Noor Al Busaidi, Prakash Shanmugam, Deepa Manoharan,Issa Al Salmi
Aims: To assess the clinical profile, glycemic control associated risk factors, co morbidities and complications of patients with diabetes who were referred from primary health care facilities. Methods: A highly specialized National Diabetes and Endocrine center (NDEC) has been established in Muscat, Oman in 2013. Clinical details, glycemic control and co morbidities of all referred patients between February 2013 to January 2014 were recorded from their medical records. A total of 611 patients with type 1 and type 2 diabetes of any age and either sex were included in this study. The center receives cases requiring a better care for complicated patients with diabetes from primary, secondary and tertiary care facilities on referral base. Results: A total of 611 patients were registered and among them 476 were with type 2 and 135 with type 1 diabetes. The mean age was 45.3 years. Nearly, 31% and 50% were overweight and obese among type 2 patients. The study highlights that above 40% patients had an HbA1c of >10% (85.8 mmol/mol) at baseline. A greater reduction in HbA1c (1.4%) was observed in type 2 patients whereas it was 0.5 % in type 1. Majority of type 2 had dyslipidaemia (84%) and hypertension (62.8%). Nephropathy was found in 40.1 and 24.4% with type 2 and type 1 diabetes whereas retinopathy was reported in 14.3 and 8.9% respectively. Female gender and longer duration of diabetes emerged as significant risk factors associated with poor glycemic control. Conclusions: Patients with diabetes referred to a tertiary care setup in Oman had high percentage of overweight and obesity. Majority of them had poor glycemic control with associated presence of co-morbidities. Effective strategies, including education of staff and patients, are highly recommended to improve the current setup at primary care level to facilitate early detection of complications.