Factors associated with glycemic control level among Type 2 Diabetes Mellitus patients at Public Health Centers in Bangkok, Thailand

Abstract

Background: Type 2 Diabetes Mellitus becomes a major health problem in many countries. Consequently, Type 2 DM is one of important public health problems in Thailand. In 2019, there are 14,025 registered cases of Type 2 DM that received health care services at 68 Public Health Centers, Bangkok Metropolitans Administration while 7,283(52%) of them were uncontrolled blood sugar; HbA1C ≥ 7% , and 6,742 (48%) were control blood sugar level; HbA1C <7% (BMA, 2019).

Objective: This study aims to determine the proportion of uncontrolled and controlled level of glycemic control, to explore levels of self-efficacy, self-care behaviors, and social support, and to identify the influencing factors on Glycemic Control among Type 2 DM patients at Public Health Centers in Bangkok, Thailand. Last, this study aims to describe which social support channels that Type 2 DM patients at Public Health Centers in Bangkok, Thailand acquires.

Method: A Cross-sectional Study was used in this study. 411 participants from 5 Public Health Centers, Bangkok Metropolitan Administration (BMA) was conducted in this study by face-to-face interview based on the questionnaire. Sampling technique, this study used purposive sampling and simple random sampling technique. Descriptive statistics were used to describe the characteristics of participants. The bivariate analysis was used to identify factors associated (a crude odds ratio) with glycemic control level (p-value < 0.2). A multivariable model (binary logistic regression analysis) was used to identify factors associated (an adjusted odds ratio) with the dependent variable (glycemic control level). The association was declared significant at p-value < 0.05.

Result: 214 (52.1%) of participants were controlled glycemic level (HbA1C<7%), while 197(47.9%) of participants were uncontrolled glycemic level (HbA1C ³ 7%). Most of the Participants had medium self-efficacy 248(60.3), medium self-care behavior 248(60.3), and moderate social support 129(31.4). Adjusted Odds Ratio of uncontrol glycemic control increased with higher level of self-efficacy, self-care behavior, and social support. 110(55.8) of participants who acquired social support from the doctor (secondary social support group) with control glycemic level (HbA1C <7%). 52(44.4) of participants who acquired social support from their family (primary social support group) with control glycemic level (HbA1C <7%).

Conclusion: The findings of this study could be used to develop an intervention program for Type 2 DM patients, patient group, family, friends, and public health volunteers at Public Health Centers in Bangkok (BMA)in order to improve the glycemic control level.