Clinical significance of barriers to blood glucose control in type 2 diabetes patients with insufficient glycemic control

Figures & data

Figure 1 Prevalence of complications among patients with or without barriers to blood glucose control. (A) Prevalence of macrovascular complications. (B) Prevalence of microvascular complications.

Notes: OR, versus patient group without a barrier. The P-value was calculated with the Fisher’s exact test (two-sided). Macrovascular complication included any one of angina pectoris, myocardial infarction, arteriosclerosis obliterans, or cerebrovascular disease. Microvascular complication included any one of diabetic nephropathy, diabetic retinopathy, or diabetic neuropathy.
Abbreviation: OR, odds ratio.

Table 1 Subject background factors

	n=713
Institution (hospital/clinic)	519/194
Physician’s specialty (Japan Diabetes Society specialist/other)	417/296
Age (years)	63.7±10.6
Male/female (%)	55.9/44.1
BMI (kg/m^2)	24.3±3.9
Diabetes duration (years)	11.6±8.6
HbA1c(NGSP) (%)	8.1±1.2
Using hypoglycemic drug (%)	93.3
Number of oral hypoglycemic drugs	1.4±1.0
Using insulin (%)	25.0
Complicated by hypertension (%)	54.0
Complicated by dyslipidemia (%)	58.9
Macrovascular complications (%)	21.5
Presence of angina pectoris (%)	9.3
Presence of myocardial infarction (%)	3.6
Presence of arteriosclerosis obliterans (%)	5.3
Presence of cerebrovascular disease (%)	9.8
Microvascular complications (%)	51.5
Presence of diabetic nephropathy (%)	24.5
Presence of diabetic retinopathy (%)	31.1
Presence of diabetic neuropathy (%)	32.4

Note: Values are expressed as the mean ± standard deviation (age, BMI, diabetes duration, HbA_1c, and number of oral hypoglycemic drugs), number (institution and physician’s specialty), or frequency (other factors).

Abbreviations: BMI, body mass index; HbA_1c, glycated hemoglobin; NGSP, National Glycohemoglobin Standardization Program.

Figure 2 Barrier to blood glucose control (proportion of responders who said the barrier was present; a comparison between physicians and patients). (A) Total, (B) patients who visited hospitals, and (C) patients who visited clinics.

Note: P-value was calculated with McNemar’s test with the continuity correction.

Table 2 Background factors according to the number of discrepancies in response among physicians and patients

	≤1 item (n=391)	≥2 items (n=322)	P-value*
Age (years)	64.1±10.1	63.2±11.2	0.285
Sex: proportion of females (%)	44.6	43.5	0.762
BMI (kg/m^2)	24.1±3.8	24.6±4.0	0.066
Diabetes duration (years)	11.4±8.3	11.9±8.9	0.491
HbA1c (NGSP) (%)	8.0±1.2	8.1±1.2	0.409
Using hypoglycemic drug (%)	92.8	94.4	0.655
Number of oral hypoglycemic drugs	1.4±1.0	1.5±1.0	0.397
Using insulin (%)	23.8	26.4	0.435
Complicated by hypertension (%)	57.0	50.3	0.082
Complicated by dyslipidemia (%)	58.8	59.0	1.000
Macrovascular complications (%)	22.0	20.8	0.715
Microvascular complications (%)	48.3	55.3	0.071

Notes: Values are expressed as the mean ± standard deviation (age, BMI, diabetes duration, HbA_1c, and number of oral hypoglycemic drugs), or frequency (other factors);

* Student’s t-test for continuous variables, Fisher’s exact test (two-sided) for proportions.

Abbreviations: BMI, body mass index; HbA_1c, glycated hemoglobin; NGSP, National Glycohemoglobin Standardization Program.

Table 3 Background factors according to the presence or absence of barriers to blood glucose control

	Compliance with exercise therapy			Concern for diabetes mellitus			Fear of hypoglycemia
	Feasible compliance (n=314)	Difficult compliance (n=373)	P-value*	With concern (n=645)	Without concern (n=52)	P-value*	Absence of fear (n=308)	Presence of fear (n=320)	P-value*
Age (years)	64.4±11.0	63.4±10.2	0.222	63.5±10.6	65.9±11.5	0.148	62.1±11.1	65.4±10.2	<0.001
Sex: proportion of females (%)	43.3	44.9	0.700	44.3	36.5	0.311	37.8	52.5	<0.001
BMI (kg/m^2)	23.8±3.5	24.8±3.9	<0.001	24.3±3.8	24.9±4.2	0.330	24.4±3.9	24.2±3.9	0.510
Diabetes duration (years)	12.0±8.7	11.7±8.5	0.651	11.5±8.4	12.9±10.4	0.333	11.3±8.9	12.5±8.6	0.075
HbA1c (NGSP) (%)	8.0±1.1	8.1±1.2	0.438	8.0±1.2	8.2±1.1	0.384	8.2±1.2	8.0±1.2	0.160
Using hypoglycemic drugs (%)	90.8	95.7	0.013	93.6	88.5	0.151	92.5	94.3	0.420
Number of oral hypoglycemic drugs	1.5±1.0	1.4±1.0	0.215	1.5±1.0	1.3±1.0	0.394	1.5±1.0	1.4±1.0	0.229
Using insulin (%)	21.0	29.5	0.014	26.0	15.4	0.098	23.7	31.3	0.040
Complicated by hypertension (%)	49.4	58.4	0.021	53.8	53.8	1.000	53.6	53.4	1.000
Complicated by dyslipidemia (%)	56.7	61.1	0.244	60.2	50.0	0.186	58.4	61.3	0.515

Notes: Values are expressed as the mean ± standard deviation (age, BMI, diabetes duration, HbA_1c, and number of oral hypoglycemic drugs), or frequency (other factors).

* Student’s t-test for continuous variables, Fisher’s exact test (two-sided) for proportions.

Abbreviations: BMI, body mass index; HbA_1c, glycated hemoglobin; NGSP, National Glycohemoglobin Standardization Program.