Evaluation of factors associated with inadequate glycemic control and some other health care indicators among patients with type 2 diabetes in Ramallah, Palestine

Inadequate glycemic control among patients with type 2 diabetes constitutes a major public health problem and major risk factor for the development of diabetes complications and evaluation of factors associated with such inadequate control among patient with type 2 diabetes in the Arab world, including Palestine is not very well known. Assessment ofthe factors associated with inadequateglycemic control and some other health care indicators among patients with type 2 diabetes who attended the Palestinian Centre for Non-Communicable Diseases (PCNCD) in Ramallah, Palestine. A random sample of 450 patients was selected from all patients with type 2 diabetes from PCNCD in Ramallah over a period of 6 months in 2012. A pre-structured questionnaire was used to collect information about sociodemographic, clinical characteristics of participants. Weight, height, and waist circumference, and blood pressure readings were measured. Participant's available last readings of glycatedhemoglobin (HbA1c) and lipid profile (Total Cholesterol, Low Density Lipoprotein , Triglycerides, High Density Lipoprotein) were abstracted from all patients' records included in the study. Poor or inadequate glycemic control of the sample pooled was defined as HbA1c ≥ 6.5%. Of the total 450 type 2 patients included in the study, 70.9% (95%CI; 66.7-75.1) had HbA1c ≥ 6.5%. The majority of patients 408 (90.7%) (95%CI; 81.5-99.9) were classified as either overweight or obese (BMI ≥ 25kg/m2). High proportion of the sample pooled (207; 46%) reported that they were not physically active and almost three quarter 328 (72.9%) and 392 (87.1%) were with hypertension and dyslipidemia respectively during the study period. There were a significant differences in HbA1c and some other health care indicators among patients with diabetes who were married, employed, non smokers, physically active, non obese, and no history of hypertension or dyslipidemia. Despite the fact of a significant correlation (r=0.737; p < 0.001) between diabetic hypertension patient and their use of anti hypertension medications, 44.2% of patients were not able to control their high blood pressure during the study period. The proportion of inadequateglycemic control, over weighted or obese, physically inactive, had hypertension or dyslipidemia was high in the patients under investigation, which was nearly comparable to that reported elsewhere. More restricted management with an educational program that emphasizes lifestyle modification and with importance of adherence to treatment plan designed according to the international clinical guidelines would be of great benefit in glycemic control of our patients.