Factors influencing the optimal glycemic levels in type 2 diabetes mellitus patients attending the diabetic clinic of a tertiary care hospital in New Delhi

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BACKGROUND: Optimal glycaemic control is essential for preventing complications of type 2 diabetes mellitus (T2DM), yet a large proportion of patients fail to achieve recommended glycaemic targets even in tertiary care settings. Identifying independent behavioural and treatment-related determinants of glycaemic control is crucial for improving diabetes management. METHODS: A hospital-based analytical cross-sectional study was conducted among 416 adult patients with T2DM attending the diabetic outpatient department of a tertiary care hospital. Data were collected using a structured, pre-tested questionnaire covering sociodemographic profile, lifestyle practices, treatment adherence, and healthcare access. Glycaemic control was assessed using HbA1c values and categorized as optimal (< 7%) and poor (≥ 7%). Descriptive statistics, chi-square test, Spearman correlation, and multivariable logistic regression were applied using IBM SPSS Statistics for Mac (Version 31.0). RESULTS: Optimal glycaemic control was observed in 239 (57.5%) participants, while 177 (42.5%) had poor control. Higher physical activity, adherence to a diabetic diet, and consistent medication adherence were significantly associated with optimal glycaemic control in bivariate analysis (p < 0.05). Spearman correlation showed a strong positive correlation between medication adherence and glycaemic control, followed by physical activity and regular follow-up. In multivariable regression analysis, medication adherence, physical activity, and regular follow-up emerged as significant independent predictors of optimal glycaemic control, whereas sociodemographic factors showed weaker adjusted effects. CONCLUSION: Glycaemic control among patients with T2DM is predominantly influenced by modifiable behavioural and treatment-related factors. Strengthening medication adherence counselling, lifestyle modification, and structured follow-up within tertiary care diabetes clinics may substantially improve glycaemic outcomes and reduce the long-term burden of diabetes-related complications. CLINICAL TRIAL NUMBER: Not applicable.

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