Evaluation of type 2 diabetes and hypertension prevalance and effectiveness of early detection and screening programme in Konyaalti district, Antalya

Number of chronic diseases is increasing all around the world because of population aging and changes in the unhealthy lifestyle. Hypertension and diabetes are the most important risk factors for some chronic diseases which take a considerable role for causes of mortality and are also rather easily early detectable. These conditions are mostly asymptomatic at the early stages and thus awareness, treatment and/or control of them are delayed. Accordingly, number of their complications increases in the population and they are getting more severe. Early diagnosis and control of hypertension and diabetes in the population might reduce these complications and early mortality as well as the individual and social burden of the disease resulting from these two conditions. This study was performed to determine the prevalence of type-2 diabetes and hypertension among people, 20 years and older, whose living in the Konyaaltı district of Antalya and also to draw attention to the importance of managing of these problems at primary healthcare services and to suggest sample service model in population. This is a cross-sectional study which performed on a representative sample. The research population is 20 years and older people who residents in Konyaaltı district of Antalya and the data was collected between 19th and 23rd of December, 2015. Cluster sampling method was used in the research and 700 individuals in total (50 clusters each including 7 sections) were targeted. However, 664 individuals in 350 household who are 20 years and older were contacted and included in the research. Dependent variables of the study are having hypertension, type-2 diabetes and prediabetes or not, and the awareness and control level for each. Independent variables are the sociodemographic and lifestyle characteristics of the participants, their anthropometric measurements, and family history for hypertension and type-2 diabetes. While the data were collected, each of the participants was visited twice in their homes. They were interviewed face to face and applied a questionnaire containing 26 items, and their waist and hip circumferences were measured. In order to diagnose diabetes and prediabetes, fasting glucose levels were measured and to diagnose hypertension, blood pressures were measured. Glycated Hemoglobin (HbA1c) levels were measured to determine the control ratios of the participants who have diagnosed diabetes. A computer program package was used for data analysis. While estimating the frequency of prevalence, awareness, and being under control, both the values collected from research group and the values collected from the weighting regarding the age and sex. The size of the group which has the highest risk was revealed by determining the number of the subjects who have diabetes and hypertension are together. Therefore, size of the groups which should be given priority on healthcare services is estimated. When the risk factors of hypertension and diabetes are analyzed; student-t and chi-square tests were used for univariate comparisons, and logistic regression for multiple comparisons. Statistical significance is accepted as p<0.05. Standardize frequency of the hypertension was 34.9%. Of the hypertensive subjects; 60.7% were unaware of that their blood pressure is high; 4.2% knew that they are hypertensive but not taking any medication; 25.5% were taking medication but their blood pressure was still high. Standardize prevalence of type-2 diabetes and of prediabetes were 8.0% and 12.7%, respectively. Of the diabetic subjects; 8% were unaware of their illness; 6% knew that they were diabetic but not taking any medication; and 40% were taking medication but their fasting glucose is still high. Total rate of population who need to take healthcare services for management of hypertension and/or diabetes was 42.5%. Our findings showed that the priority of the healthcare service should be "the diagnosis of the unknown cases" for hypertension; and "improving the efficiency in treatment of the diagnosed cases" for diabetes. The number of the subjects with both diabetes and hypertension was 51 (9.0%) and this group should be given priority on healthcare services. The fact that 42.5% of the people who is 20 year and older in the population is in need of a healthcare service regarding the hypertension and diabetes is the most important finding of that these two problems should have priority and be handled within the framework of basic health services. These services should be planned to determine the unknown subjects by home visits for hypertension and to increase the treatment efficiency among diagnosed subjects by improving the case management skills of the general practitioners for diabetes. Moreover, the fact that there are many prediabetes cases detected in our study requires that the early diagnose and follow up strategies for prediabetes should be integrated into the home visit services.