Loss of follow-up of diabetic patients: What are the reasons?

Sir,

Diabetes mellitus (DM) is a very common disease in general clinical practice. In each hospital, the DM clinic is usually crowded with many diabetic patients. An important concept in managing diabetic cases is to have a good control of blood sugar of the patients. Hence, it is no doubt that long-term follow-up of the patients is required. However, an important practical problem in general practice is the poor control of DM and an important reason is loss of follow-up. Here, the author would like to show some interesting experience on 200 diabetic patients who are regular diabetic patients in a primary care unit and had the history of loss of follow-up.

A simple question for every patient is “What is the reason for loss of follow-up?” Focusing on the answers, the following reasons are given: (a) patients think that the blood glucose is already in control (from the data in previous laboratory report) (110 cases, 55%), (b) loss of appointment card (40 cases, 20%), (c) busy on the appointment date (20 cases, 10%), (d) the appointment date is the holiday vacation period (10 cases, 5%), (e) they try to have other alternative treatment(s) (10 cases, 5%), and (f) fear of side effects of prolonged usage of antidiabetic drugs (10 cases, 5%).

Of interest, it can show that many patients who lost for follow-up have the reasons according to poor attitude and knowledge on DM. This is already described in some similar studies done previously in other settings.[1-2] Indeed, the importance of DM education for general population is recently mentioned in this journal by Pal et al.[3] The author hereby would like to add that a more specific education to the one with disease is as important.