Glycemic control in diabetes with metabolic syndrome in community hospital.

ABSTRACT

OBJECTIVE: To identify the prevalence of the metabolic syndrome in type 2 diabetic patients of Hangchat Community Hospital and to compare glycemic control between patients with and without metabolic syndrome. MATERIAL AND METHOD: A cross-sectional, hospital-based study was done in type 2 diabetic patients attending the DM Clinic of Hangchat Community Hospital in July 2007. The patients who have followed up in the diabetic clinic for at least one year, were assessed for the presence of metabolic syndrome using the criteria proposed by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). Demographic data, co-morbid diseases, concurrent medications, fasting plasma glucose, and hemoglobin A1C (HbA1c) were collected and compared among patients with and without metabolic syndrome. RESULTS: Three hundred twenty five patients (64.9% female) with mean age +/- SD of 57.8 +/- 11.1 years were analyzed. The prevalence of metabolic syndrome in diabetes was 84.0%. Only 29.7% of all patients could meet American Diabetes Association (ADA) goal for HbA1c control (lower than 7%). Compared with those patients without metabolic syndrome, the diabetic patients with metabolic syndrome had lower education, lower income, and lower proportion of achieving good blood pressure control (below 130/80 mmHg). The triglyceride levels of the metabolic syndrome group were higher and the HDL-C levels were lower than the other group. Mean HbA1c levels were not different between diabetes with and without metabolic syndrome (8.0 +/- 1.8% and 8.1 +/- 2.0%, respectively). CONCLUSION: The prevalence of metabolic syndrome was about four-fifths in type 2 diabetic patients. Similar to the diabetic patients without this syndrome, the glycemic control of the majority still had not reached the standard of diabetic care. The treatment of metabolic syndrome itself as an independent risk factor should be considered in diabetic patients.