin use, there was a shift from the use of premixed insulin to more basal insulin usage. There was marked improvement in the diabetes care situation in the Philippines from the 2008 study to the 2020 study. Glycemic control defined as HbA1c level of <7.0 increased from 15% to 47.4%. Coronary artery disease was the most common macrovascular complication while neuropathy was the most common overall and microvascular complication.
Diabetes Complications ; Glycemic Control