Assessment of patient compliance in a diabetic clinic using glycated proteins compared with blood sugar measurements

ABSTRACT

Thirty non-insulin-dependent (NID) and 10 insulin-requiring (IR) patients were randomly selected in the Diabetic Outpatients Clinic at the University Hospital of the West Indies. There were 29 (72.5 percent) female and 11 (27.5 percent) male patients with a medium age of 53.1 years (range 11-79) and a mean body mass index of 25.5 (range 17.7-35.3). Mean duration of diabetes 10+ years (range 2-25 years) They had all been attending the diabetic clinic for a minimum of two years. The patients were followed up at 30-day intervals for 90 days and at each visit, detailed checks were done of their blood count, chemistry and metabolic profile; in particular, the fasting blood sugar, fructosamine in the IR group, glycosylated haemoglobin and fasting insulin levels in the NID group were determined. Despite the close monitoring of this select group, their control as assessed by fasting blood sugar and glycated protein levels revealed uniformly insatisfactory results. These findings have an important implication on recent Pan American World Health data which reveal that diabetes mellitus is now the leading cause of death in the Caribbean (AU)