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. 1999 Oct;75(888):603–606. doi: 10.1136/pgmj.75.888.603

Assessment of glycaemic control in stable type 2 black South African diabetics attending a peri-urban clinic

R Erasmus 1, E Blanco 1, A Okesina 1, Z Gqweta 1, T Matsha 1
PMCID: PMC1741374  PMID: 10621901

Abstract

Glycaemic control was assessed in type 2 black diabetics attending the diabetic clinic at a peri-urban hospital. Baseline glycosylated haemoglobin levels were measured and a subsequent estimation was carried out in those patients who attended a follow-up consultation to see whether current recommended targets for glycosylated haemoglobin levels were being attained. Out of 708 patients, mean age 56.3 years, 14.7% were insulin treated and 85.3% were non-insulin-treated. Target values of HbA1c < 7% were achieved in only 20.1% (142) of patients. Although mean glycosylated haemoglobin levels were significantly higher in females (p= 0.03), the proportion of poorly controlled diabetics was similar in the two sexes. Patients whose HbA1c levels fell within the target values had diabetes of significantly shorter duration than those exhibiting poor control (5.0+0.2 vs 7.03+0.5 years). Obesity was present in 562 patients (79.4%). Target values were only achieved in 16.4% of non-obese and 21% of obese diabetics, with mean glycosylated haemoglobin levels being significantly higher (p<0.05) in the former group (10.3+0.4% vs 9.5+0.2%). Similar results were observed with respect to type of treatment, with only 14.4% of insulin-treated and 21% of non-insulin-treated diabetics achieving target values. The follow-up HbA1c estimation did not show any difference in the glycaemic control status of patients, with only 19.9% of them achieving the target values. Dietary advice (though minimal) seemed to have no impact on the metabolic control of our patients. These results suggest that glycaemic control was poor irrespective of sex, duration, BMI, educational status, dietary advice and type of treatment with recommended target values not being achieved in the majority of patients. Behavioural changes through health educational programmes need to be instituted with both patient and medical personnel being motivated to take this process forward.


Keywords: diabetes mellitus; black South Africans; glycaemic control

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Selected References

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  1. Anderson R. M., Herman W. H., Davis J. M., Freedman R. P., Funnell M. M., Neighbors H. W. Barriers to improving diabetes care for blacks. Diabetes Care. 1991 Jul;14(7):605–609. doi: 10.2337/diacare.14.7.605. [DOI] [PubMed] [Google Scholar]
  2. Boulton A. J. DCCT: implications for diabetes care in the UK. Diabet Med. 1993 Oct;10(8):687–687. doi: 10.1111/j.1464-5491.1993.tb00148.x. [DOI] [PubMed] [Google Scholar]
  3. Butler C., Peters J., Stott N. Glycated haemoglobin and metabolic control of diabetes mellitus: external versus locally established clinical targets for primary care. BMJ. 1995 Mar 25;310(6982):784–788. doi: 10.1136/bmj.310.6982.784. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Campbell L. V., Barth R., Gosper J. K., Jupp J. J., Simons L. A., Chisholm D. J. Impact of intensive educational approach to dietary change in NIDDM. Diabetes Care. 1990 Aug;13(8):841–847. doi: 10.2337/diacare.13.8.841. [DOI] [PubMed] [Google Scholar]
  5. Castle W. M., Wicks A. C. A follow-up of 93 newly diagnosed African diabetics for 6 years. Diabetologia. 1980;18(2):121–123. doi: 10.1007/BF00290487. [DOI] [PubMed] [Google Scholar]
  6. D'Eramo-Melkus G. A., Wylie-Rosett J., Hagan J. A. Metabolic impact of education in NIDDM. Diabetes Care. 1992 Jul;15(7):864–869. doi: 10.2337/diacare.15.7.864. [DOI] [PubMed] [Google Scholar]
  7. Delamater A. M., Albrecht D. R., Postellon D. C., Gutai J. P. Racial differences in metabolic control of children and adolescents with type I diabetes mellitus. Diabetes Care. 1991 Jan;14(1):20–25. doi: 10.2337/diacare.14.1.20. [DOI] [PubMed] [Google Scholar]
  8. Levitt N. S., Katzenellenbogen J. M., Bradshaw D., Hoffman M. N., Bonnici F. The prevalence and identification of risk factors for NIDDM in urban Africans in Cape Town, South Africa. Diabetes Care. 1993 Apr;16(4):601–607. doi: 10.2337/diacare.16.4.601. [DOI] [PubMed] [Google Scholar]
  9. McLarty D. G., Kinabo L., Swai A. B. Diabetes in tropical Africa: a prospective study, 1981-7. II. Course and prognosis. BMJ. 1990 Apr 28;300(6732):1107–1110. doi: 10.1136/bmj.300.6732.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Parson W., Macdonald F. W., Shaper A. G. African diabetics necropsied at Mulago Hospital, Kampala, Uganda 1957-1966. East Afr Med J. 1968 Mar;45(3):89–99. [PubMed] [Google Scholar]
  11. Rao R. H. Diabetes in the undernourished: coincidence or consequence? Endocr Rev. 1988 Feb;9(1):67–87. doi: 10.1210/edrv-9-1-67. [DOI] [PubMed] [Google Scholar]
  12. Weatherspoon L. J., Kumanyika S. K., Ludlow R., Schatz D. Glycemic control in a sample of black and white clinic patients with NIDDM. Diabetes Care. 1994 Oct;17(10):1148–1153. doi: 10.2337/diacare.17.10.1148. [DOI] [PubMed] [Google Scholar]

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