Inadequate Glycemic Control - Failure of Counseling or Compliance?

  • Namrah Mahmood House Officer, Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad
Keywords: Diabetes Mellitus, Glycemic control, HbA1c


Objectives: To find out the level of counseling provided by physician to diabetic patients with HbA1c > 6.5% and to determine the patient’s compliance regarding diabetes and its control.
Material & Methods: In this cross-sectional study type 2 diabetic patients were inducted using convenient sampling technique. A structured questionnaire with closed ended questions was used. Interviews were conducted by researchers after obtaining written informed consent. SPSS version 20 was used for analysis. Chi-square test was applied to find association between variables.
Result: Out of 155 participants, 141 (91%) patients knew that they have high glucose level but they have no information regarding reason of these elevated levels. Counselling regarding, pharmacological therapy, dietary changes, importance of exercise and about regular foot examination was provided to 92.3%, 86.5%, 61.9% and 19.4% patients respectively. Patients compliance was highest to pharmacological treatment (67.7%) followed by regular visits and physical exercise (51.6% and 51%) respectively. However, 49.7% (n=77) of the participants do not check their blood glucose levels at all. There was statistically strong association between level of counseling with compliance of the participants regarding both pharmacological treatment (p=0.03) and exercise (p<0.001).
Conclusion: Counseling played a pivotal role in compliance of treatment. In this study counseling was good about treatment regimens as compared to lifestyle changes. Therefore, a large number of the participants showed good compliance for treatment. Patient tailored approach should be adopted by physicians dealing with diabetes, with more emphasis to introduce lifestyle changes. 

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