Factors influencing the optimal glycemic levels in type 2 diabetes mellitus patients attending the diabetic clinic of a tertiary care hospital in New Delhi

Background Optimal glycaemic control is essential for preventing complications of type 2 diabetes mellitus (T2DM), yet a large proportion of patients fail to achieve recommended glycaemic targets even in tertiary care settings. Identifying independent behavioural and treatment-related determinants of glycaemic control is crucial for improving diabetes management. Methods A hospital-based analytical cross-sectional study was conducted among 416 adult patients with T2DM attending the diabetic outpatient department of a tertiary care hospital. Data were collected using a structured, pre-tested questionnaire covering sociodemographic profile, lifestyle practices, treatment adherence, and healthcare access. Glycaemic control was assessed using HbA1c values and categorized as optimal (< 7%) and poor (≥ 7%). Descriptive statistics, chi-square test, Spearman correlation, and multivariable logistic regression were applied using IBM SPSS Statistics for Mac (Version 31.0). Results Optimal glycaemic control was observed in 239 (57.5%) participants, while 177 (42.5%) had poor control. Higher physical activity, adherence to a diabetic diet, and consistent medication adherence were significantly associated with optimal glycaemic control in bivariate analysis ( p < 0.05). Spearman correlation showed a strong positive correlation between medication adherence and glycaemic control, followed by physical activity and regular follow-up. In multivariable regression analysis, medication adherence, physical activity, and regular follow-up emerged as significant independent predictors of optimal glycaemic control, whereas sociodemographic factors showed weaker adjusted effects. Conclusion Glycaemic control among patients with T2DM is predominantly influenced by modifiable behavioural and treatment-related factors. Strengthening medication adherence counselling, lifestyle modification, and structured follow-up within tertiary care diabetes clinics may substantially improve glycaemic outcomes and reduce the long-term burden of diabetes-related complications. Clinical trial number Not applicable.