Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China

Objective There is a high prevalence of poor glycaemic control among patients with type 2 diabetes (T2DM) in China. This study aimed to explore both organisational and individual characteristics associated with glycaemic control among patients with T2DM.Design Cross-sectional survey.Setting Shandong...

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Main Authors: Qiang Sun, Xiaolei Guo, Jingjing Yao, Haipeng Wang, Xiao Yin, Jia Yin, Haiyan Qu
Format: Article
Language:English
Published: BMJ Publishing Group 2020-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/4/e036331.full
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author Qiang Sun
Xiaolei Guo
Jingjing Yao
Haipeng Wang
Xiao Yin
Jia Yin
Haiyan Qu
author_facet Qiang Sun
Xiaolei Guo
Jingjing Yao
Haipeng Wang
Xiao Yin
Jia Yin
Haiyan Qu
author_sort Qiang Sun
collection DOAJ
description Objective There is a high prevalence of poor glycaemic control among patients with type 2 diabetes (T2DM) in China. This study aimed to explore both organisational and individual characteristics associated with glycaemic control among patients with T2DM.Design Cross-sectional survey.Setting Shandong Province, China.Participants The participants were 2166 patients with T2DM and 337 healthcare providers from 36 urban communities and 36 rural villages in Shandong Province.Primary and secondary outcome measures Multistage stratified sampling procedures were used to measure demand-side individual demographic, clinical and self-management characteristics, and supply-side organisational characteristics, and the status of glycaemic control. Multilevel logistic regression analysis was performed to assess key determinants of glycaemic control.Results Only 42.8% of the patients with T2DM achieved good glycaemic control. Age, income, hypertension and self-efficacy were significantly positive predictors of optimal glycaemic control, while duration of diabetes, antidiabetic drugs and monitoring of blood glucose were significantly negative predictors of that. Private VCs (OR=0.48, 95% CI 0.29 to 0.82, p<0.01) and lack of healthcare providers (OR=0.69, 95% CI 0.53 to 0.89, p<0.01; OR=0.71, 95% CI 0.52 to 0.98, p<0.05) were significantly negative predictors of optimal glycaemic control, while diabetes knowledge level of healthcare providers (OR=1.36, 95% CI 1.02 to 1.83, p<0.05; OR=1.45, 95% CI 1.00 to 2.10, p<0.05) and kinds of antidiabetic drugs (OR=1.37, 95% CI 0.97 to 1.93, p<0.1; OR=1.46, 95% CI 1.07 to 2.00, p<0.05) were significantly positive predictors of that.Conclusions Glycaemic control was suboptimal among patients with T2DM in China. The determinants of failing to achieve good glycaemic control included both organisational and individual characteristics. Potential interventions that target patients, providers and the healthcare organisations should be taken to improve the glycaemic control and health outcome among patients with T2DM.
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spelling doaj-art-e10751a77a7b48d7b65df2919e6499602024-12-04T06:00:10ZengBMJ Publishing GroupBMJ Open2044-60552020-04-0110410.1136/bmjopen-2019-036331Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in ChinaQiang Sun0Xiaolei Guo1Jingjing Yao2Haipeng Wang3Xiao Yin4Jia Yin5Haiyan Qu6Centre for Health Management and Policy Research, School of Public Health, Shandong University Cheeloo College of Medicine, Jinan, Shandong, ChinaShandong Center for Disease Control and Prevention, Jinan, China1 Department of Clinical Laboratory, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China1 Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaJinan Central Hospital, Jinan, Shandong, ChinaCentre for Health Management and Policy Research, School of Public Health, Shandong University Cheeloo College of Medicine, Jinan, Shandong, ChinaSchool of Health Professions, University of Alabama at Birmingham, Birmingham, United StatesObjective There is a high prevalence of poor glycaemic control among patients with type 2 diabetes (T2DM) in China. This study aimed to explore both organisational and individual characteristics associated with glycaemic control among patients with T2DM.Design Cross-sectional survey.Setting Shandong Province, China.Participants The participants were 2166 patients with T2DM and 337 healthcare providers from 36 urban communities and 36 rural villages in Shandong Province.Primary and secondary outcome measures Multistage stratified sampling procedures were used to measure demand-side individual demographic, clinical and self-management characteristics, and supply-side organisational characteristics, and the status of glycaemic control. Multilevel logistic regression analysis was performed to assess key determinants of glycaemic control.Results Only 42.8% of the patients with T2DM achieved good glycaemic control. Age, income, hypertension and self-efficacy were significantly positive predictors of optimal glycaemic control, while duration of diabetes, antidiabetic drugs and monitoring of blood glucose were significantly negative predictors of that. Private VCs (OR=0.48, 95% CI 0.29 to 0.82, p<0.01) and lack of healthcare providers (OR=0.69, 95% CI 0.53 to 0.89, p<0.01; OR=0.71, 95% CI 0.52 to 0.98, p<0.05) were significantly negative predictors of optimal glycaemic control, while diabetes knowledge level of healthcare providers (OR=1.36, 95% CI 1.02 to 1.83, p<0.05; OR=1.45, 95% CI 1.00 to 2.10, p<0.05) and kinds of antidiabetic drugs (OR=1.37, 95% CI 0.97 to 1.93, p<0.1; OR=1.46, 95% CI 1.07 to 2.00, p<0.05) were significantly positive predictors of that.Conclusions Glycaemic control was suboptimal among patients with T2DM in China. The determinants of failing to achieve good glycaemic control included both organisational and individual characteristics. Potential interventions that target patients, providers and the healthcare organisations should be taken to improve the glycaemic control and health outcome among patients with T2DM.https://bmjopen.bmj.com/content/10/4/e036331.full
spellingShingle Qiang Sun
Xiaolei Guo
Jingjing Yao
Haipeng Wang
Xiao Yin
Jia Yin
Haiyan Qu
Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China
BMJ Open
title Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China
title_full Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China
title_fullStr Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China
title_full_unstemmed Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China
title_short Organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes: cross-sectional study in China
title_sort organisational and individual characteristics associated with glycaemic control among patients with type 2 diabetes cross sectional study in china
url https://bmjopen.bmj.com/content/10/4/e036331.full
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