11 research outputs found
Prevalence of complications among Chinese diabetic patients in urban primary care clinics: A cross-sectional study
Background: A territory-wide diabetes management program (Risk Assessment Management Program - RAMP) was recently established, providing comprehensive management for all diabetics, helping to delineate current level of control and complications prevalence among primary care diabetic patients in Hong Kong. Method. This cross-sectional study captured anonymous clinical data from RAMP patients. Data obtained include sociodemographic details, type of diabetes, illness duration, family history, drug usage, coexisting illnesses, diabetic complications and other clinical parameters. Results: Data from 15,856 type 2 diabetic patients were analyzed. 57.1% were above 60 years old, with mean disease duration of 7.3 years. Hypertension was the commonest coexisting chronic illness (57.6%). 30.2% and 61.8% have their systolic and diastolic pressure controlled to below 130 mmHg and 80 mmHg respectively. Over half (51.5%) had an HbA1c level of less than 7.0%. 88.4% did not achieve target lipid level. 15% were on diet control alone. Only 22.2% were on statins. In patients with microalbuminuria and macroalbuminuria, 40.7% and 54.5% were on angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) respectively. 12.9%, 38.8% and 2.4% had diabetic retinopathy, nephropathy and neuropathy respectively. Overall, 37.9%, 7.3% and 0.4% had single, two and three concurrent microvascular complications respectively. Conclusion: The level of diabetic control is comparable with other developed countries. We demonstrated a high prevalence of microvascular complications among Chinese primary care patients despite achieving adequate HbA1c levels, highlighting the importance of managing all aspects of diabetes including weight, lipid and blood pressure. Efforts to improve holistic management must be tailored according to the needs of our population, with the challenges that the majority have low educational background and in the older age group. © 2014 Kung et al.; licensee BioMed Central Ltd.link_to_subscribed_fulltex
Recommended from our members
Neuropsychological Impairment in Prodromal, First-Episode, and Chronic Psychosis: Assessing RBANS Performance
Background: Cognitive deficits are observed throughout all developmental phases of psychosis. However, prior studies have usually focused on a limited illness period and used a wide variety of cognitive instruments. Therefore, it has been difficult to characterize or highlight cognitive functioning in different stages of psychosis. Method We administered the RBANS (Repeatable Battery for the Assessment of Neuropsychological Status) tests to 4 participant subgroups, including healthy volunteers (controls, HC, n = 28), subjects at high risk for clinical psychosis (prodrome, CHR, n = 27), first-episode schizophrenia patients (FE-Sz, n = 26), and mid-term and long-term chronic schizophrenia patients (Ch-Sz, n =147). Comparison, correlation, and regression analyses of RBANS index scores were assessed among groups. We examined clinical outcomes over 2 years between the CHR and HC subjects, and RBANS domains were used as possible predictors for conversion to psychosis. Results: Performance on all RBANS domains was significantly impaired during a post-onset stage of psychosis (FE-Sz and Ch-Sz), and RBANS scores declined along with disease progression. Regression analyses showed that for CHR and HC subjects, baseline impairment in delayed memory (DM) significantly predicted conversion to psychosis. Additionally, partial correlations showed that for FE-Sz and Ch-Sz subjects, DM was the only correlate with a later stage of psychosis. Conclusions: Cognitive deficits broadly emerged, and diminished functioning followed along with disease progression. Impairment in DM is perhaps one domain that helps us understand the development of psychosis. A critical need is to monitor and treat memory functioning for psychotic patients throughout all phases of the disease
Sample flow diagram.
<p>The RBANS tests were administered to 228 subjects enrolled at SMHC between 2011 and 2013, including 28 HC, 27 CHR, 26 FE-Sz and 147 Ch-Sz.</p
Logistic regression for predicting the transition to psychosis.
<p>Logistic regression for predicting the transition to psychosis.</p
RBANS results at different stages during the course of psychosis.
<p>The RBANS domain index scores (y axis) is plotted against the course of Sz (x axis). RBANS scores declined along with disease progression. The trajectory of delayed memory decline is consistent with RBANS total scale index score.</p
A comparison of RBANS domain index scores between controls and CHR and FE-Sz patients.
<p>* Adjustment for multiple comparisons: Bonferroni.</p><p>A comparison of RBANS domain index scores between controls and CHR and FE-Sz patients.</p
Demographic and clinical characteristics.
<p><i>Note</i>:</p><p><sup>a</sup> Chlorpromazine-equivalent antipsychotics.</p><p>Demographic and clinical characteristics.</p
Correlations between the course of Sz and RBANS domain index scores.
<p>Correlations between the course of Sz and RBANS domain index scores.</p