Factors Associated with Achieving HbA1c Targets in Patients with Type 2 Diabetes

Diabetes mellitus is a major global public health concern, particularly due to its complications and associated mortality and morbidity. Ethnic differences in the epidemiology of diabetes necessitate population-specific studies to identify factors influencing glycemic control.

This study aimed to identify demographic and clinical factors associated with achieving HbA1c targets in patients with type 2 diabetes mellitus (T2DM) at the Yazd Diabetes Center in Iran.

In this retrospective study, data were extracted from the medical records of 3,454 patients with type 2 diabetes at the Yazd Diabetes Research Center (March 2020 - December 2022). Data analysis was performed using chi-squared tests, t -tests, Mann-Whitney U tests, and logistic regression in R version 4.0.2.

The cohort, predominantly female (59%) and primarily educated at the elementary level (65%), had an average age of 59.5 years (SD = 10) and a mean diabetes duration of 10.7 years (SD = 7.6). In the multivariable logistic regression model, older age (B = 0.03, OR = 1.03 per year, P < 0.001) and higher education level (secondary school B = 0.664, OR = 1.94, P < 0.001; academic education B = 0.834, OR = 2.30, P < 0.001) remained significant independent predictors of achieving HbA1c < 7%. The interaction term revealed that each additional year of diabetes duration led to a 3% greater reduction in the odds of achieving HbA1c < 7% for females compared to males (B = -0.029, OR = 0.97, P = 0.011), indicating gender-specific impacts of diabetes duration.

This study found that demographic factors, including older age and higher education levels, were significantly associated with better glycemic control. The duration of diabetes negatively affected HbA1c outcomes, with a more pronounced impact in females than in males.