Title: Retrospective Study to evaluate factors associated with Glycaemic Control among Rural patients conducted at private clinic in Patna

Author: Dr Surendra Prasad Singh

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.134

Abstract

Objective: The objective of this study is to highlight the challenges and success faced by a Diabetes Centre in Patna, monitored and managed, using Hb1Ac as a measure of glycaemic control.

Methods: From patients OPD records demographic cross sectional data were collected. Medical records of patients who had visited one specialised diabetic clinic at Patna were included in the study and the demographic details including Age, sex, residential postcodeand glycated haemoglobin (HbA1c) levels were noted from their medical records.

Results: 524 (58.7%) patients were termed as “Metro Patients” and 368 (41.1%) were termed as “Rural Patients”. At initial baseline presentation only 230 (25.8%) patients were ay glycemic control of HbA1c≤7% in which 28% male and 25.3% female were from metro town and 24.8% male and 24.12% females were from rural town. This number was increased to 551 (62%) after proper treatment and there was more number of patients achieved glycemic control in metro town as compare to patients who were belongs to rural area.

Conclusion: Overall improvement in diabetes control was noticed among patients who attend the studied diabetes centre, however a negligible change over time were observed in female patients residing in town over time. Even within the diabetes centre, intensive intervention my needed for uncontrolled patient groups to achieve optimal diabetes control.

Keywords: Diabetes Mellitus, HbA1c, Diabetes Control, Diabetes Centre.

References

  1. IDF Diabetes atlas: Seventh edition. www.diabetesatlas.org. Assessed 12 Aug 2016.
  2. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res ClinPract. 2010;87:4–14. doi: 10.1016/j.diabres.2009.10.007.
  3. Hall V, Thomsen RW, Henriksen O, Lohse N. Diabetes in Sub Saharan Africa 1999–2011: epidemiology and public health implications. A systematic review. BMC Public Health. 2011;11:564. doi: 10.1186/1471-2458-11-564.
  4. Atun R, Gale EA. The challenge of diabetes in sub-Saharan Africa. Lancet Diabetes Endocrinol. 2015;3(9):675–677. doi: 10.1016/S2213-8587(15)00236-3.
  5. Lloyd A, Sawyer W, Hopkinson P. Impact of long-term complications on quality of life in patients with type 2 diabetes not using insulin. Value Health. 2001;4(5):392–400. doi: 10.1046/j.1524-4733.2001.45029.x.
  6. Stratton IM, Adler AI, Neil HAW, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–412. doi: 10.1136/bmj.321.7258.405.
  7. LeRoith D, Smith DO. Monitoring glycemic control: the cornerstone of diabetes care. ClinTher. 2005;27(10): 1489–1499. doi: 10.1016/j.clinthera.2005.10.010.
  8. UK Prospective Diabetes Study (UKPDS) Group Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet. 1998;352:837–853. doi: 10.1016/S0140-6736(98)07019-6.
  9. The Diabetes Control and Complications Trial Research Group The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–986. doi: 10.1056/NEJM199309303291401.
  10. Valentine WJ, Plamer AJ, Nicklasson L, Cobden D, Roze S. Improving life expectancy and decreasing the incidence of complications associated with type 2 diabetes: a modeling study of HbA1c targets. Int J ClinPract. 2006;60(9):1138–1145. doi: 10.1111/j.1742-1241.2006.01102.x.
  11. Banerji MA, Dunn JD. Impact of glycemic control on healthcare resource utilization and costs of type 2 diabetes: current and future pharmacologic approaches to improving outcomes. Am Health Drug Benefits. 2013;6(7):382–392.
  12. Oglesby AK, Secnik K, Barron J, Al-Zakwani I, Lage MJ. The association between diabetes-related medical costs and glycemic control: a retrospective analysis. Cost Eff ResourAlloc. 2006;4(1):1. doi: 10.1186/1478-7547-4-1.
  13. Abebe SM, Berhane Y, Worku A, Alemu S, Mesfin N. Level of sustained glycemic control and associated factors among patients with diabetes mellitus in Ethiopia: a hospital-based cross-sectional study. Diabetes MetabSyndrObes. 2015;8:65–71. doi: 10.2147/DMSO.S75467.
  14. Supiyev A, Kossumov A, Kassenov A, Nurgozhin T, Zhumadilov Z, Peasey A, et al. Diabetes prevalence, awareness and treatment and their correlates in older persons in urban and rural population in the Astana region, Kazakhstan. Diabetes Res ClinPract. 2016;12:6–12. doi: 10.1016/j.diabres.2015.11.011.
  15. Kassahun T, Eshetie T, Gesesew H. Factors associated with glycemic control among adult patients with type 2 diabetes mellitus: a cross-sectional survey in Ethiopia. BMC Res Notes. 2016;9:78. doi: 10.1186/s13104-016-1896-7.
  16. Yin J, Yeung R, Luk A, Tutino G, Zhang Y, Kong A, et al. Gender, diabetes education, and psychosocial factors are associated with persistent poor glycemic control in patients with type 2 diabetes in the Joint Asia Diabetes Evaluation (JADE) program. J Diabetes. 2016;8(1):109–119. doi: 10.1111/1753-0407.12262.
  17. Marden S, Thomas PW, Sheppard ZA, Knott J, Lueddeke J, Kerr D. Poor numeracy skills are associated with glycaemic control in Type 1 diabetes. Diabet Med. 2012;29(5):662–669. doi: 10.1111/j.1464-5491.2011.03466.x.
  18. Cavanaugh K, Huizinga MM, Wallston KA, Gebretsadik T, Shintani A, Davis D, et al. Association of numeracy and diabetes control. Ann Intern Med. 2008;148(10):737–746. doi: 10.7326/0003-4819-148-10-200805200-00006.
  19. Cavanaugh KL. Health literacy in diabetes care: explanation, evidence and equipment. Diabetes Manag (Lond) 2011;1(2):191–199. doi: 10.2217/dmt.11.5. [PMC free article] [PubMed] [CrossRef]
  20. Roblin DW, Ntekop E, Becker ER. Improved intermediate clinical outcomes from participation in a diabetes health education program. J Ambul Care Manag. 2007;30(1):64–73. doi: 10.1097/00004479-200701000-00009.

Corresponding Author

Dr Surendra Prasad Singh

Assistant Professor, Department of Community Medicine, Patna Medical College & Hospital, Patna