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Original Research
Compliance with diabetes guidelines at a regional hospital in KwaZulu-Natal, South Africa
Submitted: 26 March 2012 | Published: 08 April 2013
About the author(s)
Okoroma J. Igbojiaku, Department of Family Medicine, Howard Campus, University of KwaZulu-Natal, South AfricaOgbonnaya C. Harbor, Department of Family Medicine Ngwelezane Hospital, KwaZulu-Natal, South Africa
Andrew Ross, Department of Family Medicine, Howard Campus, University of KwaZulu-Natal, South Africa
Abstract
Background: Diabetes is a major problem in South Africa and throughout the world. Themanagement of type 2 diabetes aims at maintaining normoglycaemia and preventing thedevelopment of complications arising from diabetes. The Society for Endocrine Metabolismand Diabetes of South Africa (SEMDSA) guidelines are based on a number of internationaltrials which showed that strict control of blood sugar leads to a reduction in the developmentof diabetic complications. However, many studies have shown poor adherence to nationalguidelines by doctors caring for diabetes patients.
Objectives: The aim of this study was to assess doctors’ compliance with the SEMDSA diabetesguidelines at a regional hospital in KwaZulu-Natal.Method: Seven hundred and fifty diabetic patient records were selected by systematicsampling of cases from the diabetic clinic and reviewed against SEMDSA guidelines.
Results: Eighty three per cent of the patients had high values of glycated haemoglobin (HbA1c).Lipid examination was rarely performed, and comprehensive foot examination was carriedout in only 6% of patients. Although blood pressure and weight were regularly checked,these examinations were performed by the nursing staff, and medical staff generally did notrespond to abnormal results.
Conclusion: This study demonstrates poor compliance with current diabetic guidelines. Thereis an urgent need to review how guidelines are disseminated and implemented in South Africanpublic sector hospitals if evidence-based guidelines are to have any impact on patient care.
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