Suboptimal glycaemic and blood pressure control and screening for diabetic complications in adult ambulatory diabetic patients in Uganda: a retrospective study from a developing country

Abstract

BackgroundCurrently, Sub Saharan Africa is faced with a substantial burden from diabetes mellitus. In most of the African countries, screening for diabetes related complications and control of blood pressure and glycaemic levels is often suboptimal.The study aimed at assessing the extent of optimal glycaemic and blood pressure control and the frequency of screening for diabetic complications in adult ambulatory Ugandan diabetic patients.MethodsThis was a retrospective study of 250 medical records of adult diabetic patients attending the outpatient diabetic clinic at St. Raphael of St. Francis hospital Nsambya in Kampala, Uganda.ResultsThe mean age of the patients was 51.6 ± 9.2 years with the majority being females (155, 62%). Using fasting blood glucose levels assessed in all the patients, optimal glycemic control of <7.2 mmol/l was noted in 42.8% of the patients. Glycated haemoglobin was performed at least once in the last year in 24 (9.6%) patients , of which 5 (20.8%) of these attained optimal control of <7%. Optimal blood pressure (BP) control defined as BP ≤140/80 mmHg was noted in 56% of the patients. Hypertension and diabetic neuropathy were the most screened for diabetic complications in 100% and 47.2% of the patients respectively and were also the most prevalent diabetic complications (76.4% and 31.2% respectively).ConclusionsThis study demonstrates that glycemic and blood pressure control and screening for diabetic complications among the adult ambulatory diabetic patients in this urban diabetic clinic is suboptimal. This substantiates development and implementation local guidelines to improve diabetes care.

Glycemic Control in a Clinic-Based Sample of Diabetics in M’Bour Senegal

“…Similar to other studies in SSA (Kibirige et al, 2014;Sobngwi et al, 2012), our current study found that glycemic control in our sample was suboptimal. Also in the current study, we found that women are more likely to have lower Hba1c on average; however, we are unable to make an inference about gender differences in actual glycemic control because only one man had achieved glycemic control.…”

Peripheral Arterial Disease among Adult Diabetic Patients Attending a Large Outpatient Diabetic Clinic at a National Referral Hospital in Uganda: A Descriptive Cross Sectional Study

“…This can be explained by the varied study diagnostic approaches of PAD with higher prevalence noted in studies using ABI measurement [7], [8], [9], [10] compared to clinical palpation of lower limb pulses [11], [12], [13].…”

“…Despite this varied prevalence, screening of PAD among adult diabetic patients in SSA is infrequent [11], [13].…”

Major Micro vascular Complications and Associated Risk Factors among Diabetic Outpatients in Southwest Ethiopia

“…These findings are not supported by the literature [9,10] in which patients suffering from chronic complications of diabetes are usually overweigh subjects with advancing age. Regarding the relationship between types of DM and incidence and severity of microvascular complications, severe complications were frequently reported in patients with Type 1 DM [11][12][13]. Literature evidence also shows positive association between BMI and the development of microvascular complications [50,[55][56][57].…”

“…Such complications include diabetic foot, renal disease, eye problem, cardiovascular disease, neuropathy, and skin and/or subcutaneous infections [6][7][8][9][10]. In the western world, DM is the leading cause of blindness, non-traumatic lower limb amputation and chronic renal failure, which are on very much increase [11][12][13]. The situation in developing world, particularly in Africa, is even worse due to late diagnosis and poor access to diabetic care [6][7][8][9][10].…”