Characteristics of patients admitted with diabetes in Maseru, Lesotho

Abstract

Diabetes mellitus is a major cause of morbidity and mortality globally. In 2009, diabetes was the leading non-infectious cause of admissions to public hospitals in Lesotho. Our aim was to investigate the reasons for hospitalisation among diabetic patients in Maseru, Lesotho. We studied the clinical characteristics and medical history of 80 adult patients admitted to Queen Elizabeth II Referral Hospital for the management of uncontrolled diabetes and evaluated the quality of diabetes care prior to admission. The median age was 49 years; 89% of the patients had type 2 diabetes and 74% of patients had been on antidiabetic treatment for more than 1 year. The majority (85%) of patients presented with hyperglycaemia. The most common chronic complication and co-morbidities were diabetic retinopathy (35%) and hypertension (56%) respectively. Most (89%) patients had received diabetes education, but less than half were adherent to recommended lifestyle changes and only 14% performed self-monitoring of blood glucose. The medicAtion non-adherence rate was 20%, and 31% of patients had defaulted from therapy in the previous 6 months. Blood glucose was measured routinely at check-up. In the previous 12 months, 75% of the patients had had eye examinations, but lipid screening, urinalysis, and foot examinations had each been performed on less than one-third of the patients. There were 42% of the patients who had a history of diabetes-related hospitalisations. We concluded that the most common admission cause was hyperglycaemia. In general, there was poor glycaemic control, a high prevalence of complications and high rates of rehospitalisation among the study population. The quality of diabetes care prior to hospitalisation was suboptimal, characterised by low levels of self-management practices and inadequate screening for diabetes complications.