Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care intervention
Aim: To compare metabolic control and complications in people with type 2 diabetes in Nauru and the Solomon Islands before and after a project intervention. Methods: This follow-up study compared metabolic control and complications in a cohort of 216 people with diabetes (81 from Nauru and 135 from...
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| Format: | Article |
| Language: | English |
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Elsevier
2016-06-01
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| Series: | Journal of Clinical & Translational Endocrinology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214623716300035 |
| _version_ | 1818111155788316672 |
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| author | Si Thu Win Tin Nevalyn Laesango Eva Gadabu Ruth Colagiuri |
| author_facet | Si Thu Win Tin Nevalyn Laesango Eva Gadabu Ruth Colagiuri |
| author_sort | Si Thu Win Tin |
| collection | DOAJ |
| description | Aim: To compare metabolic control and complications in people with type 2 diabetes in Nauru and the Solomon Islands before and after a project intervention.
Methods: This follow-up study compared metabolic control and complications in a cohort of 216 people with diabetes (81 from Nauru and 135 from the Solomon Islands) at baseline and 15 months following a project intervention (upgrading and equipping the existing diabetes centres, and providing training and clinical support systems) aimed at improving the quality of clinical diabetes care. Subjects were screened using a standardised protocol which gathered information on demographics, treatment, physical and biochemical parameters and their outcomes.
Results: At follow-up, glycaemic control had improved and mean HbA1c had decreased in study participants in both Nauru (mean difference (MD) = −0.9 ± 2.3%) and the Solomon Islands (MD = −0.6 ± 1.4%), P < 0.001. Mean blood pressure was reduced in the Solomon Islands (systolic MD = −11.6 ± 19.2 mmHg and diastolic MD = −5.4 ± 10.5 mmHg), P < 0.001. There were no significant changes in mean blood lipids or albumin–creatinine ratio. Overall the percentage of subjects achieving recommended clinical targets increased. However these percentages remained low, e.g. 23.5% of participants in Nauru and 20.7% in the Solomon Islands achieved an HbA1c target <7% (53 mmol/mol). A trend towards lower complications rates of foot problems was observed but there were no significant changes in the prevalence of other diabetes complications.
Conclusions: This study indicates improved metabolic control but little change in diabetes complications 15 months after intervention. Efforts to improve and evaluate the ongoing quality and accessibility of diabetes care in Pacific Island settings need to be further strengthened. |
| first_indexed | 2024-12-11T02:58:33Z |
| format | Article |
| id | doaj.art-cfbf41a4f5ec4a5bb863d8bc5f58c292 |
| institution | Directory Open Access Journal |
| issn | 2214-6237 |
| language | English |
| last_indexed | 2024-12-11T02:58:33Z |
| publishDate | 2016-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical & Translational Endocrinology |
| spelling | doaj.art-cfbf41a4f5ec4a5bb863d8bc5f58c2922022-12-22T01:23:05ZengElsevierJournal of Clinical & Translational Endocrinology2214-62372016-06-014C323710.1016/j.jcte.2016.03.001Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care interventionSi Thu Win Tin0Nevalyn Laesango1Eva Gadabu2Ruth Colagiuri3The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Charles Perkins Centre D17, Level 2, NSW 2006, AustraliaMinistry of Health and Medical Services, Solomon IslandsPublic Health Centre, Ministry of Health and Medical Services, NauruHealth and Sustainability Unit, Menzies Centre for Health Policy, The University of Sydney, Victor Coppleson Building DO2, NSW 2006, AustraliaAim: To compare metabolic control and complications in people with type 2 diabetes in Nauru and the Solomon Islands before and after a project intervention. Methods: This follow-up study compared metabolic control and complications in a cohort of 216 people with diabetes (81 from Nauru and 135 from the Solomon Islands) at baseline and 15 months following a project intervention (upgrading and equipping the existing diabetes centres, and providing training and clinical support systems) aimed at improving the quality of clinical diabetes care. Subjects were screened using a standardised protocol which gathered information on demographics, treatment, physical and biochemical parameters and their outcomes. Results: At follow-up, glycaemic control had improved and mean HbA1c had decreased in study participants in both Nauru (mean difference (MD) = −0.9 ± 2.3%) and the Solomon Islands (MD = −0.6 ± 1.4%), P < 0.001. Mean blood pressure was reduced in the Solomon Islands (systolic MD = −11.6 ± 19.2 mmHg and diastolic MD = −5.4 ± 10.5 mmHg), P < 0.001. There were no significant changes in mean blood lipids or albumin–creatinine ratio. Overall the percentage of subjects achieving recommended clinical targets increased. However these percentages remained low, e.g. 23.5% of participants in Nauru and 20.7% in the Solomon Islands achieved an HbA1c target <7% (53 mmol/mol). A trend towards lower complications rates of foot problems was observed but there were no significant changes in the prevalence of other diabetes complications. Conclusions: This study indicates improved metabolic control but little change in diabetes complications 15 months after intervention. Efforts to improve and evaluate the ongoing quality and accessibility of diabetes care in Pacific Island settings need to be further strengthened.http://www.sciencedirect.com/science/article/pii/S2214623716300035Type 2 diabetesMetabolic controlComplicationsDiabetes carePacific Islands |
| spellingShingle | Si Thu Win Tin Nevalyn Laesango Eva Gadabu Ruth Colagiuri Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care intervention Journal of Clinical & Translational Endocrinology Type 2 diabetes Metabolic control Complications Diabetes care Pacific Islands |
| title | Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care intervention |
| title_full | Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care intervention |
| title_fullStr | Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care intervention |
| title_full_unstemmed | Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care intervention |
| title_short | Comparing metabolic control and complications in type 2 diabetes in two Pacific Islands at baseline and following diabetes care intervention |
| title_sort | comparing metabolic control and complications in type 2 diabetes in two pacific islands at baseline and following diabetes care intervention |
| topic | Type 2 diabetes Metabolic control Complications Diabetes care Pacific Islands |
| url | http://www.sciencedirect.com/science/article/pii/S2214623716300035 |
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