Endocrine Abstracts

Purpose of the study

In Uzbekistan, more than 80% of patients with type 2 diabetes mellitus have uncompensated diabetes, including those receiving adequate free drug therapy. This is mainly due to the neglect of non-drug measures and unhealthy diets. The purpose of the study was to establish the reasons for patients’ non-compliance with nutritional rationalization prescriptions, on the example of the Diabetes School at Khorezm Regional Endocrinology Center.

Methodology

An examination of 54 patients with type 2 diabetes mellitus, including a comparison of fasting and prandial blood sugar levels, of HbA1c, combined with an adherence survey. The survey had a question on digital literacy (capacity to use IT for remote consultations).

Results

Only 3 patients in the sample registered target levels of carbohydrate metabolism (HbA1c less than 7%, fasting sugar less than 7 mmol/l, prandial glycemia less than 10 mmol/l). Based on levels of compliance with nutritional rationalization, patients were divided into three categories: 22 (40.7%) patients with a negative attitude to any dietary restrictions, 26 (48.2%) patients wishing but lacking knowledge about correct nutrition, and 6 (11.1%) patients who were compliant and knowledgeable about nutritional rationalization. But only 3 of them had compensated diabetes. The respondents believed that the reasons for the ineffectiveness of the diet therapy are outdated nutritional traditions, the impact of food advertising, aggressive advertising of dietary supplements and the consumption of excessive amounts of processed foods, as well as the high salt, sugar and fat content in locally popular foods (e.g. bread and biscuits). Of 54 patients, only 6 (9.3%) were capable to use IT for remote consultation.

Conclusions

Regular workshops at the Diabetes Schools are not effective since they don’t offer tailored approach sensitive to the stage of the disease, its complications, age, gender, diabetes treatment, dietary habits, marital status, financial security and employment. Remote observation will not work for the elderly and digitally illiterate patients and will be limited to better educated patients active in the workforce. For sufficient glycemic control, the efforts of the endocrinologist and patients is to be combined with relevant policies at the level of the medical practice and research communities, the food industry and government agencies.