Prevalence of undiagnosed diabetes and quality of care in diabetic patients followed at primary and tertiary clinics in Abu Dhabi, United Arab Emirates.

Hussein Saadi,Mahmoud Benbarka,Laila Abdel-Wareth,Nicolaas Nagelkerke,Elsadig Kazam,Wael Almahmeed,Bayan Al-Dabbagh,Ali Khalili,Awad Al Essa,Javed Yasin,Jumaa Al-Kaabi

doi:10.1900/rds.2010.7.293

Abstract

To investigate the prevalence of undiagnosed type 2 diabetes (T2D) at primary health care (PHC) clinics, and to assess the quality of care of diabetic patients followed at a tertiary hospital diabetes center in Abu Dhabi, United Arab Emirates (UAE). Between May 2009 and October 2010, adult patients attending two PHC clinics, and adult diabetic patients attending the diabetes center, were invited to participate in the study. After overnight fast, participants returned for interview and laboratory tests. Undiagnosed T2D was defined by FPG ≥ 7.0 mmol/l or HbA1c ≥ 6.5%. Quality of care was assessed by reported care practices and achievement of internationally recognized targets. Out of 239 patients at PHC clinics without history of T2D, 14.6% had undiagnosed T2D, and 31% had increased risk of diabetes (FPG 5.6-7.0 mmol/l or HbA1c 5.7-6.5%). The independent predictors of undiagnosed T2D were age (adjusted OR per year 1.07, 95% CI 1.04-1.11, p < 0.001) and BMI ≥ 25 (adjusted OR 4.2, 95% CI 0.91-19.7, p = 0.033). Amongst all 275 diagnosed T2D patients, including those attending PHC clinics and those followed at the diabetes center, it was found that 40.1% followed dietary recommendations, 12% reported visiting a diabetes educator, 28.2% walked for exercise, and 13.5% attained recognized targets of HbA1c < 7%, blood pressure < 130/80 mmHg, and LDL cholesterol < 2.6 mmol/l. Almost half of the adult patients attending PHC clinics had undiagnosed T2D, or increased diabetes risk. Care practices, and achievement of treatment targets, were suboptimal.

Highlights

Introduction n the United ArabEmirates (UAE), there are growing concerns about diabetes-associated health problems
We found a prevalence of undiagnosed diabetes previous two weeks
We found that 31% of patients attending primary health care (PHC) clinics are at increased risk for type 2 diabetes (T2D)

Summary

Introduction

Emirates (UAE), there are growing concerns about diabetes-associated health problems. In 2004, the total annual direct treatment costs of uncomplicated diabetes were estimated at US$ 1,605 per patient, which was more than three times the per capita expenditure for health care in the UAE [3]. Treatment costs increase with age, diabetes duration, complications, and use of insulin [3]. Vol 7 ⋅ No 4 ⋅ 2010 due to the greater opportunity to reduce cardiovascular disease complications, principally through the use of statins [4, 5]. In view of the high T2D prevalence rate, and the increasing costs, in the UAE, national guidelines recommend screening of all adults aged 30 years and above

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Conclusion