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The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre
Thesis (MMed)--Stellenbosch University, 2019.
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| Other Authors: | |
| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2019
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| _version_ | 1867614091763253248 |
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| access_status_str | Open Access |
| author | Allerton, Joshua |
| author2 | Mash, Bob |
| author_browse | Allerton, Joshua Mash, Bob |
| author_facet | Mash, Bob Allerton, Joshua |
| author_sort | Allerton, Joshua |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed)--Stellenbosch University, 2019. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/105565 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:46:31.699Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/105565 The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre Allerton, Joshua Mash, Bob Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Family and Emergency Medicine. Family Medicine and Primary Care. Diabetics -- South Africa Glycemic index -- South Africa Type 2 diabetes -- Alternative treatment -- South Africa UCTD Thesis (MMed)--Stellenbosch University, 2019. ENGLISH SUMMARY: Introduction: Diabetes is a burgeoning health problem in South Africa where it is now the main cause of mortality in women. There is often clinical inertia despite poor glycaemic control. The aim was to evaluate the effect on glycaemic control of introducing a more intensive protocol of care for patients with uncontrolled type 2 diabetes (HbA1c > 10%) at Khayelitsha Community Health Centre, Cape Town. Methods: A pragmatic, quasi-experimental study. Patients were consecutively selected to obtain a sample size of 200. They participated in a 6 month programme of intensified care involving monthly clinic visits, diabetes group education sessions (GES), and algorithmic escalation of medical therapy guided by either point-of-care (POC) or standard laboratory HbA1c testing. Participants were used as their own controls by retrospective analysis of usual care. The primary outcome measure was mean change in HbA1c. Results: The mean change in HbA1c in the intervention group was -1.3% (SD 2.1) compared with 0.3% (SD 1.6) in the control group, giving a mean difference of -1.6% (p<0.001). There was a significant increase in prescription of basal insulin with a mean difference 1.3IU (p=0.02), and in number of participants increasing their dose of biphasic insulin (p=0.002). Those patients attending all 4 GES had the greatest improvement in HbA1c (-1.8%). There was no difference between POC and standard laboratory groups. Conclusion: A significant improvement in glycaemic control was seen in participants who received a pragmatic intensified intervention compared with usual care, elements of which could be readily incorporated into routine care. AFRIKAANSE OPSOMMING: AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2019-02-11T08:33:00Z 2019-04-17T08:02:38Z 2019-02-11T08:33:00Z 2019-04-17T08:02:38Z 2019-02 Thesis http://hdl.handle.net/10019.1/105565 en_ZA Stellenbosch University 17 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Diabetics -- South Africa Glycemic index -- South Africa Type 2 diabetes -- Alternative treatment -- South Africa UCTD Allerton, Joshua The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre |
| title | The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre |
| title_full | The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre |
| title_fullStr | The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre |
| title_full_unstemmed | The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre |
| title_short | The impact of point-of-care HbA1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre |
| title_sort | impact of point of care hba1c testing and intensified clinical care on glycaemic control in patients with type 2 diabetes at khayelitsha community health centre |
| topic | Diabetics -- South Africa Glycemic index -- South Africa Type 2 diabetes -- Alternative treatment -- South Africa UCTD |
| url | http://hdl.handle.net/10019.1/105565 |
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