Factors associated with poor glycemic control in older Mexican American diabetics aged 75 years and older

Objective: This study examines the prevalence and correlates of poor glycemic control in Mexican Americans aged 75 years and older with diabetes. Methods: Data are from the 5 ^th wave (2004-05) of the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE). A total of 2,069 Mexican Americans aged 75 and over were interviewed. Six hundred eighty nine subjects (33.5%) reported having been diagnosed with diabetes and 209 (30.3%) subjects agreed to a blood test of their HbA ₁c level. Results: Of the 209 diabetic subjects with an HbA ₁c test, 73 (34.9%) had good glycemic control (HbA ₁c < 7%) and 136 (65.1%) had poor glycemic control (HbA ₁c > 7%). Bivariate analysis revealed that subjects with poor control had longer disease duration, had lower education, used the glucometer more frequently, and had more diabetes-complications when compared to those in the good glycemic control group. Multivariable logistic regression analysis found the following factors associated with poor glycemic control: < 8 years of education, foreign-born, smoking, obesity, longer disease duration, daily glucometer use, and having macro-complications. Discussion: Prevalence of poor glycemic control is very high in this population with very high and rising prevalence of diabetes. Further studies are needed to explore the effect of these and other characteristics on glycemic control among older Mexican Americans and to develop appropriate interventions to improve diabetes outcomes and increase life-expectancy.