Glycemic Control Among People With Diabetes in Ontario: A Population-Based Cross-Sectional Study

Objectives: Our aim in this study was to determine the distribution of glycated hemoglobin (A1C) in the Ontario diabetes population and identify subgroups with a high risk of poor glycemic control. Methods: In this cross-sectional study, we used real-world clinical data linked with health-care administrative data to identify all people with prevalent diabetes on December 31, 2019. We then identified their most recent A1C result during the year. The distribution of A1C was assessed, and the proportion of those with an A1C of >8.0% was determined, stratified by various sociodemographic and clinical characteristics. Results: In the population of 1,009,938 individuals with diabetes, mean +/- standard deviation A1C was 7.2 +/- 1.4%, with 43.4% of them having an A1C of >7.0% and 19.0% with an A1C of >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 20% had an A1C of >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. (c) 2020 Canadian Diabetes Association.