EPIDEMIOLOGY AND MANAGEMENT OF DIABETES MELLITUS IN ZARIA URBAN AREA
EPIDEMIOLOGY AND MANAGEMENT OF DIABETES MELLITUS IN ZARIA URBAN AREA
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Date
1989-08
Authors
SANUSI, RABI RAFINDADI
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Abstract
Studies on the epidemiology end control of
diabetes mellitus among the patients of ABUTH,
Zaria were carried out. Patient understanding of
the disease and compliance with treatment and
other control measures were assessed through
direct questioning, and by detecting the
concentration of one of the oral hypoglycaemic
agents (chlorpropamide) used by majority of the
patients, in their blood. Samples of
chlorpropamide tablets were obtained from some
patients. The amount of active ingredients present
were determined by standard assay techniques in
order to determine the quality of drugs used by
the patients.
The result 6 of the study reveal that many
patients lacked the understanding of their disease
and the importance of proper management. This
ignorance was attributed to the fact that many of
the patien's had no formal education and also to
the limited number of doctors at the clinic, a
factor which limited the individual patient
education. Appearance of some diseases and
comnlications in some of the patients studied was
related to their ignorance and lack of patient
compliance with treatment. It was observed that
regular clinic attendance was variable. Those who
were not regular were often readmitted with
relapse of symptoms or complication of the
disease.
The majority of the patients were not
following a planned diet. This was because many of
them were poor and so could not afford the ideal
diabetic diet. This poverty and ignorance also
limited the Individual control monitoring of
diabetes by testing urine (and blood) for presence
of sugar. For these reasons the patients were not
able to adjust their diet and medication and so
could not achieve good control.
The result of the tablet assay showed that 2
of the 5 brands of the tablets tested did not
comply with official (B.P.) requirement. Failure
to achieve good control in some of the patients
studied could also therefore be attributed to
consumption of substandard or faked drugs.
Serum chlorpropamide levels in 54 patients
was detected using the method of Carmichael (1959)
and the result shows that majority of the patients
had levels within the therapeutic range.
Interindividual differences as expected were
observed in the serum concentration of the drug in
the patients used for the study. Differences in
metabolising capacity and renal excretion were
suggested to be responsible for this. Two patients
had serum levels well in the toxic range while a
few others achieved only subtherapeutic levels.
In conclusion, our data suggest that a
significant number of diabetic patients in Zaria
urban area lacked the understanding of their
disease and this is related to their illiteracy,
poverty and also to the inadequate number of
medical personnel at the hospitals to educate the
patients properly. The loss of control of diabetes
in some patients was probably also due to noncompliance
with treatment on the port of some
patients and consumption of substandard drugs in
addition to the above factors.
It is suggested that the Diabetic Clinic in
Zaria needs the services of a dietician as well as
more medical personnel. The Pharmacy Shop within
the hospital should always stock antidiabetic
drugs of adequate standards to reduce the risk of
patients buying faked, substandard or expired
drugs from other places. A booklet titled % Living
w i t h D i a b e t e s ' , and its Hausa translation, 'Rayuwa
da c u t a r s u k a r ' , primarily directed at the
diabetic has been prepared as part of this effort,
Description
A thesis submitted to the Postgraduate School,
Ahmadu Bello University, in partial fulfillment of
the requirements for the degree of Mater of
Science
DEPARTMENT OF PHARMACOLOGY AND CLINICAL PHARMACY
FACULTY OF PHARMACEUTICAL SCIENCES
AHMADU BELLO UNIVERSITY, ZARIA
Keywords
EPIDEMIOLOGY,, MANAGEMENT,, DIABETES,, MELLITUS,, ZARIA URBAN AREA