Prevalence and Underlying Determinants of Glycemic Control Among Diabetic Patients in Bangladesh: A Cross-Sectional Study.

Background and Aims: Bangladesh is experiencing a rapid rise in the prevalence of diabetes mellitus (DM), imposing a significant public health challenge. Identifying the predictors of glycemic control can inform targeted intervention. The study aimed to examine the sociodemographic, behavioral, and clinical factors associated with glycemic control and to estimate their relative contributions among DM individuals. Methods: A cross-sectional study was conducted among 500 DM individuals attending outpatient clinics in Dhaka. Data on sociodemographic, DM history and awareness, health-related behaviors, and comorbidities were collected through structured questionnaires and medical records. Glycemic control was categorized by HbA1c levels as poor ( ≥ 8%), fair (7-7.9%), and good ( < 7%). Ordinal logistic regression was performed to identify the predictors of good glycemic control and hierarchical regression analyses were applied to assess the variance by different domains of factors. Results: Among participants, 33% had poor glycemic control, 15% had fair control, and only 52% achieved good control. Males were more likely than females to attain good glycemic control (Adjusted odds ratio [AOR] = 2.56, 95% confidence interval [CI]: 1.06-3.56). Individuals with higher secondary education or above had greater odds of achieving good control (AOR = 2.45, 95% CI: 1.07-5.39). Conversely, a DM duration ≥ 12 years reduced the odds of good control by 58%. High DM knowledge (AOR = 7.97, 95% CI: 3.53-17.99), adherence to diet (AOR = 2.99, 95% CI: 1.65-5.41), and physical activity (AOR = 1.84, 95% CI: 1.04-3.26) were significant positive predictors. Hierarchical regression analysis showed that DM history/awareness and health-related behaviors accounted for most of the explained variance, while sociodemographic factors and comorbidities contributed less. The full model explained 23.7% of the variance. Conclusions: DM history and awareness, along with health behavior, were most influential determinants of glycemic control. Education and behavior-focused interventions should be prioritized in DM management to improve outcomes and reduce the growing burden of DM in Bangladesh.