An evaluation of type 2 diabetes care in the primary care setting

Abstract

Objectives: To assess the clinical outcome of type 2 diabetes care currently provided at the primary healthcare centres. Method: A clinical audit was performed among 110 type 2 diabetes patients in the two major primary healthcare centres. The measurements of fasting blood glucose, HbA1c, serum lipid profile, blood pressure, serum creatinine, body mass index and waist circumference were carried out during a clinical examination. Knowledge, behaviour and attitude among the participants were assessed via a questionnaire composed of four sections concerning diabetes and its complications, physical activity, nutrition and smoking. Results: The ideal standards recommended by the International Diabetes Federation were employed for data analysis. HbA1c level was controlled in 37. 3%, systolic blood pressure was controlled in 44. 5%, cholesterol was controlled in 30% while LDL was controlled in 10.9 % of patients. Body Mass Index was above the normal threshold in 72.7% of participants while waist circumference was abnormally high in 96.3% of females and 64.7% of males. Serum creatinine level was controlled in 60% of patients. Significant correlations with HbA1c were registered for BMI (p-value 0.038) and serum creatinine (p-value 0.04). Patients showed limited knowledge on diabetes, its complications and exercise but were better informed on nutrition and smoking. Inappropriate eating habits were evident among participants while better behaviour was demonstrated in relation to the adherence to medication, physical activity and smoking. Conclusion: The framework for structured care is in place at the primary healthcare centres and compliance with process measures was confirmed. The present local care is based on good practice and is compatible with that provided in developed countries. However the health status of these patients is under imminent threat by a cluster of risk factors. This necessitates improvement in all components of present care while additional efforts must address the inadequacies in cardiovascular risk and lifestyle management.