AIM: The aim was to determine prevalence and reasons for very poor glycaemic control (HbA1c≥10% [86 mmol/mol]) amongst people with Type 2 diabetes in an ethnically diverse urban population. METHODS: Databases of three primary health centres were searched for patients with Type 2 diabetes ≥1 year, most recent HbA1c≥10% [86 mmol/mol]. Patients were invited to explore reasons for poor glycaemic control and develop an individualised management plan. Review of glycaemic control was undertaken at 6 months. RESULTS: Of a total population of 28,677, 1261 had Type 2 diabetes (4.4%). 143 (11.3%) had last recorded HbA1c≥10% [86 mmol/mol]; 128 were reviewed (46.9% South Asian). People with poorer control had longer duration of diabetes and more South Asian ethnicity. Reasons for poor glycaemic control were: THERAPY: lack of titration of tablets (7.8%) or insulin (12.5%), poor concordance with medication (14.0%), insulin refusal (11.7%), side effects (16.4%); Engagement: poor concordance with lifestyle (26.5%), lack of knowledge of diabetes (14.0%), infrequent attendance at clinic (16.4%); Psychosocial/mental health: denial that diabetes was a problem (7.0%), mental health problem (9.4%), social issues (10.9%); Occupation: refusal of insulin due to occupation (1.6%); difficulty in attending reviews (5.5%). At six month review, 54.5% of patients had improved HbA1c≥1%. CONCLUSIONS: Poor control affects 1 in 10 of our population. We have determined a number of factors which may explain most causes. Individualised management using care planning can significantly improve control.
AIM: The aim was to determine prevalence and reasons for very poor glycaemic control (HbA1c≥10% [86 mmol/mol]) amongst people with Type 2 diabetes in an ethnically diverse urban population. METHODS: Databases of three primary health centres were searched for patients with Type 2 diabetes ≥1 year, most recent HbA1c≥10% [86 mmol/mol]. Patients were invited to explore reasons for poor glycaemic control and develop an individualised management plan. Review of glycaemic control was undertaken at 6 months. RESULTS: Of a total population of 28,677, 1261 had Type 2 diabetes (4.4%). 143 (11.3%) had last recorded HbA1c≥10% [86 mmol/mol]; 128 were reviewed (46.9% South Asian). People with poorer control had longer duration of diabetes and more South Asian ethnicity. Reasons for poor glycaemic control were: THERAPY: lack of titration of tablets (7.8%) or insulin (12.5%), poor concordance with medication (14.0%), insulin refusal (11.7%), side effects (16.4%); Engagement: poor concordance with lifestyle (26.5%), lack of knowledge of diabetes (14.0%), infrequent attendance at clinic (16.4%); Psychosocial/mental health: denial that diabetes was a problem (7.0%), mental health problem (9.4%), social issues (10.9%); Occupation: refusal of insulin due to occupation (1.6%); difficulty in attending reviews (5.5%). At six month review, 54.5% of patients had improved HbA1c≥1%. CONCLUSIONS: Poor control affects 1 in 10 of our population. We have determined a number of factors which may explain most causes. Individualised management using care planning can significantly improve control.
Authors: Elizabeth A Beverly; Shane M Fitzgerald; Kelly M Brooks; Brittney A Hultgren; Om P Ganda; Medha Munshi; Katie Weinger Journal: Diabetes Educ Date: 2013-05-02 Impact factor: 2.140
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Authors: Mekha Mathew; Jeremy van Vlymen; Bernardo Meza-Torres; William Hinton; Gayathri Delanerolle; Ivelina Yonova; Michael Feher; Xuejuan Fan; Harshana Liyanage; Mark Joy; Fabrizio Carinci; Simon de Lusignan Journal: JMIR Res Protoc Date: 2022-04-22
Authors: Turki J Al Harbi; Ayla M Tourkmani; Hesham I Al-Khashan; Adel M Mishriky; Hala Al Qahtani; Ahmed Bakhiet Journal: Saudi Med J Date: 2015-02 Impact factor: 1.484