Practice Of Self-Monitoring Blood Glucose Among Insulin-treated Diabetic Patients In Hospital Serdang

Background: Diabetes Mellitus (DM), characterised by chronic hyperglycaemia, exposes patients to acute and chronic complications, such as hypoglycaemia and vascular complications, respectively. The latter is associated with the degree of glycaemic control. Glycated haemoglobin (HbA1c) indicates long-term glycaemic control of the preceding 2-3 months. The practice of self-monitoring blood glucose (SMBG) is essential for insulin-treated diabetic patients to achieve optimum glycaemic control and prevent hypoglycaemia. Aim: The study aimed to determine the SMBG practice and frequency and its association with HbA1c and factors in insulin-treated diabetic patients. Methods: This was a cross-sectional study of insulin-treated diabetic patients attending follow-up at the diabetic clinic of Hospital Serdang from April 2015 to August 2015. Consented eligible patients completed validated selfadministered questionnaires. Patients’ HbA1c results were obtained from the hospital information system. Results: Ninetyone of 137 (66%) patients practiced SMBG and 46 (34%) did not. Although 82% had seen diabetic nurses, 54% of patients did not alter their treatment accordingly. Neither the practice nor the frequency of SMBG was significantly associated with differences in HbA1c levels (p=0.334 and p=0.116 respectively). Ethnicity and household income significantly affected SMBG practice. The presence and frequency of hypoglycaemia significantly increased the likelihood of SMBG practice (p<0.001) and frequency (p<0.001). Conclusions: The prevalence of SMBG practice in diabetic patients on insulin was 66%. However, SMBG was not followed by proper treatment alteration in 54% of patients. There was no association between SMBG practice and frequency with good glycaemic control. Hypoglycaemia significantly affected the practice and frequency of SMBG.

Current Clinical Status and Vascular Complications among Patients with Type 2 Diabetes Mellitus at Tertiary Hospitals in Malaysia.

Objective: To assess the prevalence of diabetic vascular complications and cardiovascular risk factors control in type 2 diabetic patients at tertiary settings. Methods: This cross-sectional study was conducted among 313 patients diagnosed with type 2 diabetes mellitus (T2DM) at two tertiary referral hospitals in Malaysia. Data regarding socio-demographics, macro- and microvascular complications, family health history, blood pressure, anthropometric indices, glycaemic control, and lipid profile were obtained from medical records, face-to-face interview and physical examination. Results: The mean age of patients was 55.7±9.2 years, mean diabetes duration was 10.1±8.1 years, and 52.1% were females. Approximately 36.1% patients had cardiovascular disease (CVD). There were high prevalence of established coronary artery disease (30.7%), cerebrovascular disease (10.2%), and peripheral vascular disease (5.1%). Peripheral neuropathy, diabetic nephropathy and retinopathy were present in 41.5%, 17.6% and 15.0% patients respectively. Only 14.1% of the patients reached optimal HbA1c level and 21.1% patients achieved target fasting plasma glucose. The overall prevalence of dyslipidemia was 89.1%, hypertension was 80.2%, and obesity was 35.9% (BMI) and 86.5% (waist-to-hip ratio). Conclusions: Diabetic vascular complications were highly prevalent among the type 2 diabetic patients. Cardiovascular risk factors control was suboptimal. Both awareness and application of recommended guidelines need to be reinforced.