A cross-sectional study of diabetes in Mt Eden Prison, Auckland

To study the control, complications and management of prisoners with diabetes on treatment with oral hypoglycaemic agents or insulin in Mt Eden prison, Auckland.

A cross-sectional study of those prisoners known to be on oral hypoglycaemic agents or insulin by personal interview using a structured questionnaire followed by physical examination and random measurement of fructosamine, lipids and renal function.

At the time of the study the prison population was 438 (47 females). Fifty three percent were Maori, 29% European, 14% of Pacific Islands origin and 4% of other nationality. Five males were known to be on oral hypoglycaemics and three further males, also with non-insulin dependent diabetes (NIDDM) were on insulin. Two other males were insulin dependent diabetics (IDDM) aged 22 and 25 years. All were Maori. The mean age (range) of NIDDM patients was 50 (35-68) years. As a group these prisoners were obese with a high prevalence of smoking, hypertension, dyslipidaemia, retinopathy, nephropathy and neuropathy. Four of the five insulin treated patients had been in hospital a total of 11 times in the preceding 12 months for diabetes related health problems accounting for a total hospital stay of 60 days. Three of these prisoners had recurrent self-induced hypoglycaemia or diabetic ketoacidosis. Metabolic control of glucose was however reasonable.

Prisoners known to be on treatment for diabetes have a high prevalence of complications (many previously unrecognised) and display manipulative behaviour. This group requires specialised health care by diabetes trained staff with a knowledge of local prison conditions.