Key result
High diabetes knowledge with insulin therapy is linked to ~4.6-fold higher odds of target glycemic control.
Why the study?
What demographic, clinical, behavioral, and healthcare management factors—and interactions between patient knowledge or glucose monitoring adherence and insulin therapy—are associated with good glycemic control (HbA1c < 7.0%) in T2DM patients aged ≥40 years under NEPHS management?
Cross-Sectional (n=1,500)
Yes
What demographic, clinical, behavioral, and healthcare management factors—and interactions between patient knowledge or glucose monitoring adherence and insulin therapy—are associated with good glycemic control (HbA1c < 7.0%) in T2DM patients aged ≥40 years under NEPHS management?
Answers are grounded in this paper and cite their sources.
Glycemic control among middle-aged and elderly T2DM patients in China's primary care public health program remains suboptimal at 49.5%, highlighting the importance of periodic HbA1c monitoring, regular exercise, and pairing insulin therapy with high patient diabetes knowledge.
Background This study aimed to explore the demographic characteristics and risk factors of glycemic control among type 2 diabetes mellitus (T2DM) patients aged 40 years and above enrolled in the National Essential Public Health Services (NEPHS) in China, providing scientific evidence for further improving grassroots glycemic control management. Methods A stratified multi-stage sampling method was used to select 1500 patients. Their diabetes management files were retrieved, and questionnaire surveys, physical examinations, and laboratory tests were conducted simultaneously. Skewed quantitative variables were described as median (25th percentile, 75th percentile), and nonparametric rank-sum tests were used for group comparisons. Categorical variables were expressed as frequencies and percentages (%) with group comparisons using χ² tests. Logistic regression with Huber–White (sandwich) standard errors was performed to identify risk factors for glycemic control. Furthermore, interaction models (knowledge level × insulin injection, blood glucose monitoring adherence× insulin injection) were established to evaluate the stratified effects. Results 49.5% of patients achieved good glycemic control (HbA1c < 7.0%). Multivariate analysis revealed that age ≥ 60 years (OR = 1.41, 95% CI: 1.12–1.77, P = 0.003), rural (OR = 1.33, 95% CI: 1.06–1.66, P = 0.012), regular physical exercise (OR = 1.51, 95% CI: 1.21–1.88, P < 0.001), periodic HbA1c monitoring (1 time/year: OR = 1.44, 95% CI: 1.11–1.89, P = 0.007; ≥4 times/year: OR = 1.93, 95% CI: 1.31–2.85, P = 0.001), and comorbid hypertension (OR = 1.31, 95% CI: 1.06–1.62, P = 0.015) were independently cross-sectionally associated with good glycemic control. Conversely, diabetes duration ≥ 10 years (OR = 0.67, 95% CI: 0.50–0.89, P = 0.006), current smoking (OR = 0.66, 95% CI: 0.48–0.91, P = 0.010), moderate knowledge level (OR = 0.61, 95% CI: 0.46–0.81, P = 0.001), treatment status (oral antidiabetic agents only: OR = 0.49, 95% CI: 0.24–0.98, P = 0.045; insulin only: OR = 0.36, 95% CI: 0.15–0.86, P = 0.022), and high blood glucose monitoring adherence (OR = 0.59, 95% CI: 0.41–0.86, P = 0.006) were cross-sectionally associated with poor glycemic control. Interaction analysis demonstrated a significant positive interaction between high knowledge level and insulin therapy (OR = 4.60, 95% CI: 1.78–11.89, P = 0.002). No significant interaction was observed between blood glucose monitoring adherence and insulin therapy ( P > 0.05). Conclusion Glycemic control among aged ≥ 40 years with T2DM under the NEPHS remains suboptimal. Strengthened proactive clinical monitoring and integrated multimorbidity care are warranted to improve primary care diabetes outcomes. The observed knowledge–treatment interaction, while suggesting potential for precision stratified management, requires confirmation through prospective or interventional studies before implementation.
No takes yet. Share an insight, caveat, or question.
Xiao et al. (2026) conducted a cross-sectional in Type 2 diabetes mellitus (T2DM) (n=1,500). High diabetes knowledge level combined with insulin therapy (interaction term; alongside demographic, lifestyle, and healthcare monitoring exposures) vs. Low diabetes knowledge level / no insulin therapy was evaluated on Good glycemic control (HbA1c < 7.0%) (OR 4.60, 95% CI 1.78-11.89, p=0.002). Among 1,500 T2DM patients under NEPHS management, 49.5% achieved HbA1c <7.0%, with a strong positive interaction between high diabetes knowledge and insulin therapy.
Synapse has enriched 10 related papers. Consider them for comparative context: