An Internal Audit of Diabetes Care for Type 2 Diabetic Patients in a Public Hospital Diabetes Clinic in Malaysia

Abstract

Introduction: Earlier studies have identified a gap between guidelines and actual clinical diabetes care in Malaysia.Objective: We audited the quality of care for patients with type 2 diabetes mellitus (T2DM) attending our diabetes clinic at a public hospital.Methods: A structured review of the outpatient clinic cards, prescriptions and laboratory results was conducted for patients attending the diabetes clinic at Sibu Hospital in October and November 2014.Results: For the total of 233 patients who were audited, the levels of fasting blood sugar, blood pressure, body mass index and fasting lipid profile were satisfactory at 99.1%, 99.6%, 92.6% and 99.6% respectively. 79.7% of the subjects had had HbA1c performed at least once over the previous six months. Only 25.8% had annual foot screening, while the eye screening rate was 71.2% and the albuminuria screening rate was 93.6%. For outcome measures, the mean (SD) HbA1c level was 9.2% (1.91%), with 13 patients (6.7%) having HbA1c less than 6.5%; 36.4% of participants achieved BP < 130/80 mmHg; and 69.4% had LDL < 2.6 mmol/L. The majority of the patients were overweight or obese (91.4%).Conclusions: Overall, the performance of diabetic care processes at our hospital was satisfactory, except for foot examination. The glycaemic and weight control among the subjects were suboptimal and warrant an optimised and comprehensive approach on the part of the management.

Management and glycemic control of patients with type 2 diabetes mellitus at primary care level in Kedah, Malaysia: A statewide evaluation

“…The results demonstrate that uncontrolled T2DM, indicated by a HbA1C level above 6.5%, occurred in approximately 85% of the patients. This was consistent with the findings of several studies, which suggest that the glycemic control of T2DM patients in Malaysia has been generally suboptimal [2,21,22]. The overall mean HbA1C level found in this study (8.4%) was also slightly higher than those reported based on the NDR for the general population of Malaysia during 2009 to 2012 (8.0 to 8.3%) [20].…”

“…Consistent with the global trend, the prevalence of type 2 diabetes mellitus (T2DM) in Malaysia also grew from 11.6 to 17.5% in the last decade. The number of T2DM patients in the country is projected to reach 2.48 million by 2030 [2,3]. As one of the major non-communicable diseases, diabetes has been posing a major challenge to the Malaysian public health system, incurring an additional healthcare cost of USD 1.07 to 1.83 (MYR 4.49 to 7.67) million annually [4].…”