Self-perceived health and metabolic control in Tanzanian diabetic patients

Abstract

Objectives: To analyse self-perceived health and metabolic control over a two-year period in a group of urban adult diabetic patients in Dar es Salaam, Tanzania.
Design: A longitudinal study with cross-sectional measurements of metabolic control and self-perceived health.
Setting: The study was carried out at the diabetes out-patient clinic of Muhimbili Medical Centre and at three district hospitals in the Dar es Salaam area in Tanzania.
Subjects: In 1995, one hundred and fifty consecutive diabetic patients (M/F:78/72) were seen. A re-organisation of the diabetes care was done in 1996. Due to difficulties in tracing the patients after the re-organisation, 50.4% of them were re-assessed in 1997.
Main outcome measures: The Swahili version of SF-36 health questionnaire was used to assess health. HbA1c and fasting blood-glucose were used to evaluate metabolic control.

Results: In patients assessed both in 1995 and 1997 significant improvements were found in the socialand emotional functioning health domains. The mean HbA1c valuewas significantly improved after the two years (9.3±3.2% in 1995 versus 7.5±2.8%). Significant negative
correlations were found between metabolic control and the health domains bodily pain, general health and vitality.
Conclusions: The study has highlighted the difficulties in performing follow up studies and it is most important to put lot of effort in informing patients prior to re-organisation of the care. Furthermore, our findings have shown that Tanzanian diabetic patients had improved their self-perceived health in social and emotional functioning and they had an improved metabolic control over the two-year period indicating an improved diabetes care.