Control of Risk Factors for Cardiovascular Disease Among Adults with Previously Diagnosed Type 2 Diabetes Mellitus: A Descriptive Study from a Middle Eastern Arab Population

Abstract

Background:Despite the high burden of type 2 diabetes mellitus (T2DM) in Oman, there are scarce data from a nationally representative sample on the level of glycaemia and other cardiovascular (CVD) risk factor control.Objective:To estimate the proportion of patients with T2DM at goal for glycaemia and CVD risk factors using the National Diabetes Guidelines (NDG) and the American Diabetes Association (ADA) clinical care guidelines; and to assess the quality of selected services provided to patients with T2DM.Methods:A sample of 2,551 patients (47% men) aged ≥20 years with T2DM treated at primary health care centers was selected. Patient characteristics, medical history and treatment were collected from case notes, Diabetes Registers and computer frameworks including the use of the last 3 laboratory investigations results and blood pressure (BP) readings recorded in 2007.Results:The overall mean age of the cohort was 54±13 years with an average median duration of diabetes of 4 (range 2 to 6) years. Over 80% of patients were overweight or obese (body mass index (BMI) of ≥25 Kg/m2). Sixty-nine percent were on oral anti-diabetic medication, 52% on anti-hypertensives and 40% on lipid lowering drugs. Thirty percent of patients were at goal for glycosylated haemoglobin level (<7%), 26% for BP (systolic/diastolic <130/80 mmHg), 55% for total cholesterol (<5.2 mmol/l), 4.5% for low-density lipoprotein cholesterol (<1.8 mmol/l), 52% for high-density lipoprotein cholesterol (>1 mmol/l for men, >1.3 mmol/l for women), and 61% for triglycerides (<1.7 mmol/l). Over 37% had micro-albuminuria and 5% had diabetic nephropathy.Conclusion:Control of hyperglycaemia and other CVD risk factor appears to be suboptimal in Omani patients with T2DM and need to be addressed in the triad of patient, physician and health system.

Quality of Diabetes Care at Outpatient Clinic, Sultan Qaboos University Hospital

“…Previous studies among Omani patients, at primary health care centers reported similar results. [10][11][12] Our blood pressure control results are similar to tertiary centers in Saudi Arabia, the United Arab Emirates, and Lebanon. [22][23][24] Other studies reported it at 11-36%.…”

“…16 Other Omani studies, done at primary health care centers, also reported a higher number of patients (24-30%) with glycemic control. 10,12 The clinical outcomes from care that patients with T2D received at SQUH did not match those from Europe, 17,18 North America, 19 Canada, 20 and Australia. 21 Compared to reports from similar tertiary centers in Europe, 17 Canada, 20 and Australia, 21 clinical outcomes in Omani patients were lower.…”

“…[10][11][12] This study assessed the quality of diabetes care at Sultan Qaboos University Hospital (SQUH), a countrywide tertiary referral center in Oman, through the evaluation of HbA 1C , blood pressure, serum lipids and urine albumin/creatinine ratio in a sample of Omani T2D patients. The assessment was done using the American Diabetes Association (ADA) standards of medical care in diabetes and guidelines from the American National Cholesterol Education Program III NCDP NIII Adult Treatment Panel (ATP).…”

Glycated Hemoglobin (Hba1c) Is a Predictor of Dyslipidemia in Type 2 Diabetes Nepalese Patients.

“…It seems that type 2 diabetic patients of > 40 years of age are slightly more vulnerable in this respect compared to the < 40 age group. However, study done by Al Lawati et al [8], reported that the younger Omani type 2 diabetics exhibited worse glycemic state compared to older patients.…”

“…In each year, about 5% of all deaths are caused by diabetes globally [7]. This risk, however, can be reduced by good management and control of hyperglycemia as well as dyslipidemia [8].…”