title: Association of Comorbid and Metabolic Factors with Optimal Control of Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  Type 2 diabetes mellitus (T2DM) is a poorly controlled epidemic worldwide that demands active research into mitigation of the factors that are associated with poor control.
  
  
  OBJECTIVE
  The study was to determine the factors associated with suboptimal glycemic control.
  
  
  METHODS
  Electronic medical records of 263 adult patients with T2DM in our suburban internal medicine office were reviewed. Patients were divided into two groups: Group 1 [optimal diabetes control with glycosylated hemoglobin (HbA1c) of 7% or less] and Group 2 (suboptimal diabetes control with HbA1c greater than 7%). The influence of factors such as age, gender, race, social history, comorbid conditions, gestational diabetes, family history of diabetes, diabetes management, statin use, aspirin use, angiotensin convertase enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use, body mass index (BMI), blood pressures, lipid profile, and urine microalbumin level were analyzed in the two groups.
  
  
  RESULTS
  In the suboptimal diabetes control group (N = 119), the majority (86.6%) of the patients were 41-80 years old. Factors associated with the suboptimal control were male gender [odds ratio (OR) 2.6, 95% confidence interval (CI), 1.579-4.321], Asian ethnicity (OR 1.4, 95% CI, 0.683-3.008), history of peripheral arterial disease (PAD; OR 3.9, 95% CI, 1.017-14.543), history of congestive heart failure (CHF; OR 3.9, 95% CI, 1.017-14.543), elevated triglycerides (OR 1.004, 95% CI, 1.000-1.007), and elevated urine microalbumin level of 30 mg/24 h or above (OR 4.5, 95% CI, 2.446-8.380). Patients with suboptimal diabetes control had a 3.8 times greater odds (95% CI, 1.493-6.885) of receiving the insulin and oral hypoglycemic agent together.
  
  
  CONCLUSIONS
  In adult patients with T2DM, male gender, Asian ethnicity, CHF, PAD, management with insulin along with oral hypoglycemic agents, hypertriglyceridemia, and microalbuminuria were associated with suboptimal control.
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Satyajeet
authors.initials: S
authors.lastname: Roy
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sherman
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Mary Joan
authors.initials: MJ
authors.lastname: Monari-Sparks
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Olga
authors.initials: O
authors.lastname: Schweiker
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Navjot
authors.initials: N
authors.lastname: Jain
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Etty
authors.initials: E
authors.lastname: Sims
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Breda
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Gita P
authors.initials: GP
authors.lastname: Byraiah
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Ryan George
authors.initials: RG
authors.lastname: Belecanech
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Michael Domenic
authors.initials: MD
authors.lastname: Coletta
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Cristian Javier
authors.initials: CJ
authors.lastname: Barrios
authors.affiliation: Department of Biostatistics, Cooper Research Institute, Cooper Medical School of Rowan University, Camden, New Jersey, USA.
authors.forename: Krystal
authors.initials: K
authors.lastname: Hunter
authors.affiliation: Department of Biostatistics, Cooper Research Institute, Cooper Medical School of Rowan University, Camden, New Jersey, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Gaughan
keywords: Asian ethnicity; congestive heart failure (CHF); hypertriglyceridemia; male gender; microalbuminuria; peripheral arterial disease (PAD); suboptimal control of type 2 diabetes; type 2 diabetes mellitus (T2DM)