Evaluation of Blood Glycaemia Control and Related Factors in Patients with Type 2 Diabetes Mellitus Using Generalized Estimator Equations (GEE) Model

Qualified care and decreased blood sugar can prevent or suspend the side effects in patients with
type 2 diabetes mellitus. The present study aimed to determine the state of glycemic control and related factors in
patients with type 2 diabetes mellitus in the post-diagnosis care period using generalized estimator equations
(GEE) model.
Methods: In this historical cohort study, data from 500 patients with type 2 diabetes mellitus that were under
care in health centers in Golestan Province, Iran, were collected for three years (2013-2014). For each individual,
the biological markers [fasting blood sugar, non-fasting blood sugar, and glycated hemoglobin (HbA1c)] outside
the standard cut-point were counted as the response variable (called the "count of abnormal markers"). This
variable could have numbers from zero to three. A higher number indicated less glycemic control.
Findings: The mean age of the patients was 45.2 years, and 58.8% were women. The "count of abnormal markers"
variable had a very slow downward trend over three years. The results of the model showed that associated
significant factors with increasing "count of abnormal markers" included short duration of care (b = 0.77),
no family history of diabetes (b = 0.47), low age of diagnosis (b = -0.06), obese-overweight (b = 0.03), having a
history of hyperlipidemia (b = 0.31), and having insulin therapy (b = 0.24).
Conclusion: According to the results, glycemic control does not show the desired condition, and in addition to
continuous care and more strictness of patients, their weight, blood lipids, and insulin treatment should be
controlled as well.