Factors associated with poor control of type 2 diabetes mellitus: A systematic review and Meta-analysis

Diabetes is estimated to be responsible for 3.96 million adult deaths per year at global level. By 2025, the number of people with diabetes in India is estimated to rise to 70 million. In spite of well-defined treatment for type 2 diabetes, in majority of the people, disease is poorly controlled. Hence controlling the disease is a major issue to prevent complications, increase the life expectancy and improve the quality of life. To find out the factors associated with poor control of diabetes, a systematic review and meta-analysis was carried out. The data source was Published and unpublished studies from 1980 to October 2010. Two of the authors applied selection criteria to get the relevant studies. Glycated hemoglobin level was the measure for outcome. Meta-analysis was performed by pooling the results of selected studies. Mantel – Haenszel Odds Ratios, standardized mean differences and 95 % Confidence Intervals of estimates were calculated for Meta-analysis. The results were presented using forest plot. Meta-analysis showed that, elderly people and males had better control on diabetes. Presence of coronary heart disease and non-adherence to diet, exercise, medication and glucose monitoring are the factors associated with poor control of diabetes. Neuropathy, retinopathy, renal failure and neurological disorders are the complications of poor control. In spite of our sincere attempt to consolidate all studies, which give evidence of factors responsible for poor control of diabetes, we did not find this as the primary objective in many well-conducted studies. Hence, this area requires more attention of diabetes researchers.