Clinical Outcomes and Predictors of Poor Glycemic Control in Type 2 Diabetes on Basal Bolus Insulin Regime

Introduction National Diabetes Registry showed that insulin used among type 2 diabetic (T2DM) has increased from 23.1% in 2013 to 30.3% in 2019. DiabCare also showed the increment used of basal-bolus among outpatient public hospitals from 10.6% in 2008 to 20.6% in 2013. Despite the increasing use of insulin, three-quarters of patients still do not have good glycemic control. This study aimed to describe the diabetic patients on the basal-bolus regime and the predictors of poor glycemic control. Methodology A cross-sectional study was conducted among T2DM patients on basal-bolus regime attending an endocrine clinic, Putrajaya hospital from January to December 2019. Demographic and clinical profiles were retrieved. Logistic regressions were used to predict factors associated with poor glycemic control (defined as HbA1c >8%). Results There were 789 subjects, 61.1% had HbA1c > 8.0%, with mean HbA1c of 8.87%. The mean age was 57 years, with the majority had a duration of diabetes of more than 10 years. Eighty-one percent of subjects were on combination with oral antidiabetic drugs (OAD). The mean total insulin dose was 86.5unit/day. In multivariate analysis, combinations with OAD (OR 1.73, 95% CI 1.04-2.89); elevated low-density lipoprotein cholesterol (LDL-C) (OR 1.98, 95% CI 1.35-2.92); high fasting plasma glucose (OR 3.64, 95% CI 2.34-5.67) and total insulin requirement/day (OR 1.01, 95% CI 1.01-1.02) were associated with poor glycemic control. Conclusion The glycemic control in our population was suboptimal. Combinations with OAD, higher fasting plasma glucose levels, LDL-C, and total insulin requirement were predictors of poor glycemic control. [Disclaimer: Abstract text might vary slightly from what is displayed in the e-poster]This poster was submitted to the 14th National Conference for Clinical Research (NCCR) in August 18-20, 2021. https://nccrconference.com.my