Comprehensive management of non-insulin-dependent diabetes mellitus. A diabetes clinic revisited.

OBJECTIVE: To 'revisit' the Johannesburg Hospital diabetes clinic to ascertain whether the established risk factors for CAD were being identified and appropriately managed. DESIGN: Body mass indices (BMI), fasting lipograms and glycated haemoglobin (HBA) estimations were done on a random sample of white NIDDM patients aged over 35 years. RESULTS: Eighty-two patients (39 males, 43 females) were tested. The mean age was 60 years (range 36-80 years) and the mean duration of NIDDM 6.2 years (range 1-25 years). The mean HBA value was 10% (normal 4-8%). Obesity was present in 82%; it was moderate (BMI 25-30 kg/m2) in 46% and severe (BMI > 30 kg/m2) in 36%. Hypercholesterolaemia was present in 46%, hypertriglyceridaemia in 68%, and both in 34%. Uncontrolled hypertension was present in 20% of patients, and 27% smoked. CONCLUSIONS: Management of patients at our clinic remains confined to the control of hyperglycaemia. Despite increased awareness of the risk factors for CAD, these factors have largely been ignored.