The status of diabetes mellitus in primary care institution and restructured hospitals in Singapore.
The Diabcare-Asia Singapore 1998 project was carried out using data from 22 centres collected on paper forms to provide an overview of diabetes management and metabolic control status in 1697 diabetic patients from both primary health care clinic (PHC) (67%) and restructured hospital (RH) (33%) settings. PHC patients were on average older than RH patients (61.3 +/- 11.2 years vs 51.5 +/- 17.7 years), and had a shorter duration of diagnosed diabetes (9.2 +/- 6.8 years vs 12.0 +/- 8.5 years). The mean body mass index (BMI) for PHC patients was 25.5 +/- 4.4 kg/m2 vs 24.5 +/- 4.2 kg/m2 for RH patients. Proportionately more PHC than RH patients were overweight (BMI >25 kg/m2) (49% vs 42%). Patients with type I diabetes constituted 3.5% of PHC vs 18.1% of the RH cohort. HbA1c information was available for 92.5% of RH vs 69% of PHC patients. HbA1c measurements were <1% above ULN in 50% of PHC vs 37% of RH patients, while FBG was >7.8 mmol/l in >61% of all patients. Proteinuria (>500 mg/24 hrs) was reported in 13% of PHC vs 26% of RH patients tested. Microalbuminuria (20-300 mg/l) was noted in 36% of 171 RH patients tested. Oral hypoglycaemic agents were used as sole therapy in 83.5% of PHC vs 43% of RH patients. Eye, feet, renal and severe late complications were more commonly reported by RH than PHC patients. There is a variation in the patient profiles and care between PHC and RH patients.
Lee
W R
WR
Dept of Paediatrics, KK Women s and Children s Hospital, Singapore. warren@kkh.com.sg
Emmanuel
S
S
Lim
H S
HS
Thai
A C
AC
Chew
W L
WL
Goh
L G
LG
Lau
H C
HC
Lee
C H
CH
Soon
P C
PC
Tambyah
J A
JA
Tan
Y T
YT
Jorgensen
L N
LN
Chua
A
A
Yeo
J P
JP
D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000503:physiopathology; D019468:Disease Management; D005128:Eye Diseases / Q000209:etiology; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore