title: Diabetes mellitus related treatment goals: awareness and attainment in the Ife-Ijesa zone of south-western Nigeria.
abstract: Evidence emanating from research data have demonstrated that improved metabolic and blood pressure outcomes reduce the morbidity and mortality associated with diabetes. Primary goals of therapy have also been recommended to realise this objective. This study determined the prevalence of attainment of recommended goals for glycaemic and blood pressure control in type 2 diabetics attending the diabetes clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. We also assessed the knowledge and use of International guidelines for the clinical management of diabetes mellitus by health care providers in the Ife-Ijesa health zone of Osun State, South Western Nigeria. The charts and case records of One hundred and five (105) type 2 diabetics seen over a five-week period were reviewed to assess the prevalence of attainment of blood pressure and glycaemic control goals. The mean BP and fasting blood glucose of all patients at each clinic visit was determined and were compared statistically. Knowledge and practice of diabetes related treatment goals were assessed by means of a questionnaire administered on 133 diabetes health care providers. Forty-six (43.8%) patients attained the target fasting blood glucose level of = 6.7mmol/l while 52 (49.5%) had blood sugar levels = 7.8mmol/l after three clinic visits. Comparable results were obtained for the target 2 hour post prandial blood glucose targets. 15 (20%) subjects attained the target SBP of = 120/80 mmHg and 25 (25%) if the target was = 130/85 mmHg. All patients demonstrated significant mean BP lowering by the third clinic visit P = 0.000 (ANOVA) in all cases. There was also a significant lowering of mean FBS and 2hrPP blood glucose in all patients after 3 clinic visits P < 0.01. 16 (12%) health care providers had a good knowledge of current treatment recommendations. Of these, 13 (81.3%) were Doctors, 2 (12.5%) were nurses, and 1 (6.3%) other allied health worker. When analysed according to occupational groups, 17.3% doctors, 4.1% nurses and 11.1% amongst the group of allied health providers possessed good knowledge and practice of current treatment guidelines and treatment goals. While our current strategies achieved significant BP and blood glucose lowering, very few patients attained recommended targets. There is still a need for intensification of current strategies and periodic evaluation of its effectiveness in achieving optimal targets.
authors.affiliation: Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. kkole@oauife.edu.ng
authors.forename: B A
authors.initials: BA
authors.lastname: Kolawole
authors.forename: C
authors.initials: C
authors.lastname: Adegbenro
authors.forename: Z O
authors.initials: ZO
authors.lastname: Ayoola
authors.forename: B
authors.initials: B
authors.lastname: Opebiyi
mesh_terms: D001364:Awareness; D001786:Blood Glucose / Q000032:analysis; D001795:Blood Pressure Determination; D002983:Clinical Competence; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose