Table 2. Characteristics Associated with Variable Glycemic Control in Adult Patients with Diabetes, Relative to Patients With Good Control,a Hawaii, 2006–2009.
| Characteristic | Poor Control (n = 2,034), OR (95% CI) | Wide Glycemic Variability (n = 76), OR (95% CI) | Some Variability (n = 694), OR (95% CI) |
|---|---|---|---|
| Age, y | |||
| <35 | 2.90 (1.02–8.22) | 7.67 (1.71–34.52) | 1.72 (0.46–6.38) |
| 35–49 | 1.37 (0.89–2.10) | 2.55 (1.15–5.68) | 1.05 (0.64–1.71) |
| 50–64 | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 65–79 | 1.33 (0.69–2.56) | 1.40 (0.52–3.79) | 1.68 (0.83–3.42) |
| ≥80 | 1.03 (0.40–2.68) | 1.21 (0.24–6.17) | 1.49 (0.54–4.10) |
| Sex | |||
| Female | 0.97 (0.69–1.37) | 1.77 (0.95–3.30) | 0.81 (0.56–1.18) |
| Male | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Type of insurance coverage | |||
| Health maintenance organization | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Preferred provider organization | 0.44 (0.26–0.75) | 0.58 (0.22–1.48) | 0.44 (0.25–0.78) |
| Medicare cost contract | 0.28 (0.12–0.62) | 0.30 (0.08–1.19) | 0.23 (0.10–0.56) |
| Morbidity level | |||
| Low | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Highb | 0.62 (0.44–0.87) | 0.80 (0.40–1.57) | 0.69 (0.47–1.01) |
| History of coronary artery disease | |||
| Yes | 1.50 (0.89–2.53) | 2.42 (1.01–5.82) | 1.61 (0.97–2.69) |
| No | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| History of congestive heart failure | |||
| Yes | 0.73 (0.39–1.34) | 1.06 (0.34–3.26) | 0.90 (0.48–1.71) |
| No | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Diabetes duration, y | |||
| ≥10 | 9.20 (5.82–14.54) | 3.48 (1.46–8.32) | 4.76 (2.90–7.81) |
| 8–9 | 5.21 (2.94–9.24) | 1.79 (0.59–5.43) | 3.17 (1.69–5.95) |
| 6–7 | 7.20 (3.84–13.51) | 3.00 (1.02–8.82) | 4.08 (2.09–7.98) |
| 4–5 | 2.91 (1.66–5.12) | 1.14 (0.38–3.46) | 2.18 (1.18–4.02) |
| 1–3 | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| No of medicationsc | |||
| ≥15 | 2.08 (1.23–3.54) | 1.54 (0.65–3.69) | 2.10 (1.16–3.81) |
| 10–14 | 1.58 (0.95–2.63) | 0.42 (0.15–1.18) | 0.84 (0.52–1.34) |
| 5–9 | 0.75 (0.49–1.15) | 0.37 (0.15–0.90) | 0.84 (0.53–1.34) |
| 0–4 | 1 [Reference] | 1 [Reference] | 1 [Reference] |
Abbreviations: OR, odds ratio; CI, confidence interval.
a Poor control indicates patients who had a mean HbA1c higher than 9% for 3 years (2007–2009) after the baseline year (2006); wide glycemic variability indicates patients who had a reduction in annual mean HbA1c from higher than 9% to less than 7%, followed by an increase to higher than 9% for 3 years after the baseline year; some glycemic variability indicates patients who did not meet criteria for any of the first 3 categories. Patients with good control achieved and maintained a mean HbA1c of less than 7% for 3 years after the baseline year.
b High morbidity was defined according to the Johns Hopkins Adjusted Clinical Groups methodology; levels of 4 or 5 on the 5-point scale were considered high morbidity (23).
c Count of all medications taken by a patient during a given year.