Self-perceived health and metabolic control in Tanzanian diabetic patients

Abstract

Objectives: To analyse self-perceived health and metabolic control over a two-year period in a group of urban adult diabetic patients in Dar es Salaam, Tanzania. Design: A longitudinal study with cross-sectional measurements of metabolic control and self-perceived health. Setting: The study was carried out at the diabetes out-patient clinic of Muhimbili Medical Centre and at three district hospitals in the Dar es Salaam area in Tanzania. Subjects: In 1995, one hundred and fifty consecutive diabetic patients (M/F:78/72) were seen. A re-organisation of the diabetes care was done in 1996. Due to difficulties in tracing the patients after the re-organisation, 50.4% of them were re-assessed in 1997. Main outcome measures: The Swahili version of SF-36 health questionnaire was used to assess health. HbA1c and fasting blood-glucose were used to evaluate metabolic control. Results: In patients assessed both in 1995 and 1997 significant improvements were found in the social and emotional functioning health domains. The mean HbA1c value was significantly improved after the two years (9.3±3.2% in 1995 versus 7.5±2.8%). Significant negative correlations were found between metabolic control and the health domains bodily pain, general health and vitality. Conclusions: The study has highlighted the difficulties in performing follow up studies and it is most important to put lot of effort in informing patients prior to re-organisation of the care. Furthermore, our findings have shown that Tanzanian diabetic patients had improved their self-perceived health in social and emotional functioning and they had an improved metabolic control over the two-year period indicating an improved diabetes care.