Research Article
Improving Diabetes Care: A Fijian Diabetes Service Improvement Study
Table 1
Measures for evaluating optimal management. Description of optimal diabetic management as per the Fijian diabetes guidelines [
16].
| Evaluation area | Recommendations as per guidelines |
| Targets for glycemic control | | RBS | | Good control (optimal control) | 4-8 mmol/L | Fair control (suboptimal control) | 8.1-10 mmol/L | Poor control | >10-14 mmol/L | Worse control | ≥14 mmol/L | HbA1c | | Good control | <6.5% | Fair control | 6.5-7.5% | Poor control | >7.5% |
| Glycemic management | | No ODA | Dietary advice | Single ODA | MTF or SU | Combination ODA | MTF + SU |
| Dosing of oral drugs | | Minimum | Level 1 dosing | Metformin 250 mg-1 g/day | Glipizide 5-12.5 mg/day | Glibenclamide 2.5-7.5 mg/day | Moderate | Level 2 dosing | Metformin 1 g-2 g/day | Glipizide 12.6-20 mg/day | Glibenclamide 7.6-15 mg/day | Maximum | Level 3 dosing | Metformin >2 g/day | Glipizide >20 mg/day | Glibenclamide >15 mg/day |
| Combination ODA dosing levels | | Level 1 | Minimum dose of 2 drugs | Level 2 | Moderate dose of 2 drugs or 1 moderate dose and 1 minimum dose | Level 3 | Maximum dose of 2 drugs or 1 maximum dose and the other drug with moderate or minimum dose |
| Using HbA1c tests | Every 6 months |
| MDT assessments | (i) Foot assessment referral and foot risks classification-yearly (ii) Eye assessment-yearly (iii) Dietician referral |
|
|
ODA: oral drug administration; SU: sulphonylurea; MTF: metformin.
|