Assessment of Poor Glycemic Control and Associated Factors in Type ۲ Diabetes Patients at Comprehensive Health Centers, Qaemshahr in ۲۰۲۳

Background: Between ۴۰% and ۶۰% of patients worldwide have poorly controlled diabetes. Although blood glucose control is the main goal of treatm-ent, in most patients it is not achieved. Identifying factors related to poor control is essential for effective management. Objectives: To investigate the prevalence of poor glycemic control and its associated factors in patients with type ۲ diabetes in Qaemshahr in ۲۰۲۳. Methods: A cross-sectional descriptive-analytical study was conducted employing multistage sampling. Data were collected from ۶۴۲ type ۲ diabetic patients using fasting blood glucose and HbA۱c measurements. The Diabetes Self-Care Activities questionnaire and the Morisky Medication Adherence Scale were used to assess self-care and medication adherence, respectively. Data were analyzed using SPSS version ۱۹ with descriptive statistics and inferential analyses. First, the normality of the data was assessed using the Kolmogorov–Smirnov test. For variables that did not follow a normal distribution, the non-parametric Mann–Whitney test was used, and for qualitative variables, the chi-square test was applied; significance was set at p < ۰.۰۵. Results: The number of participants was ۶۴۲.The prevalence of controlled blood glucose was ۴۵.۳%. Significant associations were found between glycemic control and education level, residence, insurance type, medication type, glucometer use, and regular visits to physicians and health caregivers ‘P < ۰.۰۵. Medication adherence was high in۱۹۴(۳۰%) of patients, while optimal self-care was observed only in ۵۲(۸%). Self-care showed a significant association with HbA۱c levels ‘P = ۰.۰۰۱, family size, living arrangements, and presence of diabetic complications. No significant association was observed between self-care and age, gender, or education level. Conclusions: Despite good medication adherence in some patients, the low rate of optimal self-care underscores the need for continuous education and counseling to improve comprehensive diabetes management and prevent complications. Sole reliance on medication adherence is insufficient to ensure health outcomes.

کلیدواژه ها:

Diabetes Mellitus ، Type ۲ ، glycemic control ، Hemoglobin A ، Glycosylated (HbA۱c) ، Medication Adherence