Diabetic patients served at a regional level hospital: What is their clinical picture?

Abstract

Objectives: We describe the demographics, diabetic characteristics, diabetic control and complications in the diabetes service in Edendale Regional Hospital, Pietermaritzburg, in this study. Diabetes mellitus, together with its complications, is increasing at an alarming rate worldwide. Good glycaemic control translates into lower long-term complications and longer life expectancy. Previous studies performed in both the public and the private sectors have demonstrated that there is suboptimal diabetic control in South Africa. Design: This was a retrospective database analysis. Datasheets were designed to ensure a comprehensive and standardised assessment of patients attending Edendale Hospital's diabetic clinic. Data were stored in a designed-forpurpose database. Subjects and setting: Data from 653 first-visit diabetic patients visiting Edendale Hospital's diabetic clinic between 1 October 2012 and 30 September 2013 were collected. Outcome measures: Glycaemic control, diabetic complications and target blood pressure were the outcome measures studied. Results: A total of 653 first-visit patients were seen, of whom 77.03% were female and 83.40% were type 2 diabetes patients. Only 36.33% of the type 2, and 49.07% of the type 1, diabetes mellitus patients, achieved a target blood pressure of ≤ 140/80 mmHg. Only 1.23% of the type 1, and 11.18% of the type 2, diabetes mellitus patients, achieved optimal glycaemic control, defined as haemoglobin (Hb)A1c ≤ 7%. The mean HbA1c in the patients with type 1 diabetes mellitus was 11.82%, and 10.52% in the type 2 diabetes mellitus patients. Conclusion: This study showed the suboptimal control of both diabetes mellitus and hypertension in the clinic, together with high rates of diabetes complications. Obesity remains a major modifiable risk factor in both type 1 and 2 diabetes patients. Blood glucose control in this resource-limited setting was similar in those patients with home blood glucose monitoring versus those without it.