Achievement of diabetes care goals at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

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  • Submited: September 21, 2020
  • Published: September 23, 2020

Abstract

Introduction: Diabetes mellitus (DM) is a major public health problem and responsible for premature death, and chronic disabling complications. Implementation of evidence-based interventions have resulted in improvement in achievement of diabetes care goals in several high-income countries. However, there is limited evidence for this in low-middle-income countries.

Objective: To assess achievement of diabetes care goals in people with diabetes at the Tikur Anbessa Hospital diabetes center in Ethiopia.

Methods: We conducted a cross-sectional hospital-based study (n=421) at Tikur Anbessa Specialized Hospital, in Addis Ababa. The study was done among ambulatory patients with type 2 diabetes and type 1 diabetes of > 5 years duration. We used a structured questionnaire and data abstraction checklist to document demographic characteristics and diabetes-related information. We also conducted physical examination and laboratory tests.

Results: Overall, 421 study participants were included. The mean age was 52.7±13 years.  Majority was female (55.6%). Sixty-one percent access health care service for free. Majority (81.5%) of the study participants were type 2.  The mean duration of diabetes was 12.6± 8.9 years. More than 50% of the study participants had diabetes for more than 10 years. 45% were on Insulin, 30% on metformin and 25% on combined oral agents.

 

Conclusion: The achievement of diabetes care goals is lower as compared to other studies done in Ethiopia. The absence of standardized monitoring tool, inconsistent patient-doctor relationship and follow up by internal medicine residents with little supervision may have contributed for the lower rate of diabetes care goal achievement.

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References

  1. International Diabetes Federation. IDF Diabetes Atlas, 7th edn. Brussels, Belgium
  2. L.D. Nshisso et al. / Diabetes & Metabolic Syndrome: Clinical Research & Reviews 6 (2012) 36–41
  3. Abebe et al. BMC Public Health 2014, 14:97
  4. Eagan, Arielle. (2018). Ethiopia NCDI Poverty Commission: Commission Summary Report.
  5. Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008;358(24):2560–72.
  6. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators. Lancet 2000;355(9200):253–9.
  7. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ 1998;317(7160):703–13.
  8. Collins R, Armitage J, Parish S, Sleigh P, Peto R. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet 2003;361(9374):2005–16.
  9. Mohammed K. Ali, Kai McKeever Bullard, Jinan B. Saaddine et al. Achievement of Goals in U.S Diabetes Care, 1999–2010.N Engl J Med 2013;368:1613-24. DOI: 10.1056/NEJMsa1213829
  10. Jennifer Manne-Goehler, Rifat Atun, Andrew Stokes et al. Diabetes diagnosis and care in sub-Saharan Africa: pooled analysis of individual data from 12 countries Lancet Diabetes Endocrinol 2016; 4: 903–12
  11. Shillah Mwaniga Mwavua, Edward Kiogora Ndungu et al. A comparative study of the quality of care and glycemic control among ambulatory type 2 diabetes mellitus clients, at a Tertiary Referral Hospital and a Regional Hospital in Central Kenya: Mwavua et al. BMC Res Notes (2016) 9:12
  12. Gudina et al. Assessment of quality of care given to diabetic patients at Jimma
  13. University Specialized Hospital diabetes follow-up clinic, Jimma, Ethiopia BMC
  14. Endocrine Disorders 2011, 11:19.
  15. IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care - 2017
  16. JNC 8 Guidelines for the Management of Hypertension in Adults. Am Family Physician. 2014 Oct 1;90(7):503-504.
  17. Ezra Belay et al. Achievement of Diabetes goals and their determinants in Type 2 Diabetic patients attending outpatient diabetic clinic in Northern Ethiopia. International journal of Chronic Diseases Volume 2017, Article ID 571318
  18. R. Kamuhabwa and E. Charles, “Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam,” Journal of Drug, Healthcare and Patient Safety, vol. 6, pp. 155–165, 2014
  19. A. Elis, L. Rosenmann, G. Chodick, A. D. Heymann, E. Kokia, and V. Shalev, “Te association between glycemic, lipids and blood pressure control among Israeli diabetic patients,” QJM: An International Journal of Medicine, vol. 101, no. 4, pp. 275–280, 2008
  20. Y. Pinchevsky, V. Shukla, N. Butkow, FJ. Raal, and T. Chirwa, “The achievement of glycaemic, blood pressure and LDL cholesterol targets in patients with type 2 diabetes attending a South African tertiary hospital outpatient clinic,” Journal of Endocrinology, Metabolism and Diabetes of South Africa, vol. 20, no. 2, pp. 81–86, 2015
  21. Jinan B. Saaddine et al. Improvements in Diabetes Processes of Care and Intermediate Outcomes: United States, 1988–2002. Ann Intern Med. 2006;144:465-474
  22. Mohammed K. Ali et al. Achievement of Goals in U.S. Diabetes Care, 1999–2010. N Engl J Med 2013;368:1613-24
  23. Goh CC, Koh KH, Goh SCP, et al. Achieving triple treatment goals in multi-ethnic Asian patients with type 2 diabetes mellitus in primary care. Malays Fam Physician. 2018;13(2);10–18
  24. Ji L, Hu D, Pan C, Weng J, Huo Y, Ma C, et al. Primacy of the 3B approach to control risk factors for cardiovascular disease in type 2 diabetes patients. Am J Med. 2013 Oct;126(10):925.e11–22.
  25. Mohammed K. Ali et al. Effectiveness of a Multicomponent Quality Improvement Strategy to Improve Achievement of Diabetes Care Goals. Ann Intern Med. Doi:10.7326/MI5-2807
How to Cite
Yifter, H. ., Reja, A. ., Ahmed, A. ., Narayan, K. V. ., & Amogne, W. . (2020). Achievement of diabetes care goals at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia . Ethiopian Medical Journal, 58. Retrieved from https://emjema.org/index.php/EMJ/article/view/1702

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