Glucose Control in Diabetic Patients Attending Parirenyatwa Group of Hospitals in Zimbabwe

Magnus Chirombe, B. Ngara, Raymond Chibvongodze, Venneth Charuka, Danai Tavonga Zhou
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引用次数: 6

Abstract

Diabetes mellitus is a non-communicable disease whose prevalence is increasing even in low-income countries like Zimbabwe. It is usually diagnosed late when complications are already present mainly due to slow onset of disease, low accessibility to healthcare facilities and socio-economic hardships. Poor glycaemic control in diabetics is associated with the development of long-term microvascular and macrovascular complications such as nephropathy, neuropathy, retinopathy, cardiovascular disease and diabetic foot syndrome. Therefore, good glycaemic control is essential to prevent complications, to improve the quality of life of diabetic patients and to reduce healthcare costs. This study sought to find the status of glycaemic control and to identify factors that are associated with poor glycaemic control among diabetic patients attending Parirenyatwa Group of Hospitals Diabetic Clinic in Harare, Zimbabwe. A cross-sectional study involving a total of 182 diabetic patients was carried out. Demographic data (age and gender) and clinical information (hypertension, duration, height, weight and lipid therapy) were retrieved from patients’ clinical records. Blood samples from participating diabetic patients were analysed for HbA1c on the Mindray® BS 400 Analyser. Measurement of HbA1c was done enzymatically using the International Federation of Clinical Chemists (IFCC) method. A total of 182 patients (30.2% men, 69.8% women) were enrolled whose mean (SD) age in years was 55 (9.0). The glycaemic status was generally poor with a prevalence of poor glycaemic control as high as 58.2%. This prevalence is higher than that previously obtained at the same hospital in 2013 thus presenting a major health challenge. This also means the burden of diabetic complications is likely to increase. Poor glycaemic control was significantly associated with gender and duration of diabetes mellitus. We conclude that in order to improve glycaemic control among diabetic patients, primary healthcare facilities need to focus on patient education and should facilitate early diagnosis through routine medical check-ups.
津巴布韦Parirenyatwa集团医院糖尿病患者的血糖控制
糖尿病是一种非传染性疾病,即使在津巴布韦等低收入国家,其患病率也在上升。通常在已经出现并发症时诊断较晚,主要原因是发病缓慢、难以获得卫生保健设施以及社会经济困难。糖尿病患者血糖控制不良与长期微血管和大血管并发症的发展有关,如肾病、神经病变、视网膜病变、心血管疾病和糖尿病足综合征。因此,良好的血糖控制对预防并发症、提高糖尿病患者的生活质量和降低医疗费用至关重要。本研究旨在发现在津巴布韦哈拉雷Parirenyatwa集团医院糖尿病诊所就诊的糖尿病患者的血糖控制状况,并确定与血糖控制不良相关的因素。对182例糖尿病患者进行了横断面研究。从患者的临床记录中检索人口统计数据(年龄和性别)和临床信息(高血压、病程、身高、体重和脂质治疗)。采用迈瑞®bs400分析仪对参与研究的糖尿病患者的血液样本进行HbA1c分析。采用国际临床化学家联合会(IFCC)的方法酶法测定HbA1c。共纳入182例患者(男性30.2%,女性69.8%),平均(SD)年龄为55岁(9.0岁)。血糖状况普遍较差,血糖控制不良的患病率高达58.2%。这一患病率高于2013年在同一家医院获得的数据,因此对健康构成重大挑战。这也意味着糖尿病并发症的负担可能会增加。血糖控制不良与性别和糖尿病病程显著相关。我们的结论是,为了改善糖尿病患者的血糖控制,初级卫生保健机构需要重视患者教育,并通过常规体检促进早期诊断。
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