Factors Associated with Achieving HbA1c Targets in Patients with Type 2 Diabetes

Abstract

Background: Diabetes mellitus is a major global public health concern, particularly due to its complications and associated mortality and morbidity. Ethnic differences in the epidemiology of diabetes necessitate population-specific studies to identify factors influencing glycemic control. Objectives: This study aimed to identify demographic and clinical factors associated with achieving HbA1c targets in patients with type 2 diabetes mellitus (T2DM) at the Yazd Diabetes Center in Iran. Methods: In this retrospective study, data were extracted from the medical records of 3,454 patients with type 2 diabetes at the Yazd Diabetes Research Center (March 2020 - December 2022). Data analysis was performed using chi-squared tests, t-tests, Mann-Whitney U tests, and logistic regression in R version 4.0.2. Results: The cohort, predominantly female (59%) and primarily educated at the elementary level (65%), had an average age of 59.5 years (SD = 10) and a mean diabetes duration of 10.7 years (SD = 7.6). In the multivariable logistic regression model, older age (B = 0.03, OR = 1.03 per year, P < 0.001) and higher education level (secondary school B = 0.664, OR = 1.94, P < 0.001; academic education B = 0.834, OR = 2.30, P < 0.001) remained significant independent predictors of achieving HbA1c < 7%. The interaction term revealed that each additional year of diabetes duration led to a 3% greater reduction in the odds of achieving HbA1c < 7% for females compared to males (B = -0.029, OR = 0.97, P = 0.011), indicating gender-specific impacts of diabetes duration. Conclusions: This study found that demographic factors, including older age and higher education levels, were significantly associated with better glycemic control. The duration of diabetes negatively affected HbA1c outcomes, with a more pronounced impact in females than in males.