Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
J Diabetes Res. 2017;2017:9536025. doi: 10.1155/2017/9536025. Epub 2017 Oct 10.
The management of cardiometabolic goals or "ABCs" (HbA1c, blood pressure (BP), and cholesterol) ultimately determines the morbidity and mortality outcomes in patients with type 2 diabetes mellitus (T2DM). We sought to determine if patients with T2DM attending an urbanized public sector community health centre (CHC) were having their ABCs measured, were treated with appropriate cardioprotective agents and finally, were achieving guideline-based targets.
A cross-sectional record review of 519 patients was conducted between May and August 2015. The mean age was 54 years (SD: ±11.5) and 54% ( = 280) were females. Testing of ABCs occurred in 68.8% ( = 357) for HbA1c, 95.4% ( = 495) for BP, and 58.6% ( = 304) for LDL-C. Achievement of ABC targets was as follows: 19.3% (HbA1c < 7%), 22.0% (BP < 140/80 mmHg), and 56.3% (LDL-C < 2.5 mmol/l).
There were a significant number of patients who were not tested nor received adequate pharmacotherapy or achieved their ABC targets. This places these patients at an increased risk for the development of diabetes-related complications. Although the realities of resource constraints exist in South Africa's public sector settings, a wider implementation of evidence-based guidelines must be instituted in order to ensure better patient outcomes.
心脏代谢目标的管理（即“ABCs”，HbA1c、血压（BP）和胆固醇）最终决定了 2 型糖尿病（T2DM）患者的发病率和死亡率。我们试图确定在接受城市化公立社区卫生中心（CHC）治疗的 T2DM 患者是否测量了他们的 ABC，是否使用了适当的心脏保护剂，最终是否达到了基于指南的目标。
2015 年 5 月至 8 月期间，对 519 名患者进行了横断面记录回顾。平均年龄为 54 岁（标准差：±11.5），54%（=280）为女性。HbA1c 的 ABC 检测率为 68.8%（=357），BP 为 95.4%（=495），LDL-C 为 58.6%（=304）。ABC 目标的达标率如下：19.3%（HbA1c<7%），22.0%（BP<140/80mmHg），56.3%（LDL-C<2.5mmol/l）。
有相当数量的患者既未接受检测，也未接受足够的药物治疗，也未达到 ABC 目标。这使这些患者面临着发生与糖尿病相关的并发症的风险增加。尽管南非公立部门的资源限制是现实存在的，但必须更广泛地实施基于证据的指南，以确保更好的患者结局。
