International Journal of Women's Health (Jun 2022)

Factors Associated with Hemoglobin A1c Level Among Women Without Prior Diabetes Diagnosis in Rural Areas of Central South China: A Cross-Sectional Study

  • Jiang Y,
  • Jiang S,
  • Long Q,
  • Yang J,
  • Chen JL,
  • Guo J

Journal volume & issue
Vol. Volume 14
pp. 741 – 755

Abstract

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Yuanyuan Jiang,1 Shan Jiang,1,2 Qing Long,1 Jundi Yang,1,3 Jyu-Lin Chen,4 Jia Guo1 1Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China; 2Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu, People’s Republic of China; 3School of Nursing, The University of Hong Kong, Hong Kong, People’s Republic of China; 4School of Nursing, University of California San Francisco, San Francisco, CA, USACorrespondence: Jia Guo, Tel +86 13875947418, Email [email protected]: Women in rural areas of China face the unique risk of developing diabetes, but data on the glycemic status among women without prior diabetes diagnosis in rural areas are lacking which may limit the decision-making for diabetes screening or prevention. This study was aimed to describe the glycemic status of women determined by hemoglobin A1c (HbA1c) and explore its associating factors.Methods: A cross-sectional survey was conducted among women without prior diabetes diagnosis from two counties of rural areas in Central South China from July to October 2018. On the basis of the life course framework, data on socio-demographic, environmental health, genetic, biological (blood pressure, weight and height, lipids), psychosocial, and healthy behavioral factors were collected on site either through questionnaires or field measurements. The questionnaires included social-demographic sheet, Perceived Stress Scale, Self-efficacy scales for health-related diet and exercise behaviors, and Chinese Diabetes Risk Questionnaire. Generalized linear model analysis was performed to determine the associating factors of glycemic status, which was measured by HbA1c level.Results: A total of 647 women were included in the study. The median age of women was 51.00 years (range 35– 65 years). The median HbA1c level was 5.1% (interquartile range 4.6%-5.5%, range 4– 13.6%), and 8.7% (n=56) of women were identified as elevated glycemic status (HbA1c> 6%). Environmental health factors (eg, living in less-developed county [β=0.206, p=0.027]), biological factors (eg, higher body mass index [β=0.201, p=0.036], higher total cholesterol [β=0.097, p=0.040], history of gestational diabetes mellitus [β=0.722, p< 0.001]), and psychosocial factors (eg, higher perceived stress [β=0.247, p=0.002]) were associated with higher HbA1c level.Conclusion: This study reported 8.7% of elevated glycemic status among women without prior diabetes diagnosis in rural Hunan Province, China. After a comprehensive investigation based on a theoretical framework, living in a less-developed county of rural areas, having larger body mass index, higher total cholesterol, higher perceived stress, and a gestational diabetes mellitus history were identified as associating factors of higher HbA1c level. Professional support regarding weight control, blood lipid control, stress management, and the prevention of gestational diabetes mellitus should be recommended among this population, especially for women from less-developed counties.Keywords: women, rural areas, glycemic status, hemoglobin A1c, associating factors, survey

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