Factors associated with poor glycemic control among patients with Type 2 diabetes

Objectives: Determine factors associated with poor glycemic control among Jordanian patients with Type 2 diabetes. Methods: A systematic random sample of 917 patients was selected from all patients with Type 2 diabetes over a period of 6 months in 2008. A prestructured questionnaire sought information about sociodemographic, clinical characteristics, self-care management behaviours, medication adherence, barriers to adherence, and attitude towards diabetes. Weight, height, and waist circumferences were measured. All available last readings of hemoglobin A1c (HbA1c), fasting blood sugar measurements and lipid were abstracted from patients' records. Poor glycemic control was defined as HbA1c >= 7%. Results: Of the total 917 patients, 65.1% had HbA1c >= 7%. In the multivariate analysis, increased duration of diabetes (>7 years vs. <= 7years) (OR=1.99, P <=.0005), not following eating plan as recommended by dietitians (OR=2.98, P <=.0005), negative attitude towards diabetes, and increased barriers to adherence scale scores were significantly associated with increased odds of poor glycemic control. Conclusion: The proportion of patients with poor glycemic control was high, which was nearly comparable to that reported from many countries. Longer duration of diabetes and not adherent to diabetes self-care management behaviors were associated with poor glycemic control. An educational program that emphasizes lifestyle modification with importance of adherence to treatment regimen would be of great benefit in glycemic control. (C) 2010 Elsevier Inc. All rights reserved.