Inadequate Glycemic Control in Southwestern Bangladesh: A Call for Urgent Intervention

A bstract Context: Effective glycemic management is crucial for preventing long-term diabetes mellitus (DM)-related complications. Amid the rising global prevalence of diabetes, the impact of inadequate glycemic control is increasing significantly, especially in low-income countries. Aims: To assess the glycemic status in the southwestern part of Bangladesh. Materials and Methods: We enrolled 514 adults with type 2 DM through purposive sampling. Baseline clinical and laboratory parameters were collected after obtaining informed consent. Glycemic control was defined by HbA1c (<7% = good, ≥7% = poor). Data were analyzed in SPSS v25 using descriptive statistics, Chi-squared tests, Spearman correlation, and multivariable logistic regression, with no multicollinearity and good model fit (area under the curve = 0.88); results were deemed significant if P < 0.05. Glycemic control was poor in 84.8% (436/514) of participants. Participants with a diabetes duration of less than 5 years had significantly better glycemic control compared to those with a longer duration (55.1% vs. 36.0%, P = 0.006). Similarly, participants who took antidiabetic medication regularly demonstrated better glycemic control than those with irregular intake (67.9% vs. 46.5%, P = 0.001). In multivariable analysis, a longer duration of diabetes was associated with higher odds of inadequate control (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.00–1.11, P = 0.03), while regular medication adherence provided significant protection, reducing the odds of poor glycemic control (OR = 0.40, 95% CI: 0.23–0.69, P = 0.001). Conclusion: The glycemic control among our study participants was notably poor. Therefore, immediate action is necessary to manage diabetes effectively and prevent potential DM-related sequelae.