J Prev Med Public Health.  2009 Sep;42(5):315-322. 10.3961/jpmph.2009.42.5.315.

Management of Diabetic Mellitus in Low-income Rural Patients

• Kim HY
• Yun WJ
• Shin MH
• Kweon SS
• Ahn HR
• Choi SW
• Lee YH
• Cho DH
• Rhee JA

• KMID: 797692
• DOI: http://doi.org/10.3961/jpmph.2009.42.5.315

Abstract

OBJECTIVES
Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. METHODS: We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. ankle-brachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. RESULTS: The age of diabetic subjects was 68.7+/-8.7 years and the duration of diabetes was 8.9+/-8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. CONCLUSIONS: DM management in low income patients is very poor and requires further work to improve.

Keyword

Diabetic mellitus; Low-income; Management status

MeSH Terms

Aged
Blood Glucose
Blood Pressure
Body Weights and Measures
Carotid Arteries/ultrasonography
Diabetes Mellitus, Type 2/complications/*therapy
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated/analysis
Humans
Korea/epidemiology
Lipids/blood
Male
Middle Aged
Patient Compliance
*Poverty
*Rural Population
Socioeconomic Factors