Abstract:
Diabetes is a rising problem globally. The World Health Organization (WHO) has classified diabetes as an epidemic. The major impact of the disease is felt in low- and middle-income countries. The literature has emphasised the fact that most patients living with diabetes are undiagnosed, and those who are diagnosed are poorly controlled. The complications associated with diabetes usually occur over a long period of time and are mainly influenced by poor glycaemic control. In South Africa, diabetes is a major cause of morbidity and mortality and a burden to the already overstretched health system in the country. In this study, factors that impair a patient’s ability to achieve good glycaemic control are investigated. '
Methods
In this cross-sectional, descriptive study was conducted at the general outpatients department (GOPD) of the Mankweng hospital in the Capricorn District of the Limpopo Province. A total number of 97 participants formed part of the study. An HbA1c test was used to classify patients into a well-controlled glycaemic group (HbA1c ≤ 7%) or a poorly controlled group (HbA1c > 7%). Factors for poor glycaemic control were investigated. The following factors were investigated to identify characteristics of poorly controlled diabetes patients: demographic data; adherence to treatment; and, clinical measurements characteristics. Frequency tables, univariate logistic regression models and chi-square tests were used to determine factors influencing glycaemic control.
Results
Of the 97 patients, only 63 (64.9%) had an HbA1C measurement done (measurable outcome). Of these patients, only 13 (15.7%) had well controlled diabetes, while diabetes in 50 patients was poorly controlled. Patients on oral treatment only comprised the bulk of the patients who were well controlled. Following multivariate analysis, being male was found to be a significant predictor of good glycaemic control.
Conclusions
Most patients who had an HbA1C done were poorly controlled. As a secondary observation, management of diabetes was suboptimal. Male patients treated with oral medication alone were more likely to have good glycaemic control.
Key concepts
Diabetes mellitus, HbA1C, glycaemic, hospital, general out-patient department, Limpopo
