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Glycemic control among people with diabetes in Ontario: a population-based cross-sectional study


Objective — To determine the distribution of A1c in the population of Ontario with diabetes, and to identify subgroups of the population who are at high risk of poor glycemic control.

Methods — In a cross-sectional study, we used real-world clinical data linked with healthcare administrative data to identify all people with prevalent diabetes on December 31, 2019, and we found their most recent A1c result in the year. The distribution of A1c was examined, and the proportion of people with A1c >8.0% was determined, stratified by various sociodemographic and clinical characteristics.

Results — In the population of 1,009,938 individuals with diabetes, mean and standard deviation A1c was 7.2±1.4%, with 43.4% of the population having an A1c >7.0%, and 19.0% of the population with A1c >8.0%. Younger age, remote location of residence, longer diabetes duration and other surrogates for diabetes severity were associated with poor control.

Conclusions — The mean A1c among people with diabetes in Ontario was 7.2%, but nearly one in five had an A1c above 8%. There were notable disparities in glycemic control that identified several high-risk groups, including younger people, people with longer disease duration, and people living in remote areas. Better clinical and policy approaches are needed to improve diabetes care for these populations.



Shah BR, Lipscombe LL, Booth G. Can J Diabetes. 2021; 45(4):313-8. Epub 2020 Sep 24.

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