Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: The Fifth Korea National Health and Nutrition Examination Survey (2010-2012)

제2형 당뇨병 환자의 혈당 비조절 관련 요인분석: 국민건강영양조사(2010-2012) 자료이용

  • Park, Jinhyun (Non Commissioned Officer Academy) ;
  • Lim, Seungji (Health Insurance Policy Research Institute, National Health Insurance Service) ;
  • Yim, Eunshil (Department of Nursing, Daegu Health College) ;
  • Kim, Youngdae (Graduate School of Public Health, Yonsei University) ;
  • Chung, Woojin (Department of Health Policy and Management, Yonsei University Graduate School of Public Health)
  • 박진현 (육군부사관학교) ;
  • 임승지 (국민건강보험공단 건강보험정책연구원) ;
  • 임은실 (대구보건대학교 간호학과) ;
  • 김영대 (연세대학교 보건대학원) ;
  • 정우진 (연세대학교 보건대학원 보건정책학과)
  • Received : 2016.03.16
  • Accepted : 2016.06.13
  • Published : 2016.06.30
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Abstract

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

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References

  1. World Health Organization. The top 10 causes of death [Internet]. Geneva: World Health Organization; 2012 [cited 2015 Mar 10]. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/.
  2. Statistic Korea. Causes of death statistics 2014 [Internet]. Daejeon: Statistic Korea; 2016 [cited 2016 May 14]. Avaliable from: http://kostat.go.kr/portal/korea/kor_nw/3/index.board?bmode=read&aSeq=348541.
  3. International Diabetes Federation. International Diabetes Federation annual report 2014. Brussels: International Diabetes Federation; 2014.
  4. Korean Diabetes Association. Korean diabetes fact sheet 2015. Seoul: Korean Diabetes Association; 2015.
  5. Park SK, Park MK, Suk JH, Kim MK, Kim YK, Kim IJ, et al. Cause-of-death trends for diabetes mellitus over 10 years. Korean Diabetes J 2009;33(1):65-72. DOI: http://dx.doi.org/10.4093/kdj.2009.33.1.65.
  6. Boo S. Glucose, blood pressure, and lipid control in Korean adults with diagnosed diabetes. Korean J Adult Nurs 2012;24(4):406-416. DOI: http://dx.doi.org/10.7475/kjan.2012.24.4.406.
  7. Park YJ, Chung IK, Shin CS, Park KS, Kim SY, Lee HK, et al. Evaluation of fasting plasma glucose to diagnose diabetes in Yonchon county. J Korean Diabetes Assoc 1998;22(3):372-380.
  8. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329(14):977-986. DOI: http://dx.doi.org/10.1056/nejm199309303291401.
  9. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352(9131):837-853. DOI: http://dx.doi.org/10.1016/s0140-6736(98)07019-6.
  10. American Diabetes Association. Standards of medical care in diabetes-2015: summary of revisions. Diabetes Care 2015;38(Suppl 1):S4-S4. DOI: http://dx.doi.org/10.2337/dc15-S003.
  11. Health Insurance Review and Assessment Service. Distribution of medical resources [Internet]. Wonju: Health Insurance Review and Assessment Service; 2016 [cited 2016 May 15]. Available from: http://www.hira.or.kr/re/gisresource/GisInfo.do?pgmid=HIRAA030501000000.
  12. Choi YJ, Kim HC, Kim HM, Park SW, Kim J, Kim DJ. Prevalence and management of diabetes in Korean adults: Korea National Health and Nutrition Examination Surveys 1998-2005. Diabetes Care 2009;32(11):2016-2020. DOI: http://dx.doi.org/10.2337/dc08-2228.
  13. Jeon JY, Kim DJ, Ko SH, Kwon HS, Lim S, Choi SH, et al. Current status of glycemic control of patients with diabetes in Korea: the fifth Korea National Health and Nutrition Examination Survey. Diabetes Metab J 2014;38(3):197-203. DOI: http://dx.doi.org/10.4093/dmj.2014.38.3.197.
  14. Kim K, Kim JS, Lee E. Diabetes-related characteristics in men with diabetes for the glucose control group and noncontrol group. J Korean Acad Fundam Nurs 2011;18(2):152-159.
  15. Pyo EY, Jung MH, Kim YS, Factors related to blood glucose control in patients with diabetes. Korean J Health Educ Promot 2012;29(3):15-22.
  16. Ali MK, McKeever Bullard K, Imperatore G, Barker L, Gregg EW; Centers for Disease Control and Prevention (CDC). Characteristics associated with poor glycemic control among adults with self-reported diagnosed diabetes: National Health and Nutrition Examination Survey, United States, 2007-2010. MMWR Suppl 2012;61(2):32-37.
  17. Fan T, Koro CE, Fedder DO, Bowlin SJ. Ethnic disparities and trends in glycemic control among adults with type 2 diabetes in the U.S. from 1988 to 2002. Diabetes Care 2006;29(8):1924-1925. DOI: http://dx.doi.org/10.2337/dc05-2238.
  18. Koro CE, Bowlin SJ, Bourgeois N, Fedder DO. Glycemic control from 1988 to 2000 among U.S. adults diagnosed with type 2 diabetes: a preliminary report. Diabetes Care 2004;27(1):17-20. DOI: http://dx.doi.org/10.2337/diacare.27.1.17.
  19. Saydah S, Cowie C, Eberhardt MS, De Rekeneire N, Narayan KM. Race and ethnic differences in glycemic control among adults with diagnosed diabetes in the United States. Ethn Dis 2007;17(3):529-535.
  20. Centers for disease control and prevention. 2014 National diabetes statis tics report [Internet]. Atlanta (GA): Centers for disease control and prevention; 2014 [cited 2014 Oct 20]. Available from: http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html.
  21. Egede LE, Gebregziabher M, Hunt KJ, Axon RN, Echols C, Gilbert GE, et al. Regional, geographic, and racial/ethnic variation in glycemic control in a national sample of veterans with diabetes. Diabetes Care 2011;34(4):938-943. DOI: http://dx.doi.org/10.2337/dc10-1504.
  22. Ahmad NS, Islahudin F, Paraidathathu T. Factors associated with good glycemic control among patients with type 2 diabetes mellitus. J Diabetes Investig 2014;5(5):563-569. DOI: http://dx.doi.org/10.1111/jdi.12175.
  23. Benoit SR, Fleming R, Philis-Tsimikas A, Ji M. Predictors of glycemic control among patients with type 2 diabetes: a longitudinal study. BMC Public Health 2005;5:36. https://doi.org/10.1186/1471-2458-5-36
  24. Hoerger TJ, Segel JE, Gregg EW, Saaddine JB. Is glycemic control improving in U.S. adults? Diabetes Care 2008;31(1):81-86. https://doi.org/10.2337/dc07-1572
  25. Kim BK, Kim BS, An SY, Lee MS, Choi YJ, Han SJ, et al. Sleep duration and glycemic control in patients with diabetes mellitus: Korea National Health and Nutrition Examination Survey 2007-2010. J Korean Med Sci 2013; 28(9):1334-1339. DOI: http://dx.doi.org/10.3346/jkms.2013.28.9.1334.
  26. Fox KM, Gerber Pharmd RA, Bolinder B, Chen J, Kumar S. Prevalence of inadequate glycemic control among patients with type 2 diabetes in the United Kingdom general practice research database: a series of retrospective analyses of data from 1998 through 2002. Clin Ther 2006;28(3):388-395. DOI: http://dx.doi.org/10.1016/j.clinthera.2006.03.005.
  27. Chung W, Yoo T, Lee S. Type of alcoholic beverage and high risk drinking for acute harm. Korean J Prev Med 2003;36(4):383-389.
  28. Kim M, Chung W, Lim S, Yoon S, Lee J, Kim E, et al. Socioeconomic inequity in self-rated health status and contribution of health behavioral factors in Korea. J Prev Med Public Health 2010;43(1):50-61. DOI: http://dx.doi.org/10.3961/jpmph.2010.43.1.50.
  29. Yoo TW, Chung WJ, Lee SM, Lee SH. Alcoholic beverage preference and high risk drinking. J Korean Acad Fam Med 2003;24(10):912-919.
  30. World Health Organization. International guide for monitoring alcoholic consumption and related harm. Geneva: World Health Organization; 2000.
  31. Goudswaard AN, Stolk RP, Zuithoff P, Rutten GE. Patient characteristics do not predict poor glycaemic control in type 2 diabetes patients treated in primary care. Eur J Epidemiol 2004;19(6):541-545. DOI: http://dx.doi.org/10.1023/b:ejep.0000032351.42772.e7.
  32. Kang HM, Kim DJ. Gender differences in the association of socioeconomic status with metabolic syndrome in middle-aged Koreans. Korean J Med 2012;82(5):569-575. DOI: http://dx.doi.org/10.3904/kjm.2012.82.5.569.
  33. Kim Y, Cho D, Kang SH. An empirical analysis on geographic variations in the prevalence of diabetes. Health Soc Welf Rev 2014;34(3):82-105. DOI: http://dx.doi.org/10.15709/hswr.2014.34.3.82.
  34. Macintyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med 2002;55(1): 125-139. DOI: http://dx.doi.org/10.1016/s0277-9536(01)00214-3.
  35. Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications 2010;24(2):84-89. DOI: http://dx.doi.org/10.1016/j.jdiacomp.2008.12.008.
  36. Kim SY. It's still not too late to make a change: current status of glycemic control in Korea. Diabetes Metab J 2014;38(3):194-196. DOI: http://dx.doi.org/10.4093/dmj.2014.38.3.194.
  37. Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care 2004;27(6):1496-1504. DOI: http://dx.doi.org/10.2337/diacare.27.6.1496.
  38. American Diabetes Association. Standards of medical care in diabetes-2011. Diabetes Care 2011;34(Suppl 1):S11-S61. DOI: http://dx.doi.org/10.2337/dc11-S011.
  39. Mackenzie T, Brooks B, O'Connor G. Beverage intake, diabetes, and glucose control of adults in America. Ann Epidemiol 2006;16(9):688-691. DOI: http://dx.doi.org/10.1016/j.annepidem.2005.11.009.
  40. Ahmed AT, Karter AJ, Warton EM, Doan JU, Weisner CM. The relationship between alcohol consumption and glycemic control among patients with diabetes: the Kaiser Permanente Northern California Diabetes Registry. J Gen Intern Med 2008;23(3):275-282. DOI: http://dx.doi.org/10.1007/s11606-007-0502-z.
  41. Christiansen C, Thomsen C, Rasmussen O, Glerup H, Berthelsen J, Hansen C, et al. Acute effects of graded alcohol intake on glucose, insulin and free fatty acid levels in non-insulin-dependent diabetic subjects. Eur J Clin Nutr 1993;47(9):648-652.
  42. Kim CG. The relation of BMI, smoking and drinking with biomedical parameters in 20s and 30s men. J Korea Acad Ind Coop Soc 2011;12(10):4425-4433. DOI: http://dx.doi.org/10.5762/kais.2011.12.10.4425.
  43. Wareham NJ, Ness EM, Byrne CD, Cox BD, Day NE, Hales CN. Cigarette smoking is not associated with hyperinsulinemia: evidence against a causal relationship between smoking and insulin resistance. Metabolism 1996;45(12):1551-1556. DOI: http://dx.doi.org/10.1016/s0026-0495(96) 90187-0.
  44. Broussard JL, Chapotot F, Abraham V, Day A, Delebecque F, Whitmore HR, et al. Sleep restriction increases free fatty acids in healthy men. Diabetologia 2015;58(4):791-798. DOI: http://dx.doi.org/10.1007/s00125-015-3500-4.

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