Glycemic and Blood Pressure Control in an Asian Malay Population With Diabetes and Diabetic Retinopathy

Abstract

To examine the prevalence of and factors associated with suboptimal glycemic and blood pressure (BP) control in a Malay population with diabetes mellitus in Singapore. The Singapore Malay Eye Study was a population-based survey of 3280 Malay individuals (78.7% response rate) aged 40 to 80 years. Diabetes was defined as a nonfasting glucose level of 200 mg/dL or greater, use of diabetic medication, or physician diagnosis. Diabetic retinopathy (DR) was graded from retinal photographs using the modified Airlie House classification. Optimal control was defined as a hemoglobin A(1c) level of less than 7% and BP of 130/80 mm Hg or lower. In participants with diabetes (n = 768), only 26.9% had optimal glycemic and 13.4% optimal BP control, respectively. In those with DR (n = 272), rates of optimal glycemic and BP control were even lower (17.4% and 10.3%, respectively). After adjusting for age, sex, socioeconomic status, and other factors, compared with participants with optimal glycemic control, those with suboptimal control were younger (P = .005), more likely to be unaware of their diabetes status (P < .001), and taking medication for diabetes (P < .001) and had higher levels of total cholesterol (P = .009) and DR (P < .001). After adjusting for similar risk factors, compared with participants with optimal BP control, those with suboptimal BP control were older (P = .006) and more likely to have higher total cholesterol levels (P = .002), BMIs (P = .04), and DR (P = .02). In this Asian Malay population with diabetes, more than three-quarters had poor glycemic and BP control. Strategies to improve awareness and implement evidence-based guidelines are needed to reduce the effect and burden of diabetic complications in Asia.