The Implementation of Guidelines in a South African Population with Type 2 Diabetes

ABSTRACT

Objective: The aim of this study was to identify the treatment gaps that pertain to risk factors in South African patients with type 2 diabetes mellitus; using national treatment guidelines.Design: Cross-sectional study.Setting and subjects: The study consisted of 666 patients with type 2 diabetes mellitus; attending a diabetes clinic at the Charlotte Maxeke Johannesburg Academic Hospital.Outcome measures: Using a public sector database; retrospective data were obtained on the treatment of type 2 diabetes mellitus participants. Patients were randomly selected on the basis of established type 2 diabetes mellitus diagnosis; and if they were receiving oral hypoglycaemic and/or insulin therapy. Age; gender; race; blood pressure; haemoglobin A1c (HbA1c) and fasting lipids were captured and measured. The history of patients' previous coronary artery disease; strokes; nephropathy; neuropathy and retinopathy was recorded.Results: The mean age of the patients was 63 years [standard deviation (SD) 11.9]; 55of whom were females. The HbA1c was 8.8 (SD 2.5). 26.2 of patients attained HbA1c levels of 7. Of the total patients; 45.8 met a 130/80 mmHg blood pressure target; and 53.8 a low-density lipoprotein (LDL) cholesterol of 2.5 mmol/l. Only 7.5 obtained the combined target for HbA1c ; blood pressure and LDL cholesterol.Conclusion: Traditionally; type 2 diabetes mellitus treatment has centred on correcting blood glucose levels. Yet; as many as 80