Diabetes guidelines and clinical practice: is there a gap? The South African cohort of the International Diabetes Management Practices Study

Amod, Aslam; Riback, Wayne; Schoeman, H S

doi:10.1080/22201009.2012.10872282

Cited by 20 publications

(28 citation statements)

References 7 publications

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“…[7][8][9][10][11] Amod and Riback demonstrated a similar picture in the South African private healthcare sector. 12 We attempted to improve the standard of clinical care in our clinic by designing and implementing a diabetes datasheet, administered by the clinical staff in the diabetes clinic.…”

Section: Introductionmentioning

confidence: 99%

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

Pillay

Aldous

Mahomed³

2015

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Section: Introductionmentioning

confidence: 99%

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

Pillay

Aldous

Mahomed³

2015

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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“…Statistics SA found that approximately half (46.8%) of the population of KZN had no access to flush toilets connected to sewerage. [2] When the abovementioned social factors of poverty, walking barefoot and poor sanitation, and the overall poor control of both blood sugar and blood pressure found in our clinics are taken into account, [6][7] it is not surprising to note that there is increasing evidence of LLA. This trend is expected to increase if measures are not implemented to achieve better control of both glycaemia and BP and improvement of socio-economic factors.…”

Section: Discussionmentioning

confidence: 99%

“…[6,7] Following the Brazzaville declaration on NCD prevention, governments worldwide have committed to a more vigorous and sustained approach to NCDs; this is similar to the approach that was used in the antiretroviral roll-out for HIV infection in SA. [8] Analyses of data relating to new cases of DM and some of the complications encountered in KwaZulu-Natal (KZN) over the last 5 years would be beneficial in helping healthcare professionals and government assess the burden of DM in this province.…”

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confidence: 99%

The burden of diabetes mellitus in KwaZulu-Natal’s public sector: A 5-year perspective

2016

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Background. Diabetes mellitus (DM), together with its devastating complications, has a huge impact on both the patients it affects and the global economy as a whole. The economies of developing countries are already under threat from communicable diseases. More needs to be done to stem the tide of non-communicable diseases like DM. In order for us to develop new strategies to tackle this dread disease we need to obtain and analyse as many data as possible from the geographical area where we work. Objective. To describe the burden of DM in the public sector of the province of KwaZulu-Natal (KZN), South Africa (SA). Method. Data on the number of diabetes visits, DM patients that were initiated on treatment, defaulters and DM-related amputations were accessed from the Department of Health records for the period 2010 -2014 inclusive.Results. There was a decline in the number of patients initiated on treatment per 100 000 population from 2010 to 2014 inclusive (265.9 v. 197.5 v. 200.7 v. 133.4 v. 148.7). Defaulter rates for 2013 compared with 2014 were 3.31% v. 1.75%, respectively and amputation rates were 0.09% v. 0.05% for 2013 and 2014, respectively. There was a strong proportional relationship observed between the number of defaulters and number of diabetes-related amputations (r=0.801; p=0.000) (Pearson correlation). A notable percentage of DM patients ranging between 63% and 80% were commenced on pharmacological therapy at their local clinics rather than at hospitals in the province. Conclusion. Strategies directed towards detection and treatment of DM, together with decreasing defaulter rates and thereby decreasing diabetes-related amputations, need to be addressed urgently. The majority of patients were initiated on therapy at the clinic level. This emphasises the need to strengthen our clinics in terms of resources, staffing, and nursing and clinician education, as this is where diabetes control begins. Although this study was based solely in KZN, the second most populous province in SA, it probably reflects the current situation regarding DM in other provinces of SA as well.

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“…Suboptimal control of DM has been described in both the public and private healthcare sectors in SA. [2,3] Poor glycaemic control increases the risks of diabetes-related complications. [4] Already poorly controlled patients are at further increased risk of developing these complications while they wait for HbA1c results.…”

Section: Researchmentioning

confidence: 99%

Validation and effect on diabetes control of glycated haemoglobin (HbA1c) point-of-care testing

et al. 2019

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Background. Optimal control of diabetes mellitus (DM) remains daunting globally. Point-of-care testing (POCT) for glycated haemoglobin (HbA1c) enables the clinician to make immediate management decisions and thereby improve DM control and complications. Better control is increasingly being striven for in developing countries where availability of POCT devices is limited. Methods. Every alternate patient who visited the diabetes clinic at Edendale Hospital, Durban, South Africa, between 1 June 2017 and 31 August 2017 was invited to participate in the study. These patients made up the POCT group, with the remainder making up the control laboratory group. The POCT group had Quo-Test HbA1c POCT done at the clinic visit and their treatment was adjusted based on the HbA1c reading, while the control group received standard treatment. The two groups of patients were reviewed at 3 months to identify differences in diabetes control between them. Results. Data from 266 patients were analysed (135 in the POCT group v. 131 in the control group). There was no significant difference between the price of the POCT and laboratory HbA1c tests (p=0.823). The POCT and laboratory HbA1c values showed good correlation at baseline (r=0.995; p<0.001). The two groups of patients were evenly matched in respect of most demographic and clinical variables. Patients in the POCT group showed a significant improvement in mean (standard deviation) glycaemic control between baseline and 3 months (9.61 (2.46) v. 8.98 (2.15); p<0.043). No improvement was noted in the control group (9.58 (2.49) v. 9.43 (2.15); p=0.823). Conclusions. The Quo-Test HbA1c POCT had good correlation with standard laboratory methods in respect of both glycaemic control and price. Patients who had POCT at baseline showed a significant improvement in glycaemic control at 3 months. HbA1c POCT in the setting of a multifaceted approach to diabetes care has been shown to have definite benefits.

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Diabetes guidelines and clinical practice: is there a gap? The South African cohort of the International Diabetes Management Practices Study

Cited by 20 publications

References 7 publications

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

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

The burden of diabetes mellitus in KwaZulu-Natal’s public sector: A 5-year perspective

Validation and effect on diabetes control of glycated haemoglobin (HbA1c) point-of-care testing

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