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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

A survey on socioeconomic determinants of diabetes mellitus management in a lower middle income setting

Authors: Ambepitiyawaduge Pubudu De Silva, Sudirikku Hennadige Padmal De Silva, Rashan Haniffa, Isurujith Kongala Liyanage, Kosala Saroj Amarasiri Jayasinghe, Prasad Katulanda, Chandrika Neelakanthi Wijeratne, Sumedha Wijeratne, Lalini Chandika Rajapakse

Published in: International Journal for Equity in Health | Issue 1/2016

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Abstract

Background

Information on socioeconomic determinants in the management of diabetes mellitus is scarce in lower middle income countries. The aim of this study is to describe the socioeconomic determinants of management and complications of diabetes mellitus in a lower middle income setting.

Methods

Cross sectional descriptive study on a stratified random sample of 1300 individuals was conducted by an interviewer administered questionnaire, clinical examinations and blood investigations. A single fasting venous blood sugar of ≥126 mg/dl was considered diagnostic of new diabetics and poor control of diabetes mellitus as HbA1C > 6.5 %.

Results

There were 202 (14.7 %) with diabetes mellitus. Poor control was seen in 130 (90.7 %) while 71 (49.6 %) were not on regular treatment. Highest proportions of poor control and not on regular medication were observed in estate sector, poorest social status category and poorest geographical area. The annual HbA1C, microalbuminuria, retinal and neuropathy examination were performed in less than 6.0 %. Social gradient not observed in the management lapses. Most (76.6 %) had accessed private sector while those in estate (58.1 %) accessed the state system.
The microvascular complications of retinopathy, neuropathy and microalbuminuria observed in 11.1 %, 79.3 % and 54.5 % respectively. Among the macrovascular diseases, angina, ischaemic heart disease and peripheral arterial disease seen in 15.5 %, 15.7 % and 5.5 % respectively. These complications do not show a social gradient.

Conclusions

Diabetes mellitus patients, irrespective of their socioeconomic status, are poorly managed and have high rates of complications. Most depend on the private healthcare system with overall poor access to care in the estate sector.
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Metadata
Title
A survey on socioeconomic determinants of diabetes mellitus management in a lower middle income setting
Authors
Ambepitiyawaduge Pubudu De Silva
Sudirikku Hennadige Padmal De Silva
Rashan Haniffa
Isurujith Kongala Liyanage
Kosala Saroj Amarasiri Jayasinghe
Prasad Katulanda
Chandrika Neelakanthi Wijeratne
Sumedha Wijeratne
Lalini Chandika Rajapakse
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0363-3

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