Prevalence and predictors of poor glycemic control in patients with type 2 diabetes mellitus attending Alexandria Main University Hospital

Objective. Despite the advances in diabetes management, there is still a high prevalence of poor glycemic control worldwide. This study aimed to determine the prevalence and predictors of poor glycemic control among patients with type 2 diabetes mellitus (T2DM) attending the outpatient clinic at Alexandria Main University Hospital (AMUH) Egypt. Methods. This cross-sectional study was conducted on 290 patients with T2DM. Data were collected on sociodemographic factors, medical history, comorbidities, lifestyle behaviors, medication adherence, and biochemical measures. Statistical analyses including correlation and regression models were used to explore the relationships between various factors and glycemic control. Results. The study revealed that 82.8% of participants had uncontrolled diabetes. Poor glycemic control was significantly associated with older age, lower education, rural residence, unemployment, and lower income. Additionally, patients with uncontrolled diabetes had higher rates of hypertension, dyslipidemia, ischemic heart disease, and diabetic peripheral neuropathy. Better physical activity and dietary adherence were linked to improved glycemic control, while medication adherence was significantly lower in the uncontrolled group. Among the significant predictors, physical activity (ORs=116.6–575.8) was the strongest predictor of improved diabetes control. Moreover, medication adherence (OR=4.098) and higher education (OR=8.354) were strongly associated with better diabetes control. Conclusions. Socioeconomic factors, lifestyle behaviors, and medication adherence are key predictors of glycemic control in T2DM patients. Physical activity, medication adherence, and higher education were the strongest predictors of better glycemic control. Addressing these factors through targeted interventions, particularly in rural areas, is crucial for improving diabetes management and reducing the related complications.