Diabetes Mellitus (DM) is a complex, chronic group of metabolic diseases characterised by hyperglycemia, which can be associated with insulin secretion and insulin action defects or both. It is a massive health issue burdening the global population. The Trinidad and Tobago population epitomises this worldwide epidemic with a high DM prevalence of 12.4% in 2024 (Magliano et al., 2025). Effective disease management can help prevent complications, thereby lowering the overall cost of diabetes to the public health sector. Clinical practice guidelines (CPGs) play an important role by equipping healthcare practitioners with the tools needed to make informed decisions ultimately resulting in better patient care outcomes.

 

This study aimed to evaluate the quality of care in known diabetic patients in public health facilities within North-East Trinidad by assessing their adherence to common fundamental diabetes management guidelines, during the years 2015 and 2016. The research studied 101 patient medical records, which were predominantly female (74%). Hypertension (77%) and dyslipidemia (53%) were the most common comorbidities. The data also revealed a significant proportion of patients with multiple comorbidities. Limitations included a relatively small sample size, sex imbalance, and important missing data on key metrics such as height, waist-hip circumference, BMI, family history, and if patients experienced depression. The study identified significant gaps in clinical guideline adherence. Foot and eye exams were documented for a mere 0.6% of patients, and referrals for retinopathy screening and dietician consultations were similarly low (4-21%). Variability in laboratory testing and poor documentation were also noted.

Drug prescribing was on par with the standards of care with combination therapy being employed in many cases.

 

The adherence to diabetic CPGs varied, with high compliance in blood pressure and random blood sugar measurements but lower rates for HbA1c and lipid profiles. Despite the limitations, this study underscores the urgent need for improved and consistent data collection practices to enhance diabetes management and outcomes in this population. By identifying gaps and opportunities in adherence to clinical practice guidelines (CPGs), this research seeks to inform future policy, enhance quality improvement efforts, and provide standardised data for ongoing monitoring. The findings may also help guide the allocation of resources and highlight areas where additional support, education, or interventions are needed to improve patient care.