Factors Associated with Diabetes Control in Predominately African American and Hispanic Population with Newly Diagnosed Type 2 Diabetes.

Abstract

This study characterizes factors affecting glycemic control in a predominately African American and Hispanic population with newly diagnosed type 2 diabetes (T2DM). Retrospective longitudinal cohort study of 1638 patients with newly diagnosed T2DM to determine factors associated with improved HbA1c (ΔHbA1c ≤ - 0.5%) and achieving target HbA1c < 7%. At baseline, mean age 51.7 ± 11.5years, males 52.9%, mean BMI 33.9 ± 7.8kg/m2, median HbA1c 9.9 (7.6-12.1)%. At study end, median follow-up duration 27 (13-54)months, median HbA1c 7.0 (6.2-8.7)%, 69.6% with improved HbA1c, 48.3% achieved target HbA1c < 7%, 88.4% monitored blood glucose, 40.1% used insulin, and 72.4% reported not missing medications. In multivariate analysis, improved HbA1c significantly correlated with glucose monitoring (OR = 2.65), higher initial HbA1c (OR = 1.85), and medication adherence (OR = 1.66) and inversely correlated with insulin use (OR = 0.38) and follow-up duration (OR = 0.99). Achieving HbA1c < 7% significantly correlated with glucose monitoring (OR = 2.14), medication adherence (OR = 1.88), more provider visits (OR = 1.04), and older age (OR = 1.03). It inversely correlated with insulin use (OR = 0.47), initial HbA1c (OR = 0.93), and follow-up duration (OR = 0.98). In those with newly diagnosed T2DM, achieving better glycemic control was mainly related to patient self-management behaviors and inversely related to insulin use. Emphasis on patients' diabetes education and empowerment are critical to improved glycemic control.