Factors affecting clinical outcome among Type 2 diabetic subjects attending the outpatient department of a tertiary care hospital in Bangladesh

Wahiduzzaman, Mohammad (2021): Factors affecting clinical outcome among Type 2 diabetic subjects attending the outpatient department of a tertiary care hospital in Bangladesh. Dissertation, LMU München: Medizinische Fakultät

Abstract

Background: Diabetes care in low- and middle-income countries, such as Bangladesh, remains challenging due to limited resources. A person’s self-care ability, his or her adherence to medical advice and knowledge about the disease are central to diabetes management. Furthermore, undiagnosed, diabetic secondary complications may severely affect patient outcome. Here, we, therefore, examined the adherence, knowledge, and undetected retinopathy in adults with diabetes attending the outpatient department of a tertiary care hospital in Bangladesh. Methods: Cross-sectional, observational, monocenter study conducted at BIHS hospital in Dhaka, Bangladesh from April to August 2017; 504 participants with type 2 diabetes; questionnaires on socio-demographic parameters, adherence to medical advice, knowledge about diabetes and medical history; anthropometrics, clinical examination, laboratory chemistry, and retinal photography (n=489). Result: Adherence to the prescribed drug therapy was 52%, to recommended diet 28% and to physical activity advice 42%. Of all study participants, only 29% had good knowledge about diabetes. Factors independently associated with good knowledge about diabetes were a higher level of education, a higher family income, a duration of diabetes of 10 years or more, and controlled fasting blood glucose. In screening, diabetic retinopathy was detected in 18.8% of the study participants. Conclusion: This study highlights possibilities for improvements of patient education, disease management and screening examinations at a diabetes care centre in Bangladesh, which are, at least in part, transferrable to other low- and middle-income countries.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: diabetes care, patient education, adherence, knowledge, type 2 diabetes, secondary complications, retinopathy, resource-limited setting
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 21. April 2021
• 1. Bericht­erstatter:in: Lechner, Andreas