The effect of comorbidities on glycemic control among Colombian adults with diabetes mellitus: a longitudinal approach with real-world data
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Fecha
2021
Autores
Urina-Jassir, Manuel
Herrera-Parra, Lina Johana
Hernández Vargas, Juliana Alexandra
Valbuena-García, Ana María
Acuña-Merchán, Lizbeth
Urina-Triana, Miguel
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BMC
Resumen
Background: Achieving an optimal glycemic control has been described to reduce the incidence of diabetes
mellitus (DM) related complications. The association between comorbidities and glycemic control remains unclear.
Our aim is to evaluate the effect of comorbidities on glycemic control in people living with DM.
Methods: A retrospective longitudinal study on data from the National Registry of Chronic Kidney Disease from
2014 to 2019 in Colombia. The outcome was poor glycemic control (PGC = HbA1c ≥7.0%). The association
between each comorbidity (hypertension (HTN), chronic kidney disease (CKD) or obesity) and PGC was evaluated
through multivariate mixed effects logistic regression models. The measures of effect were odds ratios (OR) and
their 95% confidence intervals (CI). We also evaluated the main associations stratified by gender, insurance, and
early onset diabetes as well as statistical interaction between each comorbidity and ethnicity.
Results: From 969,531 people at baseline, 85% had at least one comorbidity; they were older and mostly female. In
people living with DM and CKD, the odds of having a PGC were 78% (OR: 1.78, CI 95%: 1.55-2.05) higher than those
without CKD. Same pattern was observed in obese for whom the odds were 52% (OR: 1.52, CI 95%: 1.31-1.75)
higher than in non-obese. Non-significant association was found between HTN and PGC. We found statistical
interaction between comorbidities and ethnicity (afro descendant) as well as effect modification by health
insurance and early onset DM.
Conclusions: Prevalence of comorbidities was high in adults living with DM. Patients with concomitant CKD or
obesity had significantly higher odds of having a PGC.
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Palabras clave
Glycated hemoglobin A1c, Diabetes mellitus, Comorbidity, Hypertension, Chronic kidney Disease, Obesity
