Association of Younger Age With Poor Glycemic and Cholesterol Control in Asians With Type 2 Diabetes Mellitus in Singapore

Matthias Paul Han Sim Toh, Christine Xia Wu, Helen Soh Sum Leong


Background: The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents is increasing in both poor and rich countries. Epidemiologic studies have reported significant and continuous associations between HbA1c level and diabetes-related vascular complications. Younger adults with early exposure to hyperglycemia are at high risk for end-organ damage. Few studies have reported the relationship of age to glycemic control in patients with T2DM world-wide and little comparison among young adults and elderly patients especially in the Asian population. This study investigates the relationship of age and glycemic control in Asian patients with T2DM attending primary care clinics in Singapore.

Methods: We included T2DM patients who had at least 2 visits to the public-sector primary care clinic for diabetes treatment in 2009. Demographic characteristics, medical records and laboratory results were extracted from the enterprise-wide chronic disease registry. The mean HbA1c, blood pressure and LDL-cholesterol were trended by age. Multivariate logistic regression was used to identify the factors predicting poor glycemic control.

Results: There were 58,057 T2DM patients and both the mean HbA1c and LDL-cholesterol were lower among elderly than adult patients. Mean HbA1c was 8.08 1.62% for patients < 45 years old and 6.86 0.99% for patients 85+ years old. Mean LDL-cholesterol levels were 2.84 0.81 and 2.55 0.73 mmol/L for the respective age groups. The Malay and Indian groups had significantly poorer glycemic control compared to the Chinese, AdjOR 1.65 (95% CI: 1.54 - 1.77) and 1.50 (95% CI: 1.40 - 1.61) respectively. Other significant predictors of poor glycemic control included the male gender, presence of maculopathy or retinopathy, peripheral vascular disease, coronary heart disease, heart failure, and being on insulin therapy (AdjOR 8.00; 95% CI: 7.54 - 8.48). Patients with poor LDL-c (4.1+ mmol/L) were 4.2 times more likely to have poor glycemic control (95% CI: 3.78 - 4.66) while those with Grade 2 hypertension were 1.5 times (95% CI: 1.35 - 1.76) more likely than those without hypertension.

Conclusions: Younger T2DM patients had poorer glycemic and cholesterol control than older patients in Singapore and they should have targeted interventions to achieve optimal glycemic and cholesterol control.

J Endocrinol Metab. 2011;1(1):27-37


Glycemia; LDL-cholesterol; Control; Younger; Type 2 diabetes mellitus

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.