Abstract
ObjectiveThe objective of this study was to assess patients’ achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting.MethodsThis is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations.ResultsOf the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control.ConclusionsAmongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications.
Highlights
Type 2 Diabetes Mellitus (T2DM) is a chronic disease with a growing prevalence worldwide (Fauci et al, 2009; Aschner et al, 2014)
It has been reported that more than 80% of deaths associated with T2DM in low-middle income country (LMIC) occur due to poor metabolic control (World health Organization, 2014)
7.5% of the patients achieved the levels of glycemic control in T2DM recommended by the American Diabetes Association (ADA)
Summary
Type 2 Diabetes Mellitus (T2DM) is a chronic disease with a growing prevalence worldwide (Fauci et al, 2009; Aschner et al, 2014). A multicenter study performed in the US comparing glycemic control in Hispanic/Latino, non-Hispanic white, and non-Hispanic black populations found that the non-Hispanic black and white populations had better glycemic control when compared to their Hispanic/Latino counterparts (Schneiderman et al, 2014) They reported that Hispanic/Latino populations had the lowest percentage of participants with good glycemic control among the three groups, 47.3% compared to 52.9% and 52.6% in non-Hispanic white and black populations, respectively. In another multicenter cross-sectional study conducted in nine countries in Latin America (Lopez Stewart et al, 2007) ,the overall poor glycemic control (HbA1c ≥ 7% (53 mmol/mol)) was 56.8% while Peru had the worst numbers among all with 70% having poor glycemic control. Another study conducted within an elderly population in Costa Rica reported that 37% had poor metabolic control (HbA1c ≥ 7% (53 mmol/mol)), 78% had a systolic blood pressure ≥ 130 mmHg, 66% had a diastolic blood pressure ≥ 80 mmHg, and 78% had a LDL-cholesterol ≥ 100 mg/dl (Brenes-Camacho & Rosero-Bixby, 2008)
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