Factors Associated With Glycemic Control among Type 2 Diabetes Mellitus Patients in Primary Care Network, Song Khwae District, Nan Provice

Abstract

This retrospective analytical study aimed to determine the proportion of patients achieving glycemic control and to identify factors associated with glycemic control among patients with type 2 diabetes mellitus in the primary care network of Song Khwae District, Nan Province. The network comprised seven healthcare facilities: one community hospital, three subdistrict health-promoting hospitals, and three community health service units. All six subdistrict health-promoting hospitals and community health service units had been transferred to the Nan Provincial Administrative Organization. Secondary data were obtained from electronic medical records and health information systems covering fiscal years 2023–2025. Glycemic control was defined as HbA1c <7.0%. Data were analyzed using descriptive and inferential statistics for between-group comparisons, as well as multiple logistic regression. The study was conducted from January to March 2026.

The results showed that 436 patients were included in the study. Of these, 202 patients (46.33%) achieved glycemic control, whereas 234 patients (53.67%) did not achieve glycemic control. Multivariable complete-case analysis involving 243 patients showed that low HDL-C was associated with lower odds of achieving glycemic control (adjusted OR = 0.278, 95% CI = 0.087–0.888, p = 0.031), whereas patients who were not receiving insulin had higher odds of achieving glycemic control than those receiving insulin (adjusted OR = 2.530, 95% CI = 1.276–5.017, p = 0.008). In conclusion, although glycemic control in the study area showed an improving trend, more than half of the patients remained unable to achieve the glycemic target. Risk stratification and proactive follow-up should therefore be strengthened, particularly for patients with metabolic abnormalities and greater treatment complexity.