Prevalence and Factors Associated with Poor Glycemic Control Among Patients with Type 2 Diabetes Mellitus Attending a Tertiary Care Hospital in Khyber Pakhtunkhwa, Pakistan: A Cross-Sectional Study.

Original Article

Abstract

Objective: To assess the prevalence of poor glycemic control and identify independent factors associated with poor glycemic control in T2DM patients in the diabetes outpatient clinic of a tertiary care hospital.

Methodology: This cross-sectional study was conducted in the Department of Medicine, Mardan Medical Complex, Mardan, over six months (January to March 2026). We consecutively recruited patients with T2DM diagnosed for ≥3 months (n=400). We defined poor glycaemic control as HbA1c ≥7%. We assessed physical activity, adherence, income, and follow-up. We analyzed data using SPSS 26.0 and Python. Logistic regression identified factors associated with poor glycaemic control. We assessed model performance using the Hosmer–Lemeshow test, AUC, bootstrap resampling, and 10-fold cross-validation.

Results: Poor glycaemic control was observed in 60.8% (243/400; 95% CI, 56.0–65.5%) of patients. On multivariable analysis, poor glycaemic control was independently associated with physical inactivity, poor dietary and medication adherence, overweight/obesity, insulin-containing regimens, absence of self-monitoring of blood glucose, diabetes duration >5 years, and low household income. Rural residence, hypertension, and current smoking were significant on univariate analysis but not after multivariable adjustment. The model showed acceptable discrimination, with an apparent AUC of 0.78 and an internally validated AUC of 0.74–0.75.

Conclusions: The T2DM outpatients had poor glycemic control at their last visit. The identified associated factors were mostly modifiable with structured lifestyle counseling, adherence support, interventions, and self-management education, and warrant assessment in future interventional studies.