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Higher risk of uncontrolled disease and very poor glycemic control in younger patients with type 2 diabetes

VOLUMEN 5 - NÚMERO 3 / Julio-Septiembre (Artículo Original)


Juan M. López-Navarro, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City
Iván Pérez-Díaz, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City; Tecnológico de Monterrey, Monterrey, N.L
Eduardo J. Valladares-Pérez, Tecnológico de Monterrey, Monterrey, N.L
Jeanette Elisabeth Olivares-Serrato, Facultad de Enfermería y Nutrición de la Universidad Autónoma de San Luis Potosí, San Luis Potosí, S.L.P.
Josette R. Staufert-Gutiérrez, Department of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico C
Arturo Vega-Beyhart, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City
Reynerio Fagundo-Sierra, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City

Objective: This research aims to identify the risk factors associated with poor glycemic control in patients with Type 2 diabetes. Methods: A retrospective and transversal study was performed comprising patients with Type 2 diabetes mellitus who were classified into four groups according to glycated hemoglobin (HbA1c) level. Patients were considered to have good glycemic control when HbA1c was ≤ 7%. Clinical records were consulted to obtain clinical and laboratory information. Multivariate logistic regression analysis was performed to identify independent risk factors. Results: From the final sample (n = 204), associated risk factors for uncontrolled diabetes were < 60 years old (odds ratio [OR] 4.421; 95% confidence interval [CI], 1.991-9.817), < 7 years of education (OR 2.814; 95% CI: 1.337-5.926), ≥ 3 comorbidities (OR 3.556; 95% CI: 1.496-8.453), and history of hypoglycemia (OR 5.406; 95% CI: 1.477-19.790). Age < 50 years (OR 3.737; 95% CI: 1.403-8.357), body mass index > 25 kg/m2 (OR 23.830; 95% CI: 3.100-183.166), smoking (OR 4.511; 95% CI: 1.917-10.615), and history of diabetic ketoacidosis (OR 4.744; 95% CI: 1.061-21.210) were associated with HbA1c ≥ 12%. Conclusion: Uncontrolled disease is more prevalent in patients with low education, three or more comorbidities, and age < 60 years. Daily lifestyle factors, such as nutritional status and smoking, are associated with verypoor glycemic control.
 

Palabras clave: Diabetes. Risk factors. Glycemic control. Glycated hemoglobin.

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