Age and Comorbidities significantly influence Time to first optimal glycemic control, reveals study

T2DM still is among the major public health concerns in the world due to lack of proper handling of the glycemic control, which further promotes the development of complications such as cardiovascular disease, neuropathy, and hypertension. These complications can be prevented if appropriate adjustments in the strategies of glycaemic control occurred at an early stage of the disease.

A total of 514 eligible adult diabetes patients were followed up retrospectively from Comprehensive Specialized Hospitals, Northwest Ethiopia, January 2017 to January 2022. Simple random sampling was used to select the participants. The survival status of the participants was determined using a Kaplan Meier curve, while categorical variables were compared by the application of the log-rank test. Predictors of time to the first optimal glycemic control were identified using a Cox proportional hazard model, and variables with a p-value <.05 were considered statistically significant.

Key Findings

• The study studied the medical history of 514 patients, of whom were 227 males and 287 females. It found that the median time of first optimal glycemic control was 8.4 months with an interquartile range, IQR of 7.6 to 9.7 months. Several key predictors were identified, affecting this time frame:

• Age: Delayed glycemic control was observed for patients aged 50–59 years, AHR = 0.63, 95% CI = 0.463, 0.859; 60–69 years, AHR = 0.638, 95% CI = 0.471, 0.865; and older than 70 years, AHR = 0.480, 95% CI = 0.298, 0.774.

• Diabetes Neuropathy: Presence of diabetes neuropathy is correlated with lower probabilities of rapid glycemic control; AHR = 0.629, 95% CI = 0.441, 0.900.

• Hypertension: The patients suffering from hypertension also exhibited a slower time frame to glycemic control; AHR = 0.667, 95% CI = 0.524, 0.848.

• Dyslipidemia: The patients with dyslipidemia took more time to reach the optimal glycemic levels (AHR = 0.561, 95% CI = 0.410, 0.768).

• Cardiovascular Disease: Cardiovascular diseases were associated with delayed glycemic control (AHR = 0.681, 95% CI = 0.494, 0.938).

The authors conclude that the age of the patients and their comorbid conditions such as diabetes neuropathy, hypertension, dyslipidemia, and cardiovascular disease significantly influence the time to achieve first optimal glycemic control in T2DM. With these results, treatment providers have to focus on early intervention and personalized approaches for treatment among these high-risk populations in order to achieve improved glycemic outcomes and minimize complications of diabetes.

Reference:

Chalie, S., Alle Ewunetie, A., Assemie, M. A., Liknaw, A., Molla, F., Telayneh, A. T., & Endalew, B. (2024). Time to first optimal glycemic control and its predictors among adult type 2 diabetes patients in Amhara Regional State comprehensive specialized hospitals, Northwest Ethiopia. BMC Endocrine Disorders, 24(1). https://doi.org/10.1186/s12902-024-01695-1