A prospective study of prevalence of uncontrolled glycaemia in type 2 diabetes mellitus outpatients

Introduction: Uncontrolled diabetes is a non-specific diagnosis, which reveals the patient’s blood sugar level is not kept within acceptable levels by the current medications. This leads to significant morbidity and mortality that could be reduced with proper glycemic control. American Diabetes Association (ADA) recommends HbA1c test to be performed in all diabetic patients, as part of continuing care. HbA1c reducing by 1% can cut mortality risk within 5 years by 50%.

Objectives: To determine the prevalence of uncontrolled glycemia in type 2 diabetic outpatients in endocrine clinics at Penang General Hospital between June–December, 2015 in Penang, Malaysia.

Study Design: A prospective cross-sectional study

Methods: Patients records of 1400 cases were reviewed to identify demographic criteria and lab tests. The prevalence of glycemic control (Glycated haemoglobin, HbA1C < 7% for patients < 65 years, and < 8% for patients > 65 years) was estimated, according to ADA guidelines. The results were presented as descriptive statistics.

Results: From 1400 diabetic cases were scanned with mean age of 64.1 ± 8.9 years, only 757 (54.1%) cases had HbA1c test and 643 (45.9%) did not have HbA1c test. Only 385 (50.9%) patients from this 757 cases, had controlled glycemia, while 372 (49.1%) cases had uncontrolled glycemia. Patients with (HbA1c 7–7.9%) were 114 (30.6%), patients with (HbA1c 8–8.9%) were 98 (26.3%), patients with (HbA1c 9–9.9%) were 58 (15.6%) and patients with (HbA1c > 10%) were 102 (27.4%). 

Conclusions: About half of the patients did not have HbA1c test, which important for glycemic monitoring. Also, nearby half of the patients had uncontrolled glycemia which need more efforts to control their blood glucose level. More than quarter of patients with uncontrolled glycemia had HbA1c > 10%, which increase the risk of diabetic complications incidence. Controlling of blood glucose level will improve patients’ outcome, quality of life and decrease the total cost of illness.