Screening for diabetes complications and associated factors in primary care in Galle, Sri Lanka

Abstract

Introduction: Diabetes (DM) and its complications show an increasing trend and pose a huge burden on the health system. Thus, early detection of complications is essential. Primary care institutions treat and follow up patients with diabetes in their territories. The aim of the study was to assess awareness, practices, and service-related factors associated with screening for diabetes complications among patients attending the medical clinics of primary care level hospitals in the Galle district.Methods: A descriptive cross-sectional study was conducted at three Divisional Hospitals in Galle District, among patients attending medical clinics. Data was collected through an interviewer-administered questionnaire designed to assess awareness and screening practices for diabetes complications, screening done for diabetes complications, and associated factors were analyzed.Results: Four hundred patients with diabetes participated in the study. The majority (more than 95%) were aware of common organs affected by DM and were aware of investigations and their availability at primary care institutions (more than 85.0%). Adherence to recommended screening tests and frequency was very low (ranging from 3% to 16%) and nearly half of the patients never had any form of screening. Older age was associated with better retinopathy screening {OR = 0.61 95% CI (0.41-0.91)} while having co-morbidities was associated with better screening for retinopathy {OR = 1.67 95% CI (1.02-2.71)} and ischemic heart disease.{OR = 2.03 95% CI (1.22-3.40)}. A better awareness was associated with better screening for DM complications.Conclusions: In conclusion, awareness about screening for diabetes complications was satisfactory among the study sample. However, the screening practices were sub-optimal as the recommended screening protocols have not been followed. Better screening was associated with better awareness, older age, having comorbidities, and being employed.