Turki J Alharbi, Ayla M Tourkmani, Abdulrhamn N, Rasheed, Aboud F Alaboud, Ahmed Bakhiet, Osama Abdelhay
Background: Primary Health Care (PHC) systems have a crucial role in disease prevention and management. Most diabetic patients receive care from primary care physicians. The efforts of primary care physicians are hindered by many challenges such as long intervals visits, clinical inertia, and limited times with patients. Therefore, it is difficult to include additional disease management techniques such as health education, life-style management, and psychological support which proved to have substantial impact in reducing the risk of complications in diabetes. Many international guidelines have started to emphasis the need for comprehensive care for people with diabetes by the implementation of diabetes management through integrated medical care. Objective: to assess the impact of integrated health care services on glycaemic and diabetic nephropathy. Study Design: Interventional parallel-group clinical study Results: The results showed increase in the number of patients with HbA1c <7% (53mmol/mol) by 6.6% (31 patients) and 17.6% (83patients) with HbA1c <8 (64 mmol/mol). the total number of patients with diabetic nephropathy before enrollment was 111(19.5%) distributed as follows (82.9%, 14.4% and 2.70% had microalbuminuria, macroalbumin urea and nephritic stage respectively). After enrollment the number decreased to 100(17.6%). 78% (78patients) had microalbuminurea, 20% (20 patients) had macroabuminurea and only 2% (2 patients) had nephrotic syndrome. Conclusion: The utilization of multidisciplinary health care program with Enablement should receive more attention and recognition, especially, in countries with high prevalence of DM like KSA. Using clinical parameters with the concentration on major diabetes mellitus complications can reduce the risk of developing these complications significantly.
