How well controlled are our type 2 diabetic patients in 2002? An observational study in North and Central Trinidad

Objectives: To determine the proportion of diabetic patients that achieved glycemic control (HbAlc 17.0 pound%) and to explore some of the barriers to achieve this control. Design: Cross-sectional, observational study. Setting: Health centres in North and Central Trinidad. Patients: One hundred and thirty-two type 2 diabetics attending the health centres for more than I year. Main outcome measures: HbAlc levels and the proportion of patients who achieve glycemic control, HbAlc 0.0%. Results: The patients were categorized into two groups: well controlled, HbA1c Y0.0% and poorly controlled, HbA1c > 7.0%. The majority of patients were poorly controlled (55.3%), duration of diabetes impacted negatively older patients and patients attending the clinics for longer periods were less likely to be well controlled. There was no correlation between pharmacological treatment, availability of individual counselling by a dietician or regular monitoring of blood glucose and glycemic control (p > 0.05). Conclusion: A 44.7% of patients with type 2 diabetes were found to be well controlled. Old age (51-70 years) and lengthy periods of attendance seem to be barriers to achieving glycemic control. This study highlights the fact that there is a need for re-evaluation of the diabetic program since despite changes in the primary care system over the past 5 years a large proportion of diabetics are still uncontrolled. (c) 2006 Elsevier Ireland Ltd. All rights reserved.