Prevalence of complications among Chinese diabetic patients in urban primary care clinics: a cross-sectional study

Introduction: Diabetic retinopathy (DR) is one of the commonest complications of diabetes mellitus. This study was to determine the prevalence of DR and its association with chronic kidney disease (CKD), high HbA1c and dyslipidemia among diabetic patients in government primary care clinics. Materials and Methods: A cross sectional study was carried out. The respondents were selected from diabetic registry at two government primary care clinics in Kuantan, Pahang via stratified random sampling method during the study period from May 2010 to April 2011. The respondents were interviewed and assessed clinically using a structured questionnaire. Retinal examination was performed by accredited staff using non-mydratic retinal imaging and DR was classified according to the International Clinical Diabetic Retinopathy Disease Severity Scale. Results: Out of 400 respondents, 58.8% were diagnosed with diabetes less than 5 years and 51.0% had uncontrolled blood pressure (>130/80 mmHg). The prevalence of DR and maculopathy were 33.5% and of 17.8% respectively. Most of these patients (22.3%) had mild non-proliferative DR. DR patients had higher percentages CKD (17.9% vs. 6.8%; p<0.001) and a higher mean of HbA1C (8.69 vs. 8.11; p=0.015) compared to non-DR patients. The study revealed that DR was independently associated with CKD {OR: 3.46, 95% CI (1.76, 6.80)} and high HbA1c {OR: 1.12, 95% CI (1.02, 1.23)}. Those with dyslipidemia however, has 39% less risk of DR {OR: 0.61, 95% CI (0.39, 0.94)}. Conclusion: This study showed that diabetic patients with CKD and high HbA1c have greater risks to develop DR but has protective risk with dyslipidemia.

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Prevalence and Associated Factors of Depressive Symptoms among Adults with Overt Hypothyroidism on Treatment in Riyadh: A Cross-Sectional Study

International Journal of Psychiatry ◽

10.33140/ijp.04.01.5 ◽

2019 ◽

Vol 4 (1) ◽

Keyword(s):

Primary Care ◽

Depressive Symptoms ◽

Associated Factors ◽

Severe Depression ◽

Cross Sectional Study ◽

Overt Hypothyroidism ◽

Sectional Study ◽

Hospital Data ◽

Cross Sectional ◽

Primary Care Clinics

Background: There is strong associated between depression and hypothyroidism. People with a chronic disease and on lifelong medication are more likely to have poorer mental health than those with no illnesses. This study aimed to measure the prevalence and associated factors of depressive symptoms in adults with overt hypothyroidism on treatment in primary care clinics in Riyadh. Methods and findings: Cross-sectional study of 369 patients with overt hypothyroidism visiting primary care clinics and endocrine outpatient clinics at in Prince Mohammed bin Abdul-Aziz hospital .Data were collected using an the Arabic validated version of the Patient Health Questionnaire-9 for screening of depression among the participants . Prevalence of depression among adult patients with hypothyroidism on treatment was 56.1% . It was moderately severe and severe among 58.7% and 33.3% of depressed patients. Conclusions: Depression is a common health problem among patients with overt hypothyroidism on thyroxin treatment , majority of patients has moderately severe to severe depression. Depression was more observed among older (≥40 years), female, divorced/widowed and lower educated patients compared to their counterparts. Also, it was more reported among patients with longer duration of hypothyroidism. No association was observed with levels of TSH and thyroxin hormones.

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Continuity of care and delivery of diabetes and hypertensive care among regular users of primary care services in Chile: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-027830 ◽

2019 ◽

Vol 9 (10) ◽

pp. e027830

Author(s):

Javiera Leniz ◽

Martin C Gulliford

Keyword(s):

Primary Care ◽

Continuity Of Care ◽

Cross Sectional Study ◽

Self Report ◽

Secondary Outcome ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

Care Services ◽

Primary Care Services

ObjectivesExplore factors related to continuity of care and its association with diabetes and hypertensive care, and disease control.DesignCross-sectional study.SettingData from the Chilean Health National Survey 2009–2010.ParticipantsRegular users of primary care services aged 15 or older.Primary and secondary outcome measuresProportion of hypertensive and diabetic patients with a blood pressure <140/90 mm Hg and HbA1c<7.0% respectively, self-report of diagnosis, treatment and recent foot and ophthalmological exams. Associations between continuity of care, sociodemographic characteristics, and primary and secondary outcomes were explored using logistic regression.Results3887 primary care service users were included. 14.7% recognised a usual GP, 82.3% of them knew their name. Continuity of care was positively associated with age >65 years (OR 4.81, 95% CI 3.16 to 7.32), being female (OR 1.66, 95% CI 1.34 to 2.05), retired (OR 2.22, 95% CI 1.75 to 2.83), obese (OR 1.66, 95% CI 1.29 to 2.14), high cardiovascular risk (OR 2.98, 95% CI 2.13 to 4.17) and widowed (OR 1.50, 95% CI 1.13 to 1.99), and negatively associated with educational level (8–12 vs <8 years OR 0.79, 95% CI 0.64 to 0.97), smoking (OR 0.65, 95% CI 0.52 to 0.82) and physical activity (OR 0.76, 95% CI 0.61 to 0.95). Continuity of care was associated with diagnosis awareness (OR 2.83, 95% CI 1.21 to 6.63), pharmacological treatment (OR 2.04, 95% CI 1.15 to 3.63) and a recent foot (OR 3.17, 95% CI 1.84 to 5.45) and ophthalmological exam (OR 3.20, 95% CI 1.66 to 6.18) in diabetic but not in hypertensive patients.ConclusionsContinuity of care was associated with higher odds of having a recent foot and ophthalmological exam in patients with diabetes, but not with better diseases control. Findings suggest patients with chronic conditions have better continuity of care access.

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