Monitoring the standard of care of diabetes mellitus type 2 in a primary health care setting

Abstract

Background: Complying of diabetic patients with the standard  administered medical care at primary health care units is an important issue. Revealing the rates of compliance provide important information that can be used both by the medical staff to evaluate the administered
medical care and by the patients to evaluate their efforts to control glycemia and its possible complications.
Objectives: Reveal compliance rates of diabetics with targeted levels of medical indicators of diabetes.
Methods: Two hundred type 2 diabetic patients from Al-Yarmouk Health Center were randomly selected and followed for 2 years. Four indicators, namely, glycated hemoglobin A1c (HbA1c), microalbuminuria (MA), low density lipoprotein (LDL), and fundus examination (FE) were measured at the start and end of the field period. Age, sex, and nationality of the studied patients were recorded and their association with complying to the studied indicators was illustrated.

Results: The majority of the studied sample were females (53.5%), non-Kuwaitis (56.0%) with a
mean age of 51.2 ±8.8 years. A significant improvement has been achieved for all the targeted indicators.
Full complying increased from just 7.5% at the start of the intervention program to 24.6%
at the end. The measure with the highest percentage at the end of the program was the control of MA (85.2%) followed by FE (76.6%) while the least controlled indicator was HbA1c (46.4%). Kuwaitis were more likely to control their LDL than non-Kuwaitis by the end of the trial after adjusting for age and gender.
Conclusion: Administering standard medical care significantly improved compliance of type 2 diabetics to achieve the targeted level of medical indicators. In view of the low rate of full complying and poor glycemic control, major efforts should be undertaken to substantially increase this rate among all individuals with diabetes.