Abstract
INTRODUCTION: Diabetes mellitus (DM) may be complicated by diabetes nephropathy (DN), which may lead to end-stage renal disease. Specialized diabetes clinics were established to improve care. The purpose of the research was to assess and compare the prevalence management of renal impairment among adults with type 2 DM in general clinic and specialized diabetes clinics. METHODOLOGY: This is a retrospective cross-sectional study of the electronic medical records of patients attending both central diabetes clinics (CDCs) and noncommunicable clinics in seven primary healthcare units in Bahrain, during February to April 2020. Inclusion criteria included adults with type 2 diabetes patients. Excluded are type 1 diabetes patients, patients with renal transplants, and pregnant women. Demographic data, biochemical and clinical data, estimate glomerular filtration rate (e-GFR), albuminuria status, medication prescriptions, and secondary care nephrology referrals were studied. FINDINGS: A total of 3708 patients were enrolled in the study from both clinics. The prevalence of DN by eGFR < 60 mL/min/1.73m(2) was 16.3%, while the prevalence of DN by positive albuminuria is 13.5%. Both clinics appear to comply with the standards of care. Comparison between performances of both clinics showed that CDCs comply with intensification of therapy and rigorous and prompt referral to Nephrology clinics. CONCLUSION: The prevalence of renal impairment in people with DM in Bahrain is high comparing to nearby countries. The management needs to be further augmented by stressing on complying with standards of care and using specialized settings with a multidisciplinary team approach and meticulous monitoring. ORIGINALITY/VALUE: To the authors' knowledge, the comparison between the performance of a specialized clinic and a general noncommunicable disease clinic in the context of renal disease in diabetics is lacking in the Gulf Cooperation Council and Bahrain. The specialized CDC in Bahrain is a unique experience and meant to reduce the burden of diabetes complications through better control of diabetes comorbidities.