[Management of diabetic mellitus in low-income rural patients].
OBJECTIVE
Knowledge about the management status of diabetic mellitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area.


METHODS
We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. ankle-brachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed.


RESULTS
The age of diabetic subjects was 68.7+/-8.7 years and the duration of diabetes was 8.9+/-8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease.


CONCLUSIONS
DM management in low income patients is very poor and requires further work to improve.
Kim
Hye Yeon
HY
Department of Preventive Medicine, Chonnam National University Medical School.
Yun
Woo Jun
WJ
Shin
Min Ho
MH
Kweon
Sun Seong
SS
Ahn
Hye Ran
HR
Choi
Seong Woo
SW
Lee
Young Hoon
YH
Cho
Dong Hyeok
DH
Rhee
Jung Ae
JA
D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure; D001837:Body Weights and Measures; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011203:Poverty; D012424:Rural Population; D012959:Socioeconomic Factors; D014463:Ultrasonography
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids