Kolawole B A, Adegbenro C, Ayoola Z O, Opebiyi B
Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Afr J Med Med Sci. 2005 Dec;34(4):389-94.
Evidence emanating from research data have demonstrated that improved metabolic and blood pressure outcomes reduce the morbidity and mortality associated with diabetes. Primary goals of therapy have also been recommended to realise this objective. This study determined the prevalence of attainment of recommended goals for glycaemic and blood pressure control in type 2 diabetics attending the diabetes clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. We also assessed the knowledge and use of International guidelines for the clinical management of diabetes mellitus by health care providers in the Ife-Ijesa health zone of Osun State, South Western Nigeria. The charts and case records of One hundred and five (105) type 2 diabetics seen over a five-week period were reviewed to assess the prevalence of attainment of blood pressure and glycaemic control goals. The mean BP and fasting blood glucose of all patients at each clinic visit was determined and were compared statistically. Knowledge and practice of diabetes related treatment goals were assessed by means of a questionnaire administered on 133 diabetes health care providers. Forty-six (43.8%) patients attained the target fasting blood glucose level of = 6.7mmol/l while 52 (49.5%) had blood sugar levels = 7.8mmol/l after three clinic visits. Comparable results were obtained for the target 2 hour post prandial blood glucose targets. 15 (20%) subjects attained the target SBP of = 120/80 mmHg and 25 (25%) if the target was = 130/85 mmHg. All patients demonstrated significant mean BP lowering by the third clinic visit P = 0.000 (ANOVA) in all cases. There was also a significant lowering of mean FBS and 2hrPP blood glucose in all patients after 3 clinic visits P < 0.01. 16 (12%) health care providers had a good knowledge of current treatment recommendations. Of these, 13 (81.3%) were Doctors, 2 (12.5%) were nurses, and 1 (6.3%) other allied health worker. When analysed according to occupational groups, 17.3% doctors, 4.1% nurses and 11.1% amongst the group of allied health providers possessed good knowledge and practice of current treatment guidelines and treatment goals. While our current strategies achieved significant BP and blood glucose lowering, very few patients attained recommended targets. There is still a need for intensification of current strategies and periodic evaluation of its effectiveness in achieving optimal targets.
研究数据表明，改善代谢和血压状况可降低糖尿病相关的发病率和死亡率。还建议设定治疗的主要目标以实现这一目的。本研究确定了在尼日利亚伊费奥巴费米·阿沃洛沃大学教学医院综合院区糖尿病诊所就诊的2型糖尿病患者中，达到血糖和血压控制推荐目标的患病率。我们还评估了尼日利亚西南部奥孙州伊费-伊杰萨健康区的医疗服务提供者对糖尿病临床管理国际指南的了解和使用情况。回顾了在五周内就诊的105例2型糖尿病患者的病历和病例记录，以评估达到血压和血糖控制目标的患病率。确定每次门诊就诊时所有患者的平均血压和空腹血糖，并进行统计学比较。通过对133名糖尿病医疗服务提供者进行问卷调查，评估他们对糖尿病相关治疗目标的了解和实践情况。46例（43.8%）患者在三次门诊就诊后达到空腹血糖目标水平≤6.7mmol/l，52例（49.5%）患者血糖水平≤7.8mmol/l。餐后2小时血糖目标也得到了类似结果。15例（20%）受试者达到收缩压目标≤120/80mmHg，若目标为≤130/85mmHg，则有25例（25%）达到。在所有情况下，第三次门诊就诊时所有患者的平均血压均显著降低，P = 0.000（方差分析）。三次门诊就诊后，所有患者的平均空腹血糖和餐后2小时血糖也显著降低，P < 0.01。16名（12%）医疗服务提供者对当前治疗建议有较好的了解。其中，13名（81.3%）是医生，2名（12.5%）是护士，1名（6.3%）是其他专职医护人员。按职业群体分析时，17.3%的医生、4.1%的护士和11.1%的专职医护人员群体对当前治疗指南和治疗目标有较好的了解和实践。虽然我们目前的策略显著降低了血压和血糖，但很少有患者达到推荐目标。仍需要强化当前策略，并定期评估其在实现最佳目标方面的有效性。
