Quality of diabetes care in Arab Americans

Abstract

The quality of care received by Arab American patients with type 2 diabetes residing in a city with a large migrant Arab population has not been examined. Arab American adults with a self-reported diagnosis of diabetes were identified in a rigorous cross-sectional, population-based epidemiologic study conducted in Dearborn, MI. Quality of diabetes care was determined by assessing adherence to the American Diabetes Association (ADA) clinical practice recommendations. The Third National Health and Nutrition Examination Survey (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS) provided data for a national comparison. Among the 53 participants, mean age was 59 ± 12 years and the mean duration of diabetes was 11.3 ± 13.3 years. The ADA goal for an A1c of <7% was met by 30% of study subjects. LDL (<100 mg/dL) and BP (<130/85) goals were met by 36% and 16% of subjects, respectively. The majority of the Arab American subjects studied were treated less aggressively with pharmacologic agents than recommended by the ADA. 26% of the Arab Americans had an A1c > 9.5% as compared to 18% of the national population. Arab Americans generally had worse blood pressure control but better lipid control compared to the national sample. This is the first report of the quality of diabetes care in an Arab American population, and demonstrates sub-optimal quality of care according to the ADA clinical practice recommendations.