Do diabetes-specialty clinics differ in management approach and outcome? A cross-sectional assessment of ambulatory type 2 diabetes patients in two teaching hospitals in Nigeria.

Rasaq Adisa, Titilayo O Fakeye
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引用次数: 6

Abstract

Objectives: To evaluate management approach and outcome in two endocrinologist-managed clinics using data on treatment adherence, diabetes-specific parameters, prescribed medications and self-management practices among ambulatory type 2 diabetes patients. Opinion on cause(s) and perceived fear about diabetes were also explored.

Design: A cross-sectional prospective study using semi-structured interview among consented patients for eightweek, and a review of participants' case notes at 3-month post-interactive contact for details of diabetes-specific parameters and antidiabetes medications.

Settings: The University College Hospital (UCH) and Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in southwestern Nigeria.

Participants: Adult patients with type 2 diabetes, on therapies for >3-month and who had average fasting blood glucose (FBG)>6.0mmol/L were enrolled. All patients with type 1 diabetes, and type 2 diabetes who decline participation were excluded. Out of 185 participants who were approached, 176(95.1%) consented and completed the study including 113(64.2%) from UCH and 63(35.8%) in OAUTHC.

Results: Mean FBG for patients were 9.6mmol/L in UCH and 11.0mmol/L in OAUTHC (p=0.03). Medication adherence among patients was 47(46.5%) in UCH and 31(52.5%) in OAUTHC (p=0.46). Prescribed antidiabetes medications between the clinics significantly differ. Practice of self-monitoring of blood glucose among participants was 26(23.0%) in UCH and 13(20.6%) in OAUTHC (p=0.72). Thirty-two participants (29.4%) in UCH and 33(43.4%) from OAUTHC (p=0.02) mentioned complications as perceived fear about type 2 diabetes.

Conclusion: There are differences and similarities between the diabetes-specialty clinics with respect to diabetes management and outcome. This underscores the necessity for a protocol-driven treatment approach in ensuring improved diabetes care and outcome.

Funding: None declared.

糖尿病专科诊所在管理方法和结果方面是否存在差异?尼日利亚两家教学医院门诊2型糖尿病患者的横断面评估。
目的:利用门诊2型糖尿病患者的治疗依从性、糖尿病特异性参数、处方药和自我管理实践的数据,评估两个内分泌学家管理的诊所的管理方法和结果。还探讨了对糖尿病病因和恐惧感的看法。设计:一项横断面前瞻性研究,在同意的患者中进行为期八周的半结构化访谈,并在互动后3个月对参与者的病例记录进行审查,以了解糖尿病特异性参数和抗糖尿病药物的详细信息。背景:尼日利亚西南部的大学学院医院(UCH)和奥巴菲米·阿沃洛沃大学教学医院综合体(OAUTHC)。参与者:接受治疗超过3个月、平均空腹血糖(FBG)>6.0mmol/L的2型糖尿病成年患者。所有拒绝参与的1型糖尿病和2型糖尿病患者均被排除在外。在接触的185名参与者中,176人(95.1%)同意并完成了研究,其中113人(64.2%)来自UCH,63人(35.8%)来自OAUTHC。参与者的自我血糖监测实践在UCH中为26名(23.0%),在OAUTHC中为13名(20.6%)(p=0.072)。UCH中有32名参与者(29.4%),OAUTHC有33名参与者(43.4%)(p=0.02)提到并发症是对2型糖尿病的恐惧。结论:糖尿病专科门诊在糖尿病管理和治疗效果方面存在异同。这强调了协议驱动治疗方法的必要性,以确保改善糖尿病护理和结果。资金:未申报。
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