A review of the management of patients with Type 2 diabetes at Leratong Hospital, 2010.
Introduction: The Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) acknowledge in their guidelines that diabetic care is complex and requires that numerous issues, beyond glycaemic control, be addressed. To further ensure a high quality of care, it is necessary that healthcare workers constantly check whether the standard of care offered is effective, equitable, efficient and humane. Aim: The aim of the study was to review the clinical management of patients with type 2 diabetes at Leratong Hospital in relation to the SEMDSA guidelines for Diagnosis and Management of Type 2 Diabetes Mellitus for Primary Health Care – 2009. Methods: This was a observational descriptive study using data from the charts of 388 patients with type 2 diabetes who access care at Leratong Hospital. Results: The majority of participants were male. Their average age was 55.7 years (range: 33 to 83 years). The glycosylated haemoglobin was documented in 64.95% of patients, weight in 5.67%, blood pressure in 96.39%, lipid in 21.39%, serum creatinine in 90.46%, urine dipstick in 90.91%, patient education in 98.2%, eye examination in 51.8%, foot examination and micro albumin in less than 1%. Optimal control of glycosylated haemoglobin, systolic blood pressure, diastolic blood pressure, cholesterol and triglyceride was noted in 5.56%, 46.72%, 16.8%, 80.77% and 74.67% respectively. Thirty eight percent of patients were on two oral anti diabetic agents, the majority of patients (94.32%) were receiving an ACE inhibitor for blood pressure control, 34.02% were on statin therapy, and 92.01% were on aspirin. Less than 1% were on Clopidogrel and fibrate. Conclusion: overall the quality of management of patients with type 2 diabetes is poor and there is a need for improvement.