Diabetes in the Cape Town Metropole – a secondary analysis of the diabetes cascade database 2015 - 2020

Boake, Megan Wilson (2021-12)

Thesis (MFamMed)--Stellenbosch University, 2021.

Thesis

ENGLISH SUMMARY : Background: Diabetes is the leading cause of death in women in South Africa and one in four South Africans over the age of 45-years have diabetes. The Western Cape (WC) Provincial Health Data Centre has integrated data from multiple sources into a diabetes cascade database. The Director responsible for chronic disease management asked for an analysis of the database. Aim: The aim of the study was to describe the demographics, comorbidities and outcomes of care for patients with diabetes treated at primary care facilities in the WC between 2015 – 2020. Methods: This was a secondary analysis of data from the diabetes cascade database. Data was imported into the Statistical package for Social Sciences for analysis. Results: The database included 116726 patients with a mean age of 61.4 years and 63.8% were female. The mean age at death was 66.0 years. Ninety-eight percent of people lived in the Cape Town Metropole. Co-morbidities included hypertension (69.5%), mental health disorders (16.2%), HIV (6.4%) and previous TB (8.2%). Sixty-three percent of the study population had at least one previous hospital admission and 20.2% of all admissions were attributed to cardiovascular diseases. Coronavirus related admissions were the third highest reason for admission over a 10-year period. Up to 70% of the people were not receiving an annual HbA1c test. The mean value for the last HBA1c taken was 9.0%. Three-quarters (75.5%) of patients had poor glycaemic control (HbA1c >7%) and a third (33.7%) were very poorly controlled (HbA1c>10%). Glycaemic control was significantly different between sub-districts in Cape Town as well as rural areas. Renal disease was prevalent in 25.5%. Conclusion: Diabetes is extremely poorly controlled in the province and diabetic related morbidity and mortality are high. There is poor compliance with guidelines for HbA1c and eGFR measurement. At least 7% of diabetic patients are being admitted for diabetic-related complications annually. This is a clear call to action on the care for people with diabetes in the WC.

AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.

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