Brief report Influencing factors of glycaemic control in patients attending different types of urban health care settings in Malaysia B. Ahmad *, B.A. Khalid, A. Zaini, N.A. Hussain, K.F. Quek Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, 46150 Petaling Jaya, Malaysia 1. Introduction Diabetes is now a global epidemic [1]. The past four decades had witnessed an explosion of diabetes in Malaysia [2,3]. The 3rd National Health Mortality Survey reported prevalence had increased to 11.6% (>18 years) and 14.3% (>30 years) [4]. Of concern, patients are diagnosed younger and hence more exposed to multiple complications, consequently increasing national health cost [5,6]. Malaysia has a complex health care system and adminis- tratively under three ministries; Health, Education and Defence. Additionally, there is a large private health care sector. Patients attending public health settings are heavily subsidised by the government while those attending private health settings are self-financing. Our study is the first large study in Malaysia to include patients from both public and private health care settings from three urban areas. We examined potential influencing factors of HbA1C such as education level, occupation, age group, follow-up frequency, insulin medications and cost involvement. 2. Subjects and methods This is a cross-sectional study, involving primary care, hospital outpatient departments and specialist diabetes clinics. Consecutive patients who attended designated clinics between June 2009 and February 2010 and fulfilled inclusion and exclusion criteria were invited to participate. The main ethnic groups in the study, were representative of Malaysian d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e 9 3 ( 2 0 1 1 ) e 1 2 – e 1 4 a r t i c l e i n f o Article history: Received 5 December 2010 Received in revised form 24 January 2011 Accepted 14 February 2011 Published on line 12 March 2011 Keywords: Glycaemic control Suboptimal Socio-demographic Insulin Ethnicity a b s t r a c t The objective of this study was to elucidate influencing factors of HbA1C in various health care settings. The glycaemic control was suboptimal in all settings. Multivariate analysis confirmed three factors were significant in HbA1C outcome; insulin ( p = 0.000), medication ( p = 0.043) and ethnicity ( p = 0.000). # 2011 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Jalan Lagoon Selatan, 46150 Bandar Sunway, Selangor D.E., Malaysia. Tel.: +60 355146310; fax: +60 355146323. E-mail address: badariah.ahmad@med.monash.edu.my (B. Ahmad). C o n t e n t s l i s t s a v a i l a b l e a t S c i e n c e D i r e c t Diabetes Research and Clinical Practice journal homepage: www.elsevier.com/locate/diabres 0168-8227/$ – see front matter # 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2011.02.020