Results

A total of 1,509 clinical records were assessed for eligibility. After applying the inclusion and exclusion criteria, 514 records were excluded, and 995 patients with T2DM were included in the final analysis. Of these, 780 (78.4%) were treated with oral antidiabetic therapy alone, while 215 (21.6%) received combined insulin plus oral antidiabetic therapy. Baseline demographic and clinical characteristics according to type of antidiabetic treatment are shown in Table 1.

Characteristic | Oral antidiabetic therapy (n=780) | Combined insulin plus oral antidiabetic therapy (n=215) | Test statistic | P-value
Age (years), mean±SD | 54.43±12.08 | 58.28±11.54 | t=-4.18 | <0.001
Duration of T2DM (years), mean±SD | 8.42±8.23 | 16.06±9.15 | t=-11.07 | <0.001
Systolic blood pressure (mmHg), mean±SD | 135.59±19.44 | 134.70±21.61 | t=0.55 | 0.586
Diastolic blood pressure (mmHg), mean±SD | 81.78±10.65 | 79.11±11.36 | t=3.20 | 0.001
Height (m), mean±SD | 1.60±0.10 | 1.58±0.10 | t=2.77 | 0.006
Weight (kg), mean±SD | 77.36±18.10 | 72.35±16.96 | t=3.64 | <0.001
BMI (kg/m²), mean±SD | 29.96±5.81 | 28.87±6.00 | t=2.41 | 0.016
HbA1c (%), mean±SD | 9.15±2.32 | 9.94±2.19 | t=-4.46 | <0.001
Sex, n (%)
Male | 296 (37.9%) | 57 (26.5%) | χ²=9.63 | 0.002
Female | 484 (62.1%) | 158 (73.5%)
BMI category, n (%)
Normal weight | 150 (19.2%) | 50 (23.3%) | χ²=5.04 | 0.080
Overweight | 285 (36.5%) | 88 (40.9%)
Obesity | 345 (44.2%) | 77 (35.8%)

Patients receiving combined insulin plus oral antidiabetic therapy were older than those receiving oral therapy alone and had a longer duration of T2DM. The combined therapy group also had higher HbA1c levels and a lower mean BMI. Sex distribution differed significantly between groups, with a higher proportion of women in the combined insulin plus oral antidiabetic therapy group. BMI category distribution did not differ significantly between treatment groups.

Overall, 192 patients (19.3%) achieved adequate glycemic control, whereas 803 (80.7%) were uncontrolled. Glycemic control according to type of antidiabetic treatment is shown in Table 2.

Type of antidiabetic treatment | Uncontrolled n (%) | Controlled n (%) | Total
Oral antidiabetic therapy | 608 (77.9%) | 172 (22.1%) | 780
Combined insulin plus oral antidiabetic therapy | 195 (90.7%) | 20 (9.3%) | 215
Total | 803 (80.7%) | 192 (19.3%) | 995

The proportion of patients achieving glycemic control was higher in the oral antidiabetic therapy group than in the combined insulin plus oral antidiabetic therapy group. Although the difference was statistically significant, the strength of association was small based on Cramer's V.

A multivariable logistic regression model was performed to evaluate the independent association between type of antidiabetic treatment and glycemic control after adjustment for age, sex, duration of T2DM, and BMI. The results are shown in Table 3.

Variable | Adjusted OR | 95% CI | P-value
Oral antidiabetic therapy vs. combined insulin plus oral antidiabetic therapy | 2.35 | 1.40-3.93 | 0.001
Age | 1.028 | 1.013-1.044 | <0.001
Sex, male vs. female | 1.00 | 0.72-1.41 | 0.982
Duration of T2DM | 0.966 | 0.944-0.988 | 0.003
BMI | 1.017 | 0.989-1.046 | 0.226

In the adjusted model, oral antidiabetic therapy was independently associated with higher odds of achieving glycemic control compared with combined insulin plus oral antidiabetic therapy. Age was positively associated with glycemic control, while longer duration of T2DM was negatively associated. Sex and BMI were not independently associated with glycemic control.