Diabetes education and care in a developing country: Observations from Karachi, Pakistan

ObjectiveTo explore the kind of care being received by a sample of middle income group subjects with diabetes in Karachi.DesignCross-sectional.Place and duration of studyRaana Liaquat Ali Khan College of Home Economics, Karachi from January 2009 to September 2009.Patients and methodsInformation was collected from 105 type 2 diabetics through a structured, pre-tested, self administered questionnaire distributed in two colleges only to those students who had any adult onset diabetic in their family. SPSS version 16 was used for data entry and analysis (e.g., chi-square tests).ResultsThe mean duration of diabetes was 8.9 years. Random blood sugar, blood pressure check and urine test for sugar were the most frequently performed tests. Many important diabetes related tests had not been performed even on subjects with duration of diabetes of 10 years or more such as HbA1c had never been performed for 74% of subjects in this class. Test for circulation had never been performed for 93% of subjects with 1 year's diabetes duration and for 62% of subjects with duration of 10 years or more. More than 90% subjects received information about diet and causes of diabetes; >70% had been informed about diabetes complications, foot care, dental care, self monitoring of blood glucose and testing sugar in urine and only 48% had been educated about insulin injections. Physician was the source of this information for more than 70% of subjects.ConclusionsThis study has explored insufficient clinical monitoring of diabetes complications and provision of casual diabetes education. These observations highlight the need for provision of appropriate diabetes education, both to health care team and professionals.