Diabetic care in Nigeria: report of a self-audit

As part of a wider study aimed at establishing baseline data on standard of diabetic care to compare with subsequent reassessment after measures to improve outcomes have been introduced, the case notes of 118 Nigerians (42 males) with diabetes attending a teaching hospital-based diabetic clinic were reviewed to assess the quality of professional care in a year with reference to an international standard of diabetic care. Patient attendance at the clinic averaged about nine times annually and majority of them had been attending the facility for about 6 years. Fasting blood glucose (FBG) was tested four or more times in 92.4% of the patients. The corresponding figures for footcare were 1.7%; referrals for eye, dental, or cardiac examination were 12.7%, while lipid profile, serum creatinine, and urinary protein estimation were documented in 16.9% of the patients. In contrast, high-risk assessment or part of it was documented in all patients, and in 61.9%, high-risk intervention was recorded. The data suggest that the quality of diabetic care was less than optimal, and foot examination and referrals, etc. are specific areas for improvement.