Predictors for good glycemic control, low HbA1c identified
MedWire News: Researchers have identified a number of predictors - including age and medication adherence - for good glycemic control and low glycated hemoglobin (HbA1c) concentrations among patients with suboptimally controlled Type 2 diabetes.
"In conjunction with further research, these findings may contribute to improved understanding of glycemic control in the aging population with diabetes," say Andrew Farmer (University of Oxford, UK) and co-authors.
Using regression analysis, the researchers evaluated baseline demographic, health, and treatment-related measures as predictors of 1-year glycemic control (defined as HbA1c ≤7.5% and a continuous measure of HbA1c concentration) among 161 patients with a diagnosis of Type 2 diabetes of at least 3 months' duration who had been treated with at least one oral hypoglycemic agent.
In addition, the researchers included 50 patients who had been recruited to the trial and completed an initial 8-week observation period, which was defined as the baseline visit.
Analysis revealed that each 1% increase in HbA1c and receiving treatment with five or more medications significantly decreased the odds for achieving glycemic control at 1 year, by 52% and 68%, respectively. Conversely, each 10-year increase in age was significantly associated with a 63% increased likelihood for achieving glycemic control.
The findings showed that adhering to medications more than 80% of the time was not significantly associated with glycemic control at 1 year.
There was no evidence for an association between the duration of diabetes, body mass index (BMI), a history of diabetes-related events, or baseline blood pressure and the likelihood for glycemic control.
When the team assessed the association between patient characteristics and the continuous outcome of HbA1c concentration at 1 year (mean=8.2%), they found that baseline age, HbA1c, medication adherence, and BMI were significantly associated with this outcome. Indeed, adherent patients had a 1-year HbA1c concentration that was 0.65% lower than patients who were non-adherent.
"The lower HbA1c achieved from greater adherence to glucose lowering treatment is comparable to that achieved with additional medication," write the authors in the journal Diabetes Research and Clinical Practice.
"Relationships between older age and better glycemic control are not explained by better adherence, but may partly relate to lower BMI."
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By Ingrid Grasmo