The achievement of glycaemic, blood pressure and LDL cholesterol targets in patients with type 2 diabetes attending a South African tertiary hospital outpatient clinic

  • Yacob Pinchevsky University of the Witwatersrand
  • Varada Shukla University of the Witwatersrand
  • Neil Butkow University of the Witwatersrand
  • Frederick J Raal University of the Witwatersrand
  • Tobias Chirwa University of the Witwatersrand
Keywords: diabetes mellitus, management, risk factors, targets

Abstract

Objectives: To determine differences in the control of multiple diabetes control parameters in a select group of subjects with type 2 diabetes (T2DM) after a four-year follow-up period. Design: Cross-sectional study. Setting and subjects: The initial 2009 study population consisted of 666 T2DM patients of whom only 261 (39.2%) were audited at the Charlotte Maxeke Johannesburg Academic Hospital. Outcome measures: Using a public sector database, retrospective data were obtained on the treatment of participants with T2DM attending a tertiary care setting and a descriptive analysis was done. Results: The mean age was 64 (SD 10.6) years, women represented 55% of the cohort and the mean duration of diabetes was 16 years (range 2–40 years) in 2013. Fewer patients achieved an HbA1c goal (of < 7%) in 2013 (15.5%) compared with 2009 (25.4%), whilst an additional 13.7% and 25.0% of the 261 patients reached blood pressure targets (< 140/80 mmHg) and LDL-C targets ( < 2.5 mmol/L), respectively. Conclusion: Overall, more patients in the study reached blood pressure and LDL-C targets but there were difficulties in achieving optimal glycaemic levels over the four-year period. This study highlights the complexities of managing risk factors in T2DM, especially glucose control.

Author Biographies

Yacob Pinchevsky, University of the Witwatersrand
BPharm, MSc, PhD Candidate Department of Pharmacy and Pharmacology School of Therapeutic Sciences Faculty of Health Sciences University of the Witwatersrand
Varada Shukla, University of the Witwatersrand
BSc (Hons), Medical Student Department of Pharmacy and Pharmacology School of Therapeutic Sciences Faculty of Health Sciences University of the Witwatersrand
Neil Butkow, University of the Witwatersrand
Lecturer BSc(Hons), PhD Department of Pharmacy and Pharmacology School of Therapeutic Sciences Faculty of Health Sciences University of the Witwatersrand
Frederick J Raal, University of the Witwatersrand
FRCP, FRCPC, FCP(SA), Cert Endo, MMed, PhD Director Carbohydrate and Lipid Metabolism Research Unit; and Professor and Head Division of Endocrinology and Metabolism Faculty of Health Sciences University of the Witwatersrand
Tobias Chirwa, University of the Witwatersrand
BSc, MSc, PGDip, PhD Associate Professor Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand
Published
2015-04-22
Section
Original Research