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- Title
Socioeconomic Factors Associated With Glycemic Measurement and Poor HbA1c Control in People With Type 2 Diabetes: The Global DISCOVER Study.
- Authors
Gomes, Marília B.; Tang, Fengming; Chen, Hungta; Cid-Ruzafa, Javier; Fenici, Peter; Khunti, Kamlesh; Rathmann, Wolfgang; Shestakova, Marina V.; Surmont, Filip; Watada, Hirotaka; Medina, Jesús; Shimomura, Iichiro; Saraiva, Gabriela Luporini; Cooper, Andrew; Nicolucci, Antonio
- Abstract
DISCOVER is a 3-year observational study program of 15,983 people with type 2 diabetes initiating second-line glucose-lowering therapy in 38 countries. We investigated the association between socioeconomic status and both the availability of a baseline glycated hemoglobin (HbA1c) measurement and poor glycemic control (HbA1c level ≥ 9.0%) in participants enrolled in DISCOVER. Factors associated with a lack of baseline HbA1c measurement or an HbA1c level ≥ 9.0% were assessed using three-level hierarchical logistic models. Overall, 19.1% of participants did not have a baseline HbA1c measurement recorded. Lower-middle country income (vs. high) and primary/no formal education (vs. university education) were independently associated with a reduced likelihood of having a baseline HbA1c measurement (odds ratio [95% confidence interval]: 0.11 [0.03–0.49] and 0.81 [0.66–0.98], respectively. Of the participants with an available HbA1c measurement, 26.9% had an HbA1c level ≥ 9.0%; 68.7% of these individuals were from lower- or upper-middle-income countries. Factors associated with an increased likelihood of poor glycemic control included low country income, treatment at a site with public and/or governmental funding (vs. private funding) and having public or no health insurance (vs. private). A substantial proportion of DISCOVER participants did not have an HbA1c measurement; more than one-quarter of these participants had poorly controlled type 2 diabetes. Both individual- and country-level socioeconomic factors are associated with the quality of care regarding glycemic control. Awareness of these factors could help improve the management of patients with type 2 diabetes.
- Subjects
TYPE 2 diabetes; GLYCOSYLATED hemoglobin; SOCIOECONOMIC factors; GLYCEMIC control; LOW-income countries
- Publication
Frontiers in Endocrinology, 2022, Vol 13, p1
- ISSN
1664-2392
- Publication type
Article
- DOI
10.3389/fendo.2022.831676