The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement
BackgroundClinical guidelines for most adults with diabetes recommend maintaining hemoglobin A1c (HbA1c) levels ≤7% (≤53 mmol/mol) to avoid microvascular and macrovascular complications. People with diabetes of different ages, sexes, and socioeconomic statuses may differ in t...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-04-01
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| Series: | JMIR Diabetes |
| Online Access: | https://diabetes.jmir.org/2023/1/e35682 |
| _version_ | 1827857271937302528 |
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| author | Seyedmostafa Mousavi Dana Tannenbaum Greenberg Ruth Ndjaboué Michelle Greiver Olivia Drescher Selma Chipenda Dansokho Denis Boutin Jean-Marc Chouinard Sylvie Dostie Robert Fenton Marley Greenberg Jonathan McGavock Adhiyat Najam Monia Rekik Tom Weisz Donald J Willison Audrey Durand Holly O Witteman |
| author_facet | Seyedmostafa Mousavi Dana Tannenbaum Greenberg Ruth Ndjaboué Michelle Greiver Olivia Drescher Selma Chipenda Dansokho Denis Boutin Jean-Marc Chouinard Sylvie Dostie Robert Fenton Marley Greenberg Jonathan McGavock Adhiyat Najam Monia Rekik Tom Weisz Donald J Willison Audrey Durand Holly O Witteman |
| author_sort | Seyedmostafa Mousavi |
| collection | DOAJ |
| description |
BackgroundClinical guidelines for most adults with diabetes recommend maintaining hemoglobin A1c (HbA1c) levels ≤7% (≤53 mmol/mol) to avoid microvascular and macrovascular complications. People with diabetes of different ages, sexes, and socioeconomic statuses may differ in their ease of attaining this goal.
ObjectiveAs a team of people with diabetes, researchers, and health professionals, we aimed to explore patterns in HbA1c results among people with type 1 or type 2 diabetes in Canada. Our research question was identified by people living with diabetes.
MethodsIn this patient-led retrospective cross-sectional study with multiple time points of measurement, we used generalized estimating equations to analyze the associations of age, sex, and socioeconomic status with 947,543 HbA1c results collected from 2010 to 2019 among 90,770 people living with type 1 or type 2 diabetes in Canada and housed in the Canadian National Diabetes Repository. People living with diabetes reviewed and interpreted the results.
ResultsHbA1c results ≤7.0% represented 30.5% (male people living with type 1 diabetes), 21% (female people living with type 1 diabetes), 55% (male people living with type 2 diabetes) and 59% (female people living with type 2 diabetes) of results in each subcategory. We observed higher HbA1c values during adolescence, and for people living with type 2 diabetes, among people living in lower income areas. Among those with type 1 diabetes, female people tended to have lower HbA1c levels than male people during childbearing years but higher HbA1c levels than male people during menopausal years. Team members living with diabetes confirmed that the patterns we observed reflected their own life courses and suggested that these results be communicated to health professionals and other stakeholders to improve the treatment for people living with diabetes.
ConclusionsA substantial proportion of people with diabetes in Canada may need additional support to reach or maintain the guideline-recommended glycemic control goals. Blood sugar management goals may be particularly challenging for people going through adolescence or menopause or those living with fewer financial resources. Health professionals should be aware of the challenging nature of glycemic management, and policy makers in Canada should provide more support for people with diabetes to live healthy lives. |
| first_indexed | 2024-03-12T12:39:07Z |
| format | Article |
| id | doaj.art-318129f3f8b449fbb1f38506542b5234 |
| institution | Directory Open Access Journal |
| issn | 2371-4379 |
| language | English |
| last_indexed | 2024-03-12T12:39:07Z |
| publishDate | 2023-04-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Diabetes |
| spelling | doaj.art-318129f3f8b449fbb1f38506542b52342023-08-28T23:58:17ZengJMIR PublicationsJMIR Diabetes2371-43792023-04-018e3568210.2196/35682The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of MeasurementSeyedmostafa Mousavihttps://orcid.org/0000-0001-6466-5640Dana Tannenbaum Greenberghttps://orcid.org/0000-0002-1501-4267Ruth Ndjabouéhttps://orcid.org/0000-0002-4716-6505Michelle Greiverhttps://orcid.org/0000-0001-8957-0285Olivia Drescherhttps://orcid.org/0000-0002-4281-6695Selma Chipenda Dansokhohttps://orcid.org/0000-0003-1979-5395Denis Boutinhttps://orcid.org/0000-0003-3641-817XJean-Marc Chouinardhttps://orcid.org/0000-0001-5080-2464Sylvie Dostiehttps://orcid.org/0000-0003-1349-978XRobert Fentonhttps://orcid.org/0000-0003-3192-2633Marley Greenberghttps://orcid.org/0000-0001-7678-8699Jonathan McGavockhttps://orcid.org/0000-0002-3741-5248Adhiyat Najamhttps://orcid.org/0000-0001-9759-5060Monia Rekikhttps://orcid.org/0000-0002-8731-1965Tom Weiszhttps://orcid.org/0000-0002-5285-3238Donald J Willisonhttps://orcid.org/0000-0002-2848-3791Audrey Durandhttps://orcid.org/0000-0001-9290-8603Holly O Wittemanhttps://orcid.org/0000-0003-4192-0682 BackgroundClinical guidelines for most adults with diabetes recommend maintaining hemoglobin A1c (HbA1c) levels ≤7% (≤53 mmol/mol) to avoid microvascular and macrovascular complications. People with diabetes of different ages, sexes, and socioeconomic statuses may differ in their ease of attaining this goal. ObjectiveAs a team of people with diabetes, researchers, and health professionals, we aimed to explore patterns in HbA1c results among people with type 1 or type 2 diabetes in Canada. Our research question was identified by people living with diabetes. MethodsIn this patient-led retrospective cross-sectional study with multiple time points of measurement, we used generalized estimating equations to analyze the associations of age, sex, and socioeconomic status with 947,543 HbA1c results collected from 2010 to 2019 among 90,770 people living with type 1 or type 2 diabetes in Canada and housed in the Canadian National Diabetes Repository. People living with diabetes reviewed and interpreted the results. ResultsHbA1c results ≤7.0% represented 30.5% (male people living with type 1 diabetes), 21% (female people living with type 1 diabetes), 55% (male people living with type 2 diabetes) and 59% (female people living with type 2 diabetes) of results in each subcategory. We observed higher HbA1c values during adolescence, and for people living with type 2 diabetes, among people living in lower income areas. Among those with type 1 diabetes, female people tended to have lower HbA1c levels than male people during childbearing years but higher HbA1c levels than male people during menopausal years. Team members living with diabetes confirmed that the patterns we observed reflected their own life courses and suggested that these results be communicated to health professionals and other stakeholders to improve the treatment for people living with diabetes. ConclusionsA substantial proportion of people with diabetes in Canada may need additional support to reach or maintain the guideline-recommended glycemic control goals. Blood sugar management goals may be particularly challenging for people going through adolescence or menopause or those living with fewer financial resources. Health professionals should be aware of the challenging nature of glycemic management, and policy makers in Canada should provide more support for people with diabetes to live healthy lives.https://diabetes.jmir.org/2023/1/e35682 |
| spellingShingle | Seyedmostafa Mousavi Dana Tannenbaum Greenberg Ruth Ndjaboué Michelle Greiver Olivia Drescher Selma Chipenda Dansokho Denis Boutin Jean-Marc Chouinard Sylvie Dostie Robert Fenton Marley Greenberg Jonathan McGavock Adhiyat Najam Monia Rekik Tom Weisz Donald J Willison Audrey Durand Holly O Witteman The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement JMIR Diabetes |
| title | The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement |
| title_full | The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement |
| title_fullStr | The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement |
| title_full_unstemmed | The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement |
| title_short | The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement |
| title_sort | influence of age sex and socioeconomic status on glycemic control among people with type 1 and type 2 diabetes in canada patient led longitudinal retrospective cross sectional study with multiple time points of measurement |
| url | https://diabetes.jmir.org/2023/1/e35682 |
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