Identification of Risk Markers for Poorly Controlled Type 2 Diabetes Mellitus: A Retrospective Cross-Sectional Study with Focus on Quality Assurance Based on Real World Data30

Introduction: Poor glycemic regulation in type 2 diabetes mellitus (T2DM) significantly increases the risk of complications. Therefore, we determined the prevalence of poorly controlled T2DM at a large inner-city out-patient clinic in Denmark and identified risk markers for poorly controlled T2DM. Methods: Data were collected retrospectively on all diabetes patients attending at the out-patient clinic in 2016. Patients attending at the clinic > 2 yrs were categorized by HbA1c as tightly controlled (≤ 50 mmol/mol/ 6.7 %; n=46) or poorly controlled (≥ 75 mmol/ mol/ 9.0 %; n=108) and compared across 55 variables. Results: 313 out of 1202 (26 %) were poorly controlled T2DM patients. Poorly controlled patients had longer duration of diabetes (10.0 vs. 8.5 yrs), higher LDL values (2.34 vs. 1.86 mmol/L), higher triglyceride levels (2.15 vs. 1.63 mmol/L), received more diabetes drugs (3 vs. 2), had more insulin prescribed (85% vs. 52 %), more retinopathy (51% vs. 20%), more comorbidities (2 vs. 1), higher Charlson comorbidity index (4 vs. 3), more yearly consultations (4 vs. 3), and more often another anticipated place of origin than Denmark (57 % vs. 24 %) compared to tightly controlled patients. Conclusion: Risk markers for poorly controlled T2DM were a more pronounced metabolic syndrome and anticipated place of origin, and not clinical inertia, patient attendance at the outpatient clinic nor compliance to medication.