Background Diabetes mellitus (DM) is a highly prevalent chronic disease worldwide and is frequently accompanied by comorbidities such as hypertension and dyslipidemia, which substantially impair patients’ quality of life and clinical prognosis. This study aimed to determine the prevalence of comorbidities (hypertension, dyslipidemia), evaluate metabolic control status (blood glucose, blood pressure BP, lipids), and identify predictors of poor metabolic attainment among patients with DM in Guangdong Province, China, thereby providing evidence to inform targeted management strategies. Methods A cross-sectional study conducted from 2018 to 2020 enrolled 1575 patients with DM from the China National Diabetic Chronic Complications Study Cohort, recruiting participants across four geographically distinct regions of Guangdong Province. Data were collected through questionnaires, physical examinations, and laboratory assessments. The metabolic targets were defined as glycosylated hemoglobin (HbA1c) <7.0%, BP <130/80 mmHg, and low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/L. Descriptive statistics and multivariate logistic regression analyses were performed. Results The 1575 participants (47.9% male, 52.1% from urban areas) had a median age of 58.8 years, body mass index (BMI) of 24.7 kg/m², HbA1c of 7.1%, BP of 134/78 mmHg, and LDL-C of 3.4 mmol/L. Comorbidities were highly prevalent, with 771 patients (49.0%) having both hypertension and dyslipidemia. Achievement of individual metabolic targets was suboptimal: 46.7% for HbA1c, 17.1% for LDL-C, and 11.5% for BP. Only 4.6% achieved all three metabolic targets. Among patients with comorbidities, awareness was better for hypertension (67.2%) than that for dyslipidemia (28.4%). The prevalence of diabetic kidney disease (DKD) (44.5% vs. 14.8%) and cardiovascular disease (CVD) (6.6% vs. 1.9%) were significantly higher in the group with both comorbidities than in the DM-only group (both P < 0.001). Alarmingly, 17.4% of patients with uncontrolled HbA1c, 93.1% of those with uncontrolled LDL-C, and 44.5% of those with uncontrolled BP were not receiving any corresponding medications. Guideline-recommended therapies were underutilized. Key predictors of poor metabolic control included rural residence (OR = 1.767), DM duration ≥ 10 years (OR = 4.094), and age 50–70 years. Conclusions Suboptimal management of comorbidities, critically low rates of metabolic target attainment, and underuse of guideline-recommended therapies indicate substantial gaps in DM care in Guangdong. Urgent region-specific interventions, focusing on screening, patient education, and optimized pharmacotherapy, are warranted to improve comprehensive metabolic control and reduce diabetes-related complications.
Chen et al. (Mon,) studied this question.
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