Resumo

PILLAY, S; PILLAY, D  e  PILLAY, R. Glycated haemoglobin (HbAlc) use and glycaemic control in patients living with diabetes mellitus attending public healthcare facilities in KwaZulu-Natal Province, South Africa. SAMJ, S. Afr. med. j. [online]. 2021, vol.111, n.11, pp.1060-1064. ISSN 2078-5135.  http://dx.doi.org/10.7196/samj.2021.v111i11.15925.

BACKGROUND: Ideal control of diabetes mellitus (DM) remains a global goal, which has not yet been reached. As part of an integrated public healthcare strategy, data with subsequent analysis of diabetes control achieved in patients living with DM (PLWD) need to be available. Diabetes control data from KwaZulu-Natal (KZN) Province, South Africa, are scarce. Smaller studies conducted in public and private healthcare sectors of KZN have shown suboptimal DM controlOBJECTIVES: To identify the percentage of glycated haemoglobin (HbAlc) tests done in KZN public healthcare facilities, and to provide a glimpse into diabetes control being achieved in each KZN district municipalityMETHODS: Data regarding the number of HbAlc tests performed, number of patients with an HbAlc <7% and number of diabetes visits were accessed from the KZN Department of Health Information Systems and analysedRESULTS: The majority of HbAlc tests were performed in the metro municipality of eThekwini (p<0.001). Approximately two-thirds (64.5%) of PLWD in whom HbAlc tests had been performed, were suboptimally controlled. In 5 of the 11 KZN district municipalities more than two-thirds of PLWD had an HbAlc >7%. Most of the patients in 9 of the 11 district municipalities showed suboptimal control of their DM. The total number of HbAlc tests performed in KZN represents approximately one-tenth of the total number of diabetes treatment visits. This trend was prevalent in all 11 district municipalities, where the incidence of DM was on an upward trajectoryCONCLUSIONS: Our study demonstrated that the majority of PLWD visiting public healthcare facilities in KZN have suboptimal glycaemic control. They are at increased risk of developing diabetes-related complications, further burdening the healthcare fiscus of low- to middle-income countries. We also showed that the number of HbAlc tests being performed, in the presence of suboptimal control, was well below par. This finding serves to emphasise the need for strategies to be implemented to increase awareness of HbAlc testing for the monitoring of glycaemic control, and for making point-of-care HbAlc testing readily available in these healthcare facilities

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