Self-awareness of HbA1c and its association with glycemic control among patients with type 2 diabetes: A multicenter study

Abstract Background Diabetes-related complications can be prevented by maintaining good glycemic control. Despite huge efforts to obtain acceptable glycemic control among diabetics, this has not yet been achieved. Thus, there is a need to discover all factors that might affect glycemic control. Here, our main aim was to assess the association between self-awareness of Hemoglobin A1c (HbA1c) among Saudi patients with type 2 diabetes and glycemic control, thereby identifying those factors that might affect the glycemic control. Methods The data for this study was collected using questionnaires through interviews among 600 patients with type 2 diabetes. The study was conducted in outpatient diabetes clinics in tertiary hospitals in Riyadh, Qassim and Jeddah, Saudi Arabia. The data collection was done during the period from March and April 2018. The subject’s self-awareness about the HbA1c test was assessed based on the combined score of four questions. The latest HbA1c result before the time of data collection was obtained from medical records. Frequencies and percentages were calculated for all categorical variables used in the analysis. Means and standard deviations were calculated for continuous variables. A p-value of less than 0.05 was considered statistically significant for all analyses. Results The mean age of the respondents was 54.7 years, and the mean duration of diabetes was 11.9 years. The prevalence of HbA1c self-awareness was approximately 40%. Overall, 63.9% accurately reported their Hemoglobin A1C Self-Knowledge (HbA1csk). The prevalence of good glycemic control (defined as HbA1c less than 7.0%) was 21.0%. Five of the participants’ characteristics were associated with better glycemic control: good HbA1c self-awareness (OR = 3.25, 95%CI: 1.15–9.24), duration of diabetes (negatively associated with glycemic control) (OR = 0.91, 95%CI: 0.87–0.95), discussed HbA1c target with the health care provider (OR = 2.42, 95%CI: 1.22–4.79), monthly income between 10,001 and 15,000 SR (OR = 2.28, 95%CI: 1.13–4.60), and number of follow up visit (OR = 0.77, 95%CI: 0.63–0.94). Conclusions We conclude that there is a positive association between HbA1c self-awareness and glycemic control. Glycemic control was good among those who were educated about the meaning of the test, their levels, and their target goal. Awareness among health care providers regarding the role of the patient’s education about their condition might help in providing the patient with optimal care. Further studies with different experimental designs are needed to study this association, which will contribute to the development of a structured educational program.