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- Management of Diabetic Mellitus in Low-income Rural Patients.
- Hye Yeon Kim, Woo Jun Yun, Min Ho Shin, Sun Seong Kweon, Hye Ran Ahn, Seong Woo Choi, Young Hoon Lee, Dong Hyeok Cho, Jung Ae Rhee
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Journal of Preventive Medicine and Public Health 2009;42(5):315-322
DOI: https://doi.org/10.3961/jpmph.2009.42.5.315
2Jeonman Regional Cancer Center, Chonnam National University Hwasun Hospital, Korea.
3Department of Preventive Medicine, College of Medicine, Seonam University, Korea.
4Department of Internal Medicine, Chonnam National University Medical School, Korea.
Abstract
OBJECTIVES
Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. METHODS: We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. ankle-brachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. RESULTS: The age of diabetic subjects was 68.7+/-8.7 years and the duration of diabetes was 8.9+/-8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. CONCLUSIONS: DM management in low income patients is very poor and requires further work to improve.
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