Rapid diagnosis and effective monitoring of diabetes mellitus in central Vietnam

Point-of-care needs, improved patient access, and spatial care paths for enhanced public health

Irene J. Ventura, Amanullah Zadran, An V.D. Ho, Layma Zadran, Duong T.B. Thuan, Tung T. Pham, Gerald J Kost

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Goals Our primary objective was to describe needs for and availability of point-of-care testing for diabetes mellitus diagnosis/monitoring in Central Vietnam. Methods The field survey was designed to determine the status of point-of-care testing at 15 hospitals, comprising 1 provincial hospital (level 2), 7 district hospitals (level 3), and 7 community health centers (level 4) in Hue Province, Central Vietnam. Questions are related to diabetes and prediabetes, acute coronary syndromes, and infectious diseases. Spatial care paths for problem-solving were designed. Acute coronary syndrome results were reported open access elsewhere (see https://journals.lww.com/poctjournal/Pages/articleviewer.aspx?year=2018&issue=09000&article=00001&type=Fulltext). Results Blood glucose testing was limited. Two (28.6%) of 7 community health centers reported having glucose meters available, whereas overall, only 2 (13.3%) of 15 survey sites performed hemoglobin A1c (HbA1c) testing. Diabetes and prediabetes glucose screening cutoffs varied across levels, possibly generating erroneous/missing diagnoses. A diabetes screening program was not reported at the level 2 hospital; availability varied in levels 3 and 4. Glucose meters must be purchased at patients' expense. Microvascular and macrovascular complications, such as kidney failure, retinopathy, and neuropathy, are treated at Hue Central Hospital, the provincial hospital, and some district hospitals. Transfer depends on the extent of patient complications. Ambulance service is extremely limited. Helicopter rescue is not available. Conclusions We conclude the following: (a) diagnostic technologies should be improved; (b) HbA1c and blood glucose instruments must be supplied; (c) public health budgets should fund self-monitoring, glucose meters, and enhanced access; (d) healthcare leaders can create regional spatial care paths to improve outcomes; and (e) diagnostic cutoffs, especially HbA1c, should be harmonized after checking population differences.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalPoint of Care
Volume18
Issue number1
DOIs
StatePublished - Mar 1 2019

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Point-of-Care Systems
Vietnam
Diabetes Mellitus
Public Health
Community Health Centers
Prediabetic State
Glucose
Hemoglobins
District Hospitals
Acute Coronary Syndrome
Blood Glucose
Ambulances
Aircraft
Budgets
Financial Management
Renal Insufficiency
Communicable Diseases
Coronary Disease
Technology
Delivery of Health Care

Keywords

  • diabetes management
  • diabetes screening programs
  • fasting plasma glucose
  • hemoglobin A1c
  • macrovascular complications
  • microvascular complications
  • needs assessment survey
  • overdiagnosing
  • self-monitoring of blood glucose
  • skin autofluorescence
  • underdiagnosing
  • Vietnam
  • whole-blood glucose testing

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Rapid diagnosis and effective monitoring of diabetes mellitus in central Vietnam : Point-of-care needs, improved patient access, and spatial care paths for enhanced public health. / Ventura, Irene J.; Zadran, Amanullah; Ho, An V.D.; Zadran, Layma; Thuan, Duong T.B.; Pham, Tung T.; Kost, Gerald J.

In: Point of Care, Vol. 18, No. 1, 01.03.2019, p. 1-8.

Research output: Contribution to journalArticle

Ventura, Irene J. ; Zadran, Amanullah ; Ho, An V.D. ; Zadran, Layma ; Thuan, Duong T.B. ; Pham, Tung T. ; Kost, Gerald J. / Rapid diagnosis and effective monitoring of diabetes mellitus in central Vietnam : Point-of-care needs, improved patient access, and spatial care paths for enhanced public health. In: Point of Care. 2019 ; Vol. 18, No. 1. pp. 1-8.
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KW - skin autofluorescence

KW - underdiagnosing

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KW - whole-blood glucose testing

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