Universidad Peruana Cayetano Heredia

Disease characteristics and treatment of patients with diabetes mellitus attending government health services in Indonesia, Peru, Romania and South Africa

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dc.contributor.author Soetedjo, Nanny N. M.
dc.contributor.author McAllister, Susan M.
dc.contributor.author Ugarte‐Gil, Cesar
dc.contributor.author Firanescu, Adela G.
dc.contributor.author Ronacher, Katharina
dc.contributor.author Alisjahbana, Bachti
dc.contributor.author Costache, Anca L.
dc.contributor.author Zubiate, Carlos
dc.contributor.author Malherbe, Stephanus T.
dc.contributor.author Koesoemadinata, Raspati C.
dc.contributor.author Laurence, Yoko V.
dc.contributor.author Pearson, Fiona
dc.contributor.author Kerry‐Barnard, Sarah
dc.contributor.author Ruslami, Rovina
dc.contributor.author Moore, David A. J.
dc.contributor.author Ioana, Mihai
dc.contributor.author Kleynhans, Leanie
dc.contributor.author Permana, Hikmat
dc.contributor.author Hill, Philip C.
dc.contributor.author Mota, Maria
dc.contributor.author Walzl, Gerhard
dc.contributor.author Dockrell, Hazel M.
dc.contributor.author Critchley, Julia A.
dc.contributor.author Crevel, Reinout van
dc.date.accessioned 2018-10-10T23:38:08Z
dc.date.available 2018-10-10T23:38:08Z
dc.date.issued 2018
dc.identifier.uri https://doi.org/10.1111/tmi.13137
dc.identifier.uri http://repositorio.upch.edu.pe/handle/upch/3890
dc.description.abstract Objective To describe the characteristics and management of Diabetes mellitus (DM) patients from low- and middle-income countries (LMIC). Methods We systematically characterised consecutive DM patients attending public health services in urban settings in Indonesia, Peru, Romania and South Africa, collecting data on DM treatment history, complications, drug treatment, obesity, HbA1c and cardiovascular risk profile; and assessing treatment gaps against relevant national guidelines. Results Patients (median 59 years, 62.9% female) mostly had type 2 diabetes (96%), half for >5 years (48.6%). Obesity (45.5%) and central obesity (females 84.8%; males 62.7%) were common. The median HbA1c was 8.7% (72 mmol/mol), ranging from 7.7% (61 mmol/mol; Peru) to 10.4% (90 mmol/mol; South Africa). Antidiabetes treatment included metformin (62.6%), insulin (37.8%), and other oral glucose-lowering drugs (34.8%). Disease complications included eyesight problems (50.4%), EGFR <60 ml/min (18.9%), heart disease (16.5%) and proteinuria (14.7%). Many had an elevated cardiovascular risk with elevated blood pressure (36%), LDL (71.0%) and smoking (13%), but few were taking antihypertensive drugs (47.1%), statins (28.5%) and aspirin (30.0%) when indicated. Few patients on insulin (8.0%), statins (8.4%) and antihypertensives (39.5%) reached treatment targets according to national guidelines. There were large differences between countries in terms of disease profile and medication use. Conclusion DM patients in government clinics in four LMIC with considerable growth of DM have insufficient glycaemic control, frequent macrovascular and other complications, and insufficient preventive measures for cardiovascular disease. These findings underline the need to identify treatment barriers and secure optimal DM care in such settings.
dc.language.iso eng
dc.publisher Wiley Online Library
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Diabetes mellitus
dc.subject Low-and middle-income countries
dc.subject Glycaemic control
dc.subject Preventive measures
dc.subject Cardiovascular disease
dc.title Disease characteristics and treatment of patients with diabetes mellitus attending government health services in Indonesia, Peru, Romania and South Africa
dc.type info:eu-repo/semantics/article
dc.identifier.journal Tropical Medicine & International Health

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