Association between Oral Hypoglycemic Agents, Insulin and Lifestyle Modifications on Glycemic Control among Type 2 Diabetes Patients in Thailand: National Survey in 2011.

Background: Oral hypoglycemic agents (OHA), insulin, and lifestyle modifications are commonly prescribed to Type 2 diabetes (T2DM) patients to control their blood glucose level and prevent severe complications. However, the effects in clinical care at national level had never been evaluated. Objective: To quantify effects of oral hypoglycemic agents (OHA), insulin, and lifestyle modifications on glycemic control among T2DM patients in Thailand. Material and Method: The present paper was a part of the study involved in the national representative sample of 59,750 patients with T2DM and/or hypertension based on medical records, conducted at 548 hospitals in Thailand in 2011.The level of HbA1c was the target of the present study. Multiple logistic regression was used to obtain the magnitude of the effects of OHA, insulin, and lifestyle modifications on glycemic control. Results: Among the 20,328 T2DM patients, only 2.2% were prescribed lifestyle modifications, 82.6% were on OHA alone, 4.2% were on insulin alone, and 11.0% were both insulin and OHA. About 35.3 % (95%CI: 34.5 to 36.0) achieved glycosylated hemoglobin (HbA1c) controlled. Patients with lifestyle modifications were 4.1 times (OR= 4.1, 95%CI: 3.0 to 5.7) the odds of achieving HbA1c controlled comparing to those taking OHA alone after adjusting the various factors. Conclusion: Type 2 diabetes patients who took lifestyle modifications were more likely to reach the target HbA1c level than those who took OHA alone. [ABSTRACT FROM AUTHOR]