Factors associated with poor control of type 2 diabetes mellitus: A systematic review
and Meta-analysis
S.S. Sanal, N. S. Nair, P. Adhikari
Abstract
Diabetes is estimated to be responsible for 3.96 million adult deaths per year at
global level. By 2025, the number of people with diabetes in India is estimated
to rise to 70 million. In spite of well-defined treatment for type 2 diabetes, in
majority of the people, disease is poorly controlled. Hence controlling the disease
is a major issue to prevent complications, increase the life expectancy and improve
the quality of life. To find out the factors associated with poor control of diabetes,
a systematic review and meta-analysis was carried out. The data source was Published
and unpublished studies from 1980 to October 2010. Two of the authors applied selection
criteria to get the relevant studies. Glycated hemoglobin level was the measure
for outcome. Meta-analysis was performed by pooling the results of selected studies.
Mantel – Haenszel Odds Ratios, standardized mean differences and 95 % Confidence
Intervals of estimates were calculated for Meta-analysis. The results were presented
using forest plot. Meta-analysis showed that, elderly people and males had better
control on diabetes. Presence of coronary heart disease and non-adherence to diet,
exercise, medication and glucose monitoring are the factors associated with poor
control of diabetes. Neuropathy, retinopathy, renal failure and neurological disorders
are the complications of poor control. In spite of our sincere attempt to consolidate
all studies, which give evidence of factors responsible for poor control of diabetes,
we did not find this as the primary objective in many well-conducted studies. Hence,
this area requires more attention of diabetes researchers.
Keywords:
Health care management, Poor control of diabetes, Meta-analysis