Suboptimal glycaemic and blood pressure control and screening for diabetic complications in adult ambulatory diabetic patients in Uganda: a retrospective study from a developing country

BACKGROUND Currently, Sub Saharan Africa is faced with a substantial burden from diabetes mellitus. In most of the African countries, screening for diabetes related complications and control of blood pressure and glycaemic levels is often suboptimal.The study aimed at assessing the extent of optimal glycaemic and blood pressure control and the frequency of screening for diabetic complications in adult ambulatory Ugandan diabetic patients. METHODS This was a retrospective study of 250 medical records of adult diabetic patients attending the outpatient diabetic clinic at St. Raphael of St. Francis hospital Nsambya in Kampala, Uganda. RESULTS The mean age of the patients was 51.6 ± 9.2 years with the majority being females (155, 62%). Using fasting blood glucose levels assessed in all the patients, optimal glycemic control of <7.2 mmol/l was noted in 42.8% of the patients. Glycated haemoglobin was performed at least once in the last year in 24 (9.6%) patients , of which 5 (20.8%) of these attained optimal control of <7%. Optimal blood pressure (BP) control defined as BP ≤140/80 mmHg was noted in 56% of the patients. Hypertension and diabetic neuropathy were the most screened for diabetic complications in 100% and 47.2% of the patients respectively and were also the most prevalent diabetic complications (76.4% and 31.2% respectively). CONCLUSIONS This study demonstrates that glycemic and blood pressure control and screening for diabetic complications among the adult ambulatory diabetic patients in this urban diabetic clinic is suboptimal. This substantiates development and implementation local guidelines to improve diabetes care.