Abstract

Aims: This study describes the baseline characteristics and 24 month outcomes of diabetic patients managed in an integrated chronic care program at public facilities in rural Rwanda. Methods: Retrospective review of routine electronic medical records of patients treated for diabetes between October 1, 2006 and September 30, 2014 was conducted. Baseline demographic and clinical characteristics are described. Outcomes of HbA1c values, loss to follow-up and death are reported. Results: Of 544 patients enrolled, 305 (56.1%) were female and twenty-two (4.0%) were younger than 18 years. Of those with adequate documentation, 72.3% were subsistence farmers, 35.8% had baseline BMI ≥ 25, and 5.3% were current smokers. Median HbA1c was 10.3% (IQR: 8.3, 11.9) at baseline and 8.2% (IQR: 6.3, 10.1) at seven to 12 months of follow-up. For 394 patients with at least 24 months between enrollment and study period end, 66 (16.8%) were lost-to-follow-up, 12 (3.0%) died within the first 24 months and 316 (80.2%) were alive and in care. Conclusions: Our findings indicate that diabetes can be effectively managed with reasonable outcomes in a rural resource-limited setting. We also found relatively low lifestyle risk factors and comorbidities among our patients compared with those in the United States and Europe.

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