Association Between Type of Antidiabetic Treatment and Glycemic Control in Patients With Type 2 Diabetes Mellitus: A Retrospective Cross-Sectional Study

Background: Maintaining adequate glycemic control remains a major challenge in patients with type 2 diabetes mellitus (T2DM). Patients requiring insulin therapy often have longer disease duration and more advanced metabolic deterioration, which may influence the relationship between type of antidiabetic treatment and glycemic control. Objective: This study aimed to evaluate the association between type of antidiabetic treatment and glycemic control in patients with T2DM. Methods: This retrospective cross-sectional study analyzed a clinical database of 995 patients with T2DM treated at a specialized metabolic and cardiovascular center in southern Tamaulipas, Mexico. Patients were classified into two treatment groups: oral antidiabetic therapy and combined insulin plus oral antidiabetic therapy. Glycemic control was defined as glycated hemoglobin (HbA1c) ≤7%. Descriptive analyses were performed, and continuous and categorical variables were compared using Student's t-test and chi-squared test, respectively. Multivariable logistic regression was used to evaluate the independent association between type of antidiabetic treatment and glycemic control, adjusting for age, sex, diabetes duration, and body mass index (BMI). Results: A total of 995 patients were included: 780 (78.4%) received oral antidiabetic therapy, and 215 (21.6%) received combined insulin plus oral antidiabetic therapy. Overall, 192 patients (19.3%) achieved glycemic control, while 803 (80.7%) remained uncontrolled. Glycemic control was achieved in 172 patients (22.1%) in the oral antidiabetic therapy group and 20 patients (9.3%) in the combined insulin plus oral antidiabetic therapy group. Type of antidiabetic treatment was significantly associated with glycemic control (χ²=17.59; p<0.001). In the adjusted logistic regression model, oral antidiabetic therapy was independently associated with higher odds of achieving glycemic control compared with combined insulin plus oral antidiabetic therapy (OR=2.35; 95% CI: 1.41-3.93; p=0.001). Longer diabetes duration was negatively associated with glycemic control, whereas BMI was not independently associated. Conclusions: Type of antidiabetic treatment was significantly associated with glycemic control in patients with T2DM. However, the lower probability of glycemic control among patients receiving combined insulin plus oral antidiabetic therapy likely reflects longer disease duration and greater disease severity rather than reduced treatment effectiveness. These findings highlight the importance of early optimization of diabetes management before progression to advanced disease requiring insulin therapy.