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Original Article
Factors that Correlate with Poor Glycemic Control in Type 2 Diabetes Mellitus Patients with Complications
Mohammad Haghighatpanah, Amir Sasan Mozaffari Nejad, Maryam Haghighatpanah, Girish Thunga, Surulivelrajan Mallayasamy
Osong Public Health Res Perspect. 2018;9(4):167-174.   Published online August 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.4.05
  • 8,456 View
  • 150 Download
  • 53 Crossref
AbstractAbstract PDF
Objectives

Inadequate glycemic control amongst patients with Type 2 diabetes mellitus (T2DM) indicates a major public health problem and a significant risk factor for the progression and complications caused by diabetes. Glycemic control is the main therapeutic objective for the prevention of organ damage and other complications arising from diabetes.

Methods

This was a retrospective observational study of T2DM patients with complications, who were aged 40 years and older. The study was conducted retrospectively on medical records (in-patient and out-patient) obtained from a South Indian teaching hospital, Manipal, India. The patients included in the study had fasting blood sugar, postprandial blood sugar and HbA1c measured at least twice during follow-ups the previous year. Patients’ HbA1c levels were categorized into good control ≤7% (≤53mmol/mol), and poor control >7% (>53mmol/mol), and patients’ characteristics were analyzed.

Results

A total of 657 patients were included in the study. The mean age was 59.67 (SD = 9.617) years, with 152 (23.1%) females and 505 (76.9%) males, and 514 (78.2%) patients had poor glycemic control. Most of the patients were on insulin mono-therapy [n = 271 (42.1%)], about a third of the patients were on combination therapy that included an oral hypoglycemic agent and insulin [n = 236 (36.6%)]. Patients with a history of more than 10 years of diabetes [n = 293 (44.6%)], had a family history of diabetes [n = 256 (39%)] and obesity [n = 95 (14.5%)], all had poor glycemic control.

Conclusion

This present study indicated a significant association of gender (female), age, high-density lipoprotein level, duration of diabetes and type of medication, with poor glycemic control in T2DM patients that had secondary medical complications.

Citations

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Article
Hematological Evidence of Occupational Exposure to Chemicals and Other Factors among Auto-Repair Workers in Rawalpindi, Pakistan
Atif Kamal, Riffat Naseem Malik
Osong Public Health Res Perspect. 2012;3(4):229-238.   Published online December 31, 2012
DOI: https://doi.org/10.1016/j.phrp.2012.10.003
  • 2,784 View
  • 20 Download
  • 20 Crossref
AbstractAbstract PDF
Objectives
Occupational exposure to aromatic solvents causes many serious health hazards to workers, especially if an ambient environment increases the exposure during routine working hours. This study was conducted on two related groups, i.e., automobile mechanics (MCs) and automobile spray painters (PNs), with an effort to analyze effects of chemical exposure on hematological parameters, keeping a focus on environmental parameters and workers’ personal behavioral characteristics that could be held responsible for increasing exposure risk.
Methods
A preliminary survey of various chemicals used in these places was done, and 78 blood samples were collected from three groups (control, n = 24; mechanics, n = 25; painters, n = 29). Demographic features of workers were recorded through a short questionnaire.
Results

Results
showed that mean red blood cell (RBC) count was lower both in MCs [t(51) = 2.38, p < 0.021, r = 0.32] and in PNs [t(47) = 2.12, p < 0.03, r = 0.29], whereas mean hemoglobin (Hb) was significantly lower in MCs [t(51) = 2.5, p = 0.017, r = 0.33]. Combined data for exposed groups for smokers (SMs) versus nonsmokers (NSs) showed that SMs had a significantly lower number (RBC count: t(52) = 2.28, p < 0.027, r = 0.25; Hb count: t(52) = 2.71, p < 0.009, r = 0.30] of these parameters than NSs, even compared to the control group. Moreover, logistic regression results showed that smoking is a significant predictor of reduction in RBC and Hb counts, besides occupational exposure and work experience to a little extent among exposed workers. Mean white blood cell count [t(47) = 2.63, p < 0.01, r=0.35], mean corpuscle volume [t(47)= –2.82, p = 0.007, r = 0.29], and packed cell volume [t(47)= –2.28, p = 0.027, r = 31] were higher exclusively in painters, which could be related to exposure to benzene in addition to isocyanate.
Conclusion
It appeared that workplace exposure may be complex due to interaction of multiple factors and PNs face much more exposure to isocyanate and aromatic solvents than MCs, which had significant effects on their hematopoiesis. Smoking enhances exposure risk manifolds, and among MCs it showed combined effects along with occupational exposure. There is a need to create awareness among these workers to adopt self-safety measures during routine tasks and also of a separate study to elucidate actual occupational exposure among them, eliminating confounding factors.

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PHRP : Osong Public Health and Research Perspectives