World Journal of
Pharmaceutical and Life Sciences

EVALUATION OF GUIDELINE-ADHERENT DIABETES MANAGEMENT IN A COLLIERY TOWNSHIP OF TELANGANA, INDIA: A COMMUNITY-BASED OBSERVATIONAL STUDY

Dr. K. Shireesha*, M. Gowthami, L. Tejasri, V. Ramya Sri, M. Sowjanya, Dr. V. Pravallika, M. Jaya Gayathri, Rajani G.

ABSTRACT

Background: Diabetes mellitus requires sustained, guideline-based management to prevent long-term complications. Despite the availability of structured recommendations, implementation of standardized care in occupational primary healthcare settings remains underexplored. Objective: To evaluate adherence to American Diabetes Association (ADA)-recommended diabetes care indicators and to assess patterns of glycaemic monitoring, cardiovascular risk management, pharmacotherapeutic utilization, and complication screening among adult patients in a colliery township of Telangana, India. Methods: A retrospective observational study was conducted over six months in an occupational primary care setting. A total of 511 adult patients with documented Type 2 Diabetes Mellitus were included. Sociodemographic characteristics, anthropometric parameters, laboratory monitoring practices, pharmacotherapy patterns, and complication documentation were analyzed. Adherence to ADA-recommended care components was evaluated using predefined process indicators. Descriptive statistics were used to summarize categorical variables, and Chi-square tests were applied to assess associations, with p < 0.05 considered statistically significant. Results: The majority of participants were aged 46–55 years (45.59%), with a mean age of 49.8 ± 8.6 years. Over half of the cohort (51.85%) were overweight or obese. Elevated systolic and diastolic blood pressure were observed in 43.44% and 45.59% of patients, respectively. Serum creatinine assessment was documented in 91.0% of cases, whereas urine albumin screening was recorded in only 23.87%. Regular HbA1c monitoring was documented in 33.5% of patients, significantly lower than lipid profile documentation (99.2%) (p < 0.001). Oral hypoglycaemic agents and insulin therapy were prescribed in 49.1% and 45.2% of patients, respectively. Documented prevalence of nephropathy, foot complications, and retinopathy was 8.02%, 3.9%, and 0.97%, respectively. Adherence to ADA care components varied significantly across indicators (p < 0.001), with highest adherence observed for diabetes education (85.3%) and lowest for referral documentation (24.6%). Conclusion: Diabetes management within this occupational primary healthcare setting demonstrated selective adherence to guideline-recommended standards. While basic documentation and laboratory assessments were largely maintained, significant gaps were identified in glycaemic monitoring, nephropathy screening, and referral practices. Strengthening structured monitoring protocols and multidisciplinary coordination may enhance comprehensive diabetes care delivery in occupational communities.

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