Frequency of glycated hemoglobin monitoring was inversely associated with glycemic control of patients with Type 2 diabetes mellitus

摘要

Background: The frequency of monitoring glycated hemoglobin (HbA 1c) and its impact on glycemic control of Chinese Type 2 diabetes mellitus (T2DM) patients have not been well understood. Aim: To explore the current status of the glycemic control, the frequency of HbA1c monitoring, and their relationship in T2DM outpatients in urban China. Subjects and methods: A cross-sectional study was carried out in 15 hospitals purposely sampled from 4 cities of China. T2DM outpatients were consecutively recruited, and underwent a face-to-face interview in outpatient consulting rooms using a self-developed structured questionnaire to collect information. All consented patients were invited to have a free HbA 1ctest. Results: Among 1511 subjects, the average level of HbA 1c was 8.1±1.6% with the ideal percents of 13.6% and 24.8% (HbA 1c6.5% and 7.0%, respectively). Less than 1/3 (339/1157) had received 2 or more HbA 1c tests per yr, and they had a significantly lower average of HbA 1c than those having only 1 or no test per yr (F=5.012, p=0.007). After adjustment for possible confounders including age, gender, and city, there was a significantly inverse association with adjusted odds ratios of 2.56 [95% confidence interval (CI): 1.71, 3.86] and 1.67 (95% CI: 1.11, 2.50), respectively, between the frequency of monitoring HbA 1c (null, once vs 2 times per yr) and worse glycemic control (HbA 1c 7.0%). Conclusions: Glycemic control of T2DM outpatients was poor in urban China. Frequency of HbA 1c monitoring is seriously insufficient in majority of patients. Lower frequency of HbA 1c monitoring is significantly associated with poor glycemic control.