Glycemic Status and its Determinants among People Living with Type 2 Diabetes Attending NCD clinics of Health and Wellness Centre–Urban Primary Health Centres of Kalyani, Nadia, West Bengal
Abstract
Background: Prevalence of diabetes is on a rising trend worldwide as well as in India. Diabetes control remains suboptimal in India’s noncommunicable diseases (NCD) clinics despite the implementation of the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD). This study assessed glycemic status and determinants among diabetics attending health and wellness center (HWCs)–urban primary health centers (UPHCs). Materials and Methods: Cross-sectional study of 164 type 2 diabetics (≥6 months duration) consecutively recruited from NCD clinics of two UPHCs in the months of October and November 2025. Glycemic status was determined using hemoglobin A1c (HbA1c) where available, or fasting and postprandial blood glucose values according to the American Diabetes Association criteria. Medication adherence was measured using the Hill–Bone Medication Adherence Scale and blood investigation compliance was measured objectively. Multivariable logistic regression identified determinants of uncontrolled glycemic status, and a sensitivity analysis restricted to participants with HbA1c measurements was performed. Results: The proportion of diabetics with uncontrolled glycemic status was 59.8% (95% confidence interval [CI]: 51.8–67.3). Significant predictors included male gender (adjusted odds ratio [aOR]: 2.59; 95% CI: 1.11–6.05; P = 0.027), obesity (aOR: 0.31; 95% CI: 0.13–0.74; P = 0.008), diabetes duration >5 years (aOR: 4.55; 95% CI: 2.02–10.21; P < 0.001), and blood investigation non-compliance (aOR: 8.47; 95% CI: 3.54–20.28; P < 0.001). Sensitivity analysis yielded findings consistent with the primary analysis. Major barriers to blood investigation non-compliance were inconvenience, waiting time, and forgetfulness. Conclusion: High uncontrolled glycemia (59.8%) among NCD clinic attendees underscores implementation gaps. Male gender, long duration, and investigation non-compliance drive poor outcomes. Point-of-care testing and targeted interventions can optimize primary care diabetes management under the NP-NCD.