diabetes research initiatives in sharjah, uae nabil sulaiman nsulaiman@sharjah.ac.ae...
Post on 23-Dec-2015
216 Views
Preview:
TRANSCRIPT
Diabetes Research Initiatives in Sharjah,
UAE Nabil Sulaiman
nsulaiman@sharjah.ac.ae
n.sulaiman@unimelb.edu.au
Diabetes Supercourse, Alexandria 12 Jan 2009
Sharjah Diabetes Study
Background Why the study Methods Preliminary results Conclusions Recommendations
Environmental and behavioral changes
New dietary habits (what and how we eat),
Lack of physical activity,
Overweight/ obesity, and
Stresses of urbanization and working condition will lead to further rise of CVD and diabetes, and their risk factors.
SummaryDiabetes is a major and complex health problem worldwide.
Prevalence in UAE (24% & IGT18%) is the 2nd highest in the world
Onset of the disease in the GCC is early in late 20s
With early Dx and appropriate Mgt diabetics can live better and longer
Sharjah Diabetes Study
N. Sulaiman, Dh. Al Badri, N. Sajwani, S. Saleh, D. Young
Self monitoringNoYes
Fre
qu
en
cy
250
200
150
100
50
0
Self monitoring
1 Nabil Sulaiman, 2Dhafir Al Badry, 2Najla Sajwany, 1Amal Hussein, 1Saba Saleh, 2Doris Young(1Department of Family and Community Medicine, University of Sharjah, 2 Ministry of Health UAE, 3Department of General Practice, University of Melbourne)
The study design is a cross sectional baseline survey of patients with diabetes attending Primary Medical Care Centers in Sharjah during 2007/08.
Data Collection1. Research Assistant attended diabetes mini clinics at Riffa and Asit
centres and diabetes clinic at Al-Qassimi and Kuwaiti Hospitals:2. Patients were invited to participate 3. Patients were interviewed using structured questionnaires4. Their data were extracted from medical records5. Data cleaning and analysis was performed using SPSS
Background Diabetes is a major and complex health problem worldwide. Diabetes prevalence in UAE is the 2nd highest in the world, reaching
about 24% in UAE nationals. The prevalence of pre diabetes is reported to be about 18%. With early identification and appropriate management, people with
diabetes can live better and longer
This project was funded by the University of Sharjah. For information please contact Dr Nabil Sulaiman, HOD Family and Community Medicine, The University of Sharjah E-mail: nsulaiman@sharjah.ac.ae or n.sulaiman@unimelb.edu.au
AimTo improve diabetes management, control and quality of life of patients
with diabetes in UAE
Objectives1. Establish an electronic database for diabetic patients in Sharjah
2. Audit their medical records to identify gaps in management.
3. Pilot test known EB intervention to investigate their appropriateness to Sharjah
4. Determine barriers and facilitators to the implementation of the intervention
METHODOLOGY
Diabetes Control Indicators
body weight and waist circumference from medical records knowledge and attitudes towards healthy eating using physical
activity questionnaire and Biochemical indicators such as AbA1c and cholesterol, lipids,
blood glucose and urine test
MissingOthersUnknownDiet, tablets & InsulinDiet & InsulinDiet & TabletsInsulin onlyTablets onlyDiet onlyNone
Current Diabetes management method
PRELIMINARY RESULTS
Participants: 347 diabetic patients were interviewed and their medical records were cheeked
Gender: 65.4% (n= 227) females and 34.6% (n=120) males
Nationality: UAE 83.9%, Pakistan 3.5%, Egypt 2.6%, others 10% including Palestine, Lebanon, Yemen, Iraq, Poland , Syria, Iran and Sudan.
Marital Status: 8.9% single, 87.9% married, divorced 1.4% and 1.4% widowed.
Consanguineous Marriage: 16.4% (n=57)
Occupation: : 47.3% housewife, 28.2% clerks, 6.3% students, 0.6%retired.
Family History: 23.1% (N=80) had a positive family history of diabetes.
Smoking: 3.2% (n=11) current smokers, 3.2% (n=11), ex-smokers, never smoked 93.1% (n=323).
Current Diabetes management method
OthersUnknownDiet, tablets &
Insulin
Diet & Insulin
Diet & Tablets
Insulin onlyTablets only
Diet onlyNone
Freq
uen
cy
200
150
100
50
0
Current Diabetes management method
Diabetes in familyNot sureNoYes
Fre
qu
en
cy
250
200
150
100
50
0
Diabetes in family
CONCLUSIONS
1. Diabetes Mellitus is common problem in primary medical centers in Sharjah.
2. There is gap in self-management education including self monitoring, manifested by high levels of obesity and lack of physical activity.
3. Diabetes control in Sharjah measured by HbA1c could be improved compared with international guidelines.
4. Measures to improve control may include employing Diabetes Nurse Educators to assist doctors at the medical centers to train patients as well as CME courses for doctors working at the centers.
31.4%26.4%Diabetes complications%
9.4 ± 3.79.9 ± 4.3Fasting B Sugar (mmol/l)
27.8 ± 5.330.9 ± 6.0BMI (kg/m*m)
8.5 ± 7.47.1 ± 4.9 Duration (mean)
Females
(N=227)
Males
(N=120)
Diabetes
31.4%26.4%Diabetes complications%
9.4 ± 3.79.9 ± 4.3Fasting B Sugar (mmol/l)
27.8 ± 5.330.9 ± 6.0BMI (kg/m*m)
8.5 ± 7.47.1 ± 4.9 Duration (mean)
Females
(N=227)
Males
(N=120)
Diabetes
Current Diabetes management method
OthersUnknownDiet, tablets &
Insulin
Diet & Insulin
Diet & Tablets
Insulin onlyTablets only
Diet onlyNone
Freq
uen
cy
200
150
100
50
0
Current Diabetes management method
Diabetes in familyNot sureNoYes
Fre
qu
en
cy
250
200
150
100
50
0
Diabetes in family
Sharjah Diabetes Study
Aim
To improve diabetes management, control and quality of life of patients with diabetes in UAE
Sharjah Diabetes Study
Objectives
Identify gaps in diabetes management
Determine barriers and facilitators to implementation of known interventions
Pilot test known EB intervention in Sharjah
Study Design
Cross sectional baseline survey of patients with diabetes attending Primary Medical Centers in Sharjah during 2007/08.
Data Collection
Research Assistant attended diabetes mini clinics at Riffa and Wasit centres and diabetes clinic at Al-Qassimi and Kuwaiti Hospitals:Patients were invited to participate and interviewed using questionnairesTheir data were extracted from medical recordsData cleaning and analysis was performed using SPSS
Diabetes Control Indicators
Medical Records:Biochemical indicators such as HbA1c and cholesterol, lipids, blood glucose and urine testWeight and waist circumference
Patients questionnaire:Knowledge and attitudes healthy eating physical activity
Preliminary Results
Sample: 347 patients
Gender: 65.4% females
Mean age 53.2 (14.6)
BMI 29.8 (5.9)
Nationality
UAE 83.9%, Pakistan 3.5%, Egypt 2.6%, Others: 10% (Palestine, Lebanon, Yemen,
Iraq, Syria, Iran and Sudan)
Diabetes in Families
Diabetes in familyNot sureNoYes
Fre
qu
ency
250
200
150
100
50
0
Diabetes in family
Marital StatusMarital Status 87.9% married 8.9% single 2.8 divorced/widowed
Consanguineous Marriage: 16.4% (n=57)
Gender difference
31.4%26.4%Diabetes complications%
9.4 ± 3.79.9 ± 4.3Fasting B Sugar (mmol/l)
27.8 ± 5.330.9 ± 6.0BMI (kg/m*m)
8.5 ± 7.47.1 ± 4.9 Duration (mean)
Females
(N=227)
Males
(N=120)
Diabetes
31.4%26.4%Diabetes complications%
9.4 ± 3.79.9 ± 4.3Fasting B Sugar (mmol/l)
27.8 ± 5.330.9 ± 6.0BMI (kg/m*m)
8.5 ± 7.47.1 ± 4.9 Duration (mean)
Females
(N=227)
Males
(N=120)
Diabetes
HbA1c:
78% of patients has HbA1c (>7%) BP:
57% have high BP
Management Methods
Current Diabetes management method
OthersUnknownDiet, tablets &
Insulin
Diet & Insulin
Diet & Tablets
Insulin onlyTablets only
Diet onlyNone
Fre
qu
ency
200
150
100
50
0
Current Diabetes management method
Complications (83) 26 (Eye glaucoma, laser surgery)
74 (feet ulcer, loss of sensation)
2 (Kidney: protein urea or albumin urea)
4 (loss of toe/ foot)
6 (angina, heart attack)
Self monitoring
Self monitoringNoYes
Fre
qu
ency
250
200
150
100
50
0
Self monitoring
Self Management
I can exercise several times a week (25% strongly agree)
I can not exercise unless I feel like exercising (28% strongly agree)
I can recognize when my blood sugar is too high (27% strongly agree)
Self Management
I can do what was recommended to prevent low blood sugar (24% SA)
I can figure out what self treatment when blood sugar gets high (29% SA)
I can fit my diabetes self treatment routine into my usual lifestyle (26% SA)
CONCLUSIONS
Diabetes Mellitus is common problem in primary medical centers in Sharjah.
High levels of obesity
Low physical activity
Gap in self-management education including self monitoring, manifested by high levels of obesity and lack of physical activity.
Recommendations
Diabetes management in Sharjah could be improved compared with international guidelines
Measures to improve control: Diabetes Nurse Educators Patient’s self management education Peer-led or peer-support models CME for doctors at PHC centers
Thank You
top related