Glycemic and blood pressure control in an asian malay population with diabetes and diabetic retinopathy.

OBJECTIVE: To examine the prevalence of and factors associated with suboptimal glycemic and blood pressure (BP) control in a Malay population with diabetes mellitus in Singapore. METHODS: The Singapore Malay Eye Study was a population-based survey of 3280 Malay individuals (78.7% response rate) aged 40 to 80 years. Diabetes was defined as a nonfasting glucose level of 200 mg/dL or greater, use of diabetic medication, or physician diagnosis. Diabetic retinopathy (DR) was graded from retinal photographs using the modified Airlie House classification. Optimal control was defined as a hemoglobin A(1c) level of less than 7% and BP of 130/80 mm Hg or lower. RESULTS: In participants with diabetes (n = 768), only 26.9% had optimal glycemic and 13.4% optimal BP control, respectively. In those with DR (n = 272), rates of optimal glycemic and BP control were even lower (17.4% and 10.3%, respectively). After adjusting for age, sex, socioeconomic status, and other factors, compared with participants with optimal glycemic control, those with suboptimal control were younger (P = .005), more likely to be unaware of their diabetes status (P < .001), and taking medication for diabetes (P < .001) and had higher levels of total cholesterol (P = .009) and DR (P < .001). After adjusting for similar risk factors, compared with participants with optimal BP control, those with suboptimal BP control were older (P = .006) and more likely to have higher total cholesterol levels (P = .002), BMIs (P = .04), and DR (P = .02). CONCLUSIONS: In this Asian Malay population with diabetes, more than three-quarters had poor glycemic and BP control. Strategies to improve awareness and implement evidence-based guidelines are needed to reduce the effect and burden of diabetic complications in Asia.

Duke Scholars

Author Tien Yin Wong Ophthalmology