The effects of glycemic control on morbidity and survival among diabetic patients

• Published in: Diabetes & metabolic syndrome clinical research & reviews 2019-03, Vol.13 (2), p.1035-1040
• Main Authors: Hammad, Mohamed Anwar, Syed Sulaiman, Syed Azhar, Abubakar, Usman, Mohamed Noor, Dzul Azri
• Format: Article
• Language: English
• Subjects: Biomarkers - analysis; Blood Glucose - analysis; Controlled glycemia; Cross-Sectional Studies; Diabetes Mellitus - drug therapy; Diabetes Mellitus - mortality; Diabetes Mellitus - physiopathology; Estimated 10-year survival; Female; Follow-Up Studies; Glycated hemoglobin; Glycated Hemoglobin A - analysis; HbA1c; Humans; Hyperglycemia - metabolism; Hyperglycemia - prevention & control; Hypoglycemia - metabolism; Hypoglycemia - prevention & control; Hypoglycemic Agents - therapeutic use; Male; Middle Aged; Morbidity; Prognosis; Survival Rate; Type 2 diabetes mellitus
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2019.01.001

The study intended to investigate the impact of controlled glycemia on morbidity and estimated 10-year survival (ES-10Y). A cross-sectional investigation was conducted at General Penang Hospital, Malaysia. Demographic criteria and laboratory tests of patients were investigated. Controlled glycemia (CG) was recognized as glycated hemoglobin (HbA1c) ≤7% depending on American Diabetes Association guidelines 2018. Charlson Comorbidity Index (CCI) was used to estimate the confounding influence of co-morbidities and predict ES-10Y. Data was managed by IBM-SPSS 23.0. A total of 400 cases categorized to (44.25%) patients with CG, and (55.75%) cases had uncontrolled glycemia (UCG). HbA1c mean in CG and UCG group was (6.8 ± 0.9 vs 9.5 ± 1.6, P-value: 0.001). Fasting blood glucose was (7 ± 2.3 vs. 9.9 ± 4.3, P-value: 0.001) in CG and UCG group. CCI was (3.38 ± 2.38 vs. 4.42 ± 2.70, P-value: 0.001) and, ES-10Y was (62% vs 46.2%, p-value: 0.001) in CG vs. UCG respectively. Spearman test indicates a negative correlation between CG and CCI (r: 0.19, p-value: 0.001). Logistic regression confirmed HbA1c as a significant predictor of CCI (r2: 0.036, P-value: 0.001). CG has a positive correlation with survival (r: 0.16, P-value: 0.001) and logistic regression of survival (r2: 0.26, P-value: 0.001). More than one-half of the investigated persons had UCG. Controlled HbA1c was associated with lower co-morbidities and higher ES-10Y.