The Effect of Patients Awareness, Body Weight and Exercise On The Glycaemic Control In Type2 Diabetic Patients In Gabber Abu Elaaz Diabetic Center, Khartoum

Abstract

Diabetes mellitus is a chronic disease that requires long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur. It is an expensive disease. It is a common disease in Sudan. It is a cause of major morbidity and mortality. The objectives of this study were to assess patient’s glycaemic control and to assess the impact of patient’s therapeutic education on the control of the diease, also to assess effect of body weight on the control. The study was conducted at one of the best well formed diabetic center in Sudan (Gabber Abu Elaaz) where all facilities for patient’s therapeutic education, diabetologist, diabetic nurse, dietician, dermatologist, ophthalmologist, surgical care, investigations, were available for follow-up. Hundred adult diabetics, fifty were males, fifty were females were selected randomly and were assessed clinically and biochemically, their level of knowledge regarding diabetes, its management and complications, and their body mass index were assessed. The mean age was (57.9) years, (range 35–85 years), mean duration of diabetes, was (8.7) years. Most of these patients were either illiterate or just received primary education (77%).The symptomatology of these patients gives clear indication to their uncontrolled blood sugar levels, and complications. Polyuria, polydipsia, fatigue, numbness, impairment of vision, were the most prevalent symptoms. Presence of retinopathy & peripheral neuropathy have significant correlation to duration of DM. Fasting blood glucose & HBA1c for these patients showed that, 76% of these patients had FBS levels above the normal range, and only 14% had HBA1c less 6.5%. Level of knowledge was adequate, 81% were between good level and moderate level of knowledge regarding awareness about diabetes complications & diet, but the weakness appeared in the aspect of diabetes management and its complications. No correlation between level of knowledge and the glycemic control was found. 60% of the patients were overweight or obese. No significant correlation between BMI and glycemic control. Self-monitoring of blood glucose using glucometers was practiced by (11%). Few had regular exercise practice. Females were less active than males (22%). Although the degree of knowledge is acceptable, most patients were not well controlled. Specialized programs of diabetes education, simple educational tools and well trained educators were recommended to address older patients, illiterate groups and those with language difficulties to improve the glycaemic control.