Management of diabetes mellitus in three settings in Jamaica

ABSTRACT

A sample of 437 diabetic patients was selected during a six week census to evaluate the quality of diabetic care in three clinics in the private and public sector in Jamaica. A comparison was also made between a dedicated hospital clinic (UHWI) and general medical clinics. The mean age ranged from 54 to 62 years. Median duration of follow up ranged from 6 to 9 years. Less than 10 percent were controlled with diet only and insulin was used more commonly at the UHWI (46 percent) than at the general clinixa (7 percent each). Sulphonylurea drugs alone or in combination with metformin were the commonest agents at the other clinics. There was no significant difference among the clinics in the proportion of patients with satisfactory blood glucose control (< 8 mmol/l post-prandial). Surveillance of hypertension was frequently done (90-98 percent). The proportion of patients treated for concurrent hypertension ranged from 25 percent at UHWI to 71 percent at Spanish Town. Less than 25 percent of hypertensive patients in all clinics had good blood pressure control (BP<140/90 mmHg).(AU)