DETERMINANTS OF BLOOD SUGAR REGULATION IN PATIENTS WITH TYPE 1 DIABETES: A SYSTEMATIC LONGITUDINAL ANALYSIS.
Main Article Content
Keywords
Glycemic control, Diabetes, Insulin, Predictors, Type 1 diabetes
Abstract
Aim/Objective: To assess glycemic control and discover characteristics that predict glycemic outcomes among people with type 1 diabetes.
Methodology:This study observed 130 adults with type 1 diabetes, assessing their glycemic control monthly over three months. Data on sociodemographic, clinical, and behavioral factors were collected using structured questionnaires and clinical records. Laboratory tests followed standardized protocols. Statistical analyses identified predictors of suboptimal glycemic control using SPSS software. Ethical approval and informed consent were obtained.
Results:The study included 130 participants, predominantly male (60%) and aged 41-60 years. Most had primary education (54.6%) and were engaged in farming (34.2%). About 76.1% never smoked, and 63.6% had a healthy weight. Non-adherence to treatment was reported by 59.1% of participants. The most prevalent comorbidity was hypertension. (39.1%). Poor glycemic control was detected in 72.7% of participants, with a mean HbA1c of 8.2 ± 1.5%.
Conclusion:This study highlights the widespread issue of diabetics having poor glycemic control, emphasizing the need for targeted interventions. Lifestyle factors like overweight/obesity play a crucial role, alongside challenges related to renal function. Moving forward, personalized approaches focusing on adherence and weight management are imperative for improving diabetes care and reducing complications.
Keywords: , , , Predictors, .
References
2. Kesavadev, J., Sadikot, S. M., Saboo, B., Shrestha, D., Jawad, F., Azad, K., Wijesuriya, M. A., Latt, T. S., & Kalra, S. (2014). Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment. Indian journal of endocrinology and metabolism, 18(5), 600–607. https://doi.org/10.4103/2230-8210.139210
3. Gregory, G. A., Robinson, T. I. G., Linklater, S. E., Wang, F., Colagiuri, S., de Beaufort, C., Donaghue, K. C., International Diabetes Federation Diabetes Atlas Type 1 Diabetes in Adults Special Interest Group, Magliano, D. J., Maniam, J., Orchard, T. J., Rai, P., & Ogle, G. D. (2022). Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. The lancet. Diabetes & endocrinology, 10(10), 741–760. https://doi.org/10.1016/S2213-8587(22)00218-2
4. World Health Organization. Global report on diabetes: World Health Organization:Geneva; 2016. http://apps.who.int/iris/bitstream/10665/204871/ 1/9789241565257_eng.pdf.
5. Shahid, M. B., Saeed, M., Naeem, H., & Kumari, U. (2023). Diabetes mellitus: Is Pakistan the epicenter of the next pandemic?. Chronic diseases and translational medicine, 10(1), 75–77. https://doi.org/10.1002/cdt3.96
6. Azeem, S., Khan, U., & Liaquat, A. (2022). The increasing rate of diabetes in Pakistan: A silent killer. Annals of medicine and surgery (2012), 79, 103901. https://doi.org/10.1016/j.amsu.2022.103901
7. Giri, B., Dey, S., Das, T., Sarkar, M., Banerjee, J., & Dash, S. K. (2018). Chronic hyperglycemia mediated physiological alteration and metabolic distortion leads to organ dysfunction, infection, cancer progression and other pathophysiological consequences: An update on glucose toxicity. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 107, 306–328. https://doi.org/10.1016/j.biopha.2018.07.157
8. Sherwani, S. I., Khan, H. A., Ekhzaimy, A., Masood, A., & Sakharkar, M. K. (2016). Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker insights, 11, 95–104. https://doi.org/10.4137/BMI.S38440
9. Almomani, M. H., & Al-Tawalbeh, S. (2022). Glycemic Control and Its Relationship with Diabetes Self-Care Behaviors Among Patients with Type 2 Diabetes in Northern Jordan: A Cross-Sectional Study. Patient preference and adherence, 16, 449–465. https://doi.org/10.2147/PPA.S343214
10. Petersen, M. C., & Shulman, G. I. (2018). Mechanisms of Insulin Action and Insulin Resistance. Physiological reviews, 98(4), 2133–2223. https://doi.org/10.1152/physrev.00063.2017
11. Alsada, S. A., Ba-Essa, E. M., & Alsaffar, A. A. (2020). Trajectory Analysis of Glycemic Control in Adolescents with Type 1 Diabetes Mellitus at Dammam Medical Complex, Saudi Arabia. Advances in medicine, 2020, 1247294. https://doi.org/10.1155/2020/1247294
12. Asrat Agalu Abejew, Abebe Zeleke Belay, Mirkuzie Woldie Kerie, "Diabetic Complications among Adult Diabetic Patients of a Tertiary Hospital in Northeast Ethiopia", Advances in Public Health, vol. 2015, Article ID 290920, 7 pages, 2015. https://doi.org/10.1155/2015/290920
13. Cheneke W, Suleman S, Yemane T, Abebe G. Assessment of glycemic control using glycated hemoglobin among diabetic patients in Jimma University specialized hospital, Ethiopia. BMC Res Notes. 2016;9(1):96.
14. Abebe SM, Berhane Y, Worku A, Alemu S, Mesfin N. Level of sustained glycemic control and associated factors among patients with diabetes mellitus in Ethiopia: a hospital-based cross-sectional study. Diabetes Metab Syndr Obes Targets Ther. 2015;8:65.
15. Mideksa S, Ambachew S, Biadgo B, Baynes HW. Glycemic control and its associated factors among diabetes mellitus patients at Ayder Comprehensive Specialized Hospital, Mekelle–Ethiopia. Adipocyte. 2018;7(3):197–203.
16. Otieno C, Kariuki M. Quality of glycaemic control in ambulatory diabetics at the out-patient clinic of Kenyatta National Hospital, Nairobi. E Afr Med J. 2003;80(8):406–10.
17. Bae J, Lage M, Mo D, Nelson D, Hoogwerf B. Obesity and glycemic control in patients with diabetes mellitus: analysis of physician electronic health records in the US from 2009–2011. J Diabetes Complic. 2016;30(2):212–20.
18. Alzaheb RA, Altemani AH. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia. Diabetes Metab Syndr Obes Targets Ther. 2018;11: 15.
19. . Jaspinder Kaur SS, Kaur K. Determinants of the glycemic status and its relationship with cardiovascular risk factors. J Biochem Pharmacol Res. 2014;2(3):159–66.
20. Rhee JJ, Ding VY, Rehkopf DH, Arce CM, Winkelmayer WC. Correlates of poor glycemic control among patients with diabetes initiating hemodialysis for end-stage renal disease. BMC Nephrol. 2015;16(1):204.
21. Tsuda A, Ishimura E, Inaba M. Response to comment on Tsuda et al. Poor glycemic control is a major factor in the overestimation of glomerular filtration rate in diabetic patients. Diabetes Care. 2014;37:596–603. https://doi.org/10.2337/dc13- 2869.
22. Naderpoor N, Lyons JG, Mousa A, et al. Higher glomerular filtration rate is related to insulin resistance but not to obesity in a predominantly obese non-diabetic cohort. Sci Rep. 2017;7:45522.
23. Alramadan MJ, Afroz A, Hussain SM, et al. Patientrelated determinants of glycaemic control in people with type 2 diabetes in the Gulf Cooperation Council Countries: a systematic review. J Diabetes Res. 2018;2018:9389265.
24. Mendes ABV, Fittipaldi JAS, Neves RCS, Chacra AR, Moreira ED. Prevalence and correlates of inadequate glycaemic control: results from a nationwide survey in 6,671 adults with diabetes in Brazil. Acta Diabetol. 2010;47(2):137–45.