Assessment Of The Clinical Treatment Outcomes And Direct Medical Costs Among Type 2 Diabetes Mellitus Outpatients At The Hospital Universiti Sains Malaysia
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Date
2011
Authors
Ibrahim Abougalambou, Salwa Selim
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Publisher
Universiti Sains Malaysia
Abstract
Diabetes mellitus (DM) is becoming a major public health problem, especially now that a large proportion of health care expenditure is being spent on the treatment of this disease and its complications. This was a prospective observational study of diabetes type 2 patients with the objectives of assessing the treatment modalities, glycaemic control and the factors associated with the development of macro and microvascular complications, and evaluating the direct medical costs of treating diabetic type 2 patients at the Hospital Universiti Sains Malaysia (HUSM). All of the type 2 diabetes patients who attended and were followed-up at the HUSM diabetes clinic were included in this study.
A total of 1077 patients with type 2 diabetes were recruited for this study, with ages ranging from 18 to 88, and a median age of 58 years. The majority of the patients were female, and less than half of the patients had more than high school certificates. The mean duration of diabetes was 11.2 (+6.81) years, the mean glycosylated haemoglobin (HbA1c) was 8.7% (+2.34), the mean fasting blood glucose level was 7.8 mmol/l (+3.72), and the mean postprandial plasma glucose level was 10.0 mmol/l (+4.38).
It was found that 26.3% of the patients had optimal control (HbA1c <7%) and that 73.7% had inadequate control (HbA1c >7%). Overall, 747 patients (69.4%) were on oral antidiabetes medications, whereas 30.6% were on insulin injections, alone or with oral hypoglycaemic agents. The factors that influenced HbA1c levels were found to be age, race and antidiabetic medication. However, the factors that influenced fasting plasma glucose were age and smoking while the factors that influence postprandial plasma glucose were gender and duration of diabetes. Furthermore, it was found that the variable factors influencing the development of macrovascular complications were age, education level, body mass index (BMI), waist circumference, antidiabetic medication, diastolic blood pressure (BP), and cholesterol level. However, microvascular complications were influenced by age, triglycerides, and creatinine clearance rate.
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Keywords
Assessment of the clinical treatment outcomes , and direct medical costs among type 2 diabetes mellitus