Determinants of Glycemic Control in Thai Adults with Insulin-Treated Type 2 Diabetes Mellitus: A Cross-Sectional Study

Abstract

Introduction: Insulin is an effective treatment for achieving glycemic control and delaying diabetes-related chronic complications. Even with receiving insulin therapy, adults with type 2 diabetes (T2DM) may still struggle to reach their glycemic targets. Objective: This study aimed to determine factors associated with glycemic control in Thai adults with insulin-treated T2DM. Methods: A cross-sectional study was conducted among adults with insulin-treated T2DM between July 2021-May 2022. Glycemic control is measured by Hemoglobin A1C (HbA1C), and good glycemic control was defined as HbA1C < 7%. Characteristics of adults with T2DM were analyzed using descriptive statistics. Determinant factors of glycemic control, including diabetes self-management, attitude toward insulin treatment, social support, patient-healthcare providers communication, self-monitoring blood glucose (SMBG), insulin injection technique, self-reported hypoglycemia, and lipohypertrophy, were analyzed using binary logistic regression. Results: Of the 273 participants, the mean age was 62.1 (SD = 10.7) years, 60.8% were females, and 41.8% achieved good glycemic control. Binary logistic regression analyses after adjusting for gender, age, BMI, education level, and health benefits show that performing better diabetes self-management (Adjusted odds ratio (AOR) = 1.15; 95% CI: 1.10–1.21, p < 0.001), had a less negative attitude toward insulin treatment (AOR = 0.92; 95% CI: 0.89–0.96, p < 0.001), demonstrated better insulin injection techniques (AOR = 1.35; 95% CI: 1.13–1.60, p < 0.001), and performed SMBG at least 3 times per week (AOR = 9.80; 95% CI: 2.88–33.33, p < 0.001) were more likely to achieve good glycemic control in Thai adults with insulin-treated T2DM. Conclusion: Diabetes self-management, attitude toward insulin treatment, insulin injection technique, and SMBG were significantly associated with glycemic control in Thai adults with insulin-treated T2DM.