Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador

Abstract Background Type 2 diabetes mellitus (T2DM) is a pressing public health challenge in Latin America, with an increasing prevalence and negative impacts on population health. Achieving optimal blood glucose levels is critical for preventing complications, yet significant socioeconomic inequiti...

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Main Authors: Marta Puig-García, Cintia Caicedo-Montaño, Mónica Márquez-Figueroa, Elisa Chilet-Rosell, Blanca Lumbreras, Abraham Beltrán-Pérez, Lucy Anne Parker
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22324-z
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author Marta Puig-García
Cintia Caicedo-Montaño
Mónica Márquez-Figueroa
Elisa Chilet-Rosell
Blanca Lumbreras
Abraham Beltrán-Pérez
Lucy Anne Parker
author_facet Marta Puig-García
Cintia Caicedo-Montaño
Mónica Márquez-Figueroa
Elisa Chilet-Rosell
Blanca Lumbreras
Abraham Beltrán-Pérez
Lucy Anne Parker
author_sort Marta Puig-García
collection DOAJ
description Abstract Background Type 2 diabetes mellitus (T2DM) is a pressing public health challenge in Latin America, with an increasing prevalence and negative impacts on population health. Achieving optimal blood glucose levels is critical for preventing complications, yet significant socioeconomic inequities persist in disease management and optimal glucose control. We aimed to investigate the patient characteristics associated with optimal fasting capillary glucose in individuals living with T2DM in a hard-to-reach setting in Esmeraldas, Ecuador. Methods We carried out a cross-sectional study of individuals with T2DM in the Eloy Alfaro health district of Esmeraldas, using a complex sample design with some limitations. Data collection took place between October 2020 and May 2022 and involved face-to-face interviews to collect sociodemographic and clinical data and a Fasting Capillary Blood Glucose test. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS). We estimated the prevalence of optimal glucose levels according to patient characteristics and calculated odds ratios (OR) with 95% confidence intervals using multivariable logistic regression. Results Of the 474 participants surveyed, only 18.1% (86; 95%CI: 14.9–21.9) had optimal fasting capillary glucose levels. In this sample, optimal glucose was nearly four times more frequent among men compared to women (aOR = 3.92, 95%CI: 2.08–7.40, p < 0.001). Furthermore, older age (aOR = 1.03, 95%CI: 1.01–1.05, p = 0.006), living in an urbanised setting (aOR = 2.04, 95%CI: 1.22–3.40, p = 0.006) and unemployment (aOR = 0.48, 95%CI: 0.25–0.94, p = 0.031) were also linked to optimal blood glucose levels. While perceived social support in this population was moderate (median = 2.33, on a scale of 1 to 4), high family support appeared to reduce optimal glycaemic levels (aOR = 0.35, 95%CI: 0.18–0.70, p = 0.003). Conclusions The intricate interplay of factors influencing diabetes management and optimal blood sugar suggests that targeted, context-specific and gender-sensitive public health strategies may be needed to address diabetes disparities in vulnerable populations.
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spelling doaj-art-53889c9f67a346bb8aae48cc32f5ccae2025-08-20T03:40:50ZengBMCBMC Public Health1471-24582025-03-0125111410.1186/s12889-025-22324-zCharacteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, EcuadorMarta Puig-García0Cintia Caicedo-Montaño1Mónica Márquez-Figueroa2Elisa Chilet-Rosell3Blanca Lumbreras4Abraham Beltrán-Pérez5Lucy Anne Parker6Department of Public Health, History of Science and Gynaecology, Universidad Miguel Hernández de ElcheCentro de Epidemiología Comunitaria y Medicina Tropical (CECOMET)Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET)Department of Public Health, History of Science and Gynaecology, Universidad Miguel Hernández de ElcheDepartment of Public Health, History of Science and Gynaecology, Universidad Miguel Hernández de ElcheDepartment of Public Health, History of Science and Gynaecology, Universidad Miguel Hernández de ElcheDepartment of Public Health, History of Science and Gynaecology, Universidad Miguel Hernández de ElcheAbstract Background Type 2 diabetes mellitus (T2DM) is a pressing public health challenge in Latin America, with an increasing prevalence and negative impacts on population health. Achieving optimal blood glucose levels is critical for preventing complications, yet significant socioeconomic inequities persist in disease management and optimal glucose control. We aimed to investigate the patient characteristics associated with optimal fasting capillary glucose in individuals living with T2DM in a hard-to-reach setting in Esmeraldas, Ecuador. Methods We carried out a cross-sectional study of individuals with T2DM in the Eloy Alfaro health district of Esmeraldas, using a complex sample design with some limitations. Data collection took place between October 2020 and May 2022 and involved face-to-face interviews to collect sociodemographic and clinical data and a Fasting Capillary Blood Glucose test. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS). We estimated the prevalence of optimal glucose levels according to patient characteristics and calculated odds ratios (OR) with 95% confidence intervals using multivariable logistic regression. Results Of the 474 participants surveyed, only 18.1% (86; 95%CI: 14.9–21.9) had optimal fasting capillary glucose levels. In this sample, optimal glucose was nearly four times more frequent among men compared to women (aOR = 3.92, 95%CI: 2.08–7.40, p < 0.001). Furthermore, older age (aOR = 1.03, 95%CI: 1.01–1.05, p = 0.006), living in an urbanised setting (aOR = 2.04, 95%CI: 1.22–3.40, p = 0.006) and unemployment (aOR = 0.48, 95%CI: 0.25–0.94, p = 0.031) were also linked to optimal blood glucose levels. While perceived social support in this population was moderate (median = 2.33, on a scale of 1 to 4), high family support appeared to reduce optimal glycaemic levels (aOR = 0.35, 95%CI: 0.18–0.70, p = 0.003). Conclusions The intricate interplay of factors influencing diabetes management and optimal blood sugar suggests that targeted, context-specific and gender-sensitive public health strategies may be needed to address diabetes disparities in vulnerable populations.https://doi.org/10.1186/s12889-025-22324-zDiabetes MellitusType 2Rural PopulationGlycaemic ControlNoncommunicable DiseasesCross-Sectional Studies
spellingShingle Marta Puig-García
Cintia Caicedo-Montaño
Mónica Márquez-Figueroa
Elisa Chilet-Rosell
Blanca Lumbreras
Abraham Beltrán-Pérez
Lucy Anne Parker
Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador
BMC Public Health
Diabetes Mellitus
Type 2
Rural Population
Glycaemic Control
Noncommunicable Diseases
Cross-Sectional Studies
title Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador
title_full Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador
title_fullStr Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador
title_full_unstemmed Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador
title_short Characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard-to-reach rural communities: results of a cross-sectional study in Esmeraldas, Ecuador
title_sort characteristics associated with optimal blood sugar in individuals living with type 2 diabetes in hard to reach rural communities results of a cross sectional study in esmeraldas ecuador
topic Diabetes Mellitus
Type 2
Rural Population
Glycaemic Control
Noncommunicable Diseases
Cross-Sectional Studies
url https://doi.org/10.1186/s12889-025-22324-z
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