Original Data

Prevalence of Undiagnosed Diabetes and Quality of Care in Diabetic Patients Followed at Primary and Tertiary Clinics in Abu Dhabi, United Arab Emirates

Hussein Saadi¹, Jumaa Al-Kaabi¹, Mahmoud Benbarka², Ali Khalili³, Wael Almahmeed², Nicolaas Nagelkerke⁴, Alessandro Salustri², Laila Abdel-Wareth⁵, Awad Al Essa¹, Javed Yasin¹, Bayan Al-Dabbagh¹, Elsadig Kazam¹

Manuscript submitted December 14, 2010; resubmitted January 24, 2011; accepted January 28, 2011.

Keywords: type 2 diabetes, diabetes screening, quality of care, diabetes diagnosis, obesity, hypertension, albuminuria, questionnaire, OGTT, fasting plasma glucose

Abstract

AIMS: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Fulltext: HTML , PDF (140KB)

This article has been cited by other articles:

	Physicians' attitudes towards provision of primary care services in community pharmacy in the United Arab Emirates Hasan S, Stewart K, Chapman CB, Hasan MY, Kong DC Int J Pharm Pract 2014. In press
	Risk assessment for developing type 2 diabetes mellitus and its determinants among adults attending Dubai Primary Health Care centers, 2012 Alshaali A, Wasfy A, Mahdy N Hamdan Med J 2014. 7(2):195-205
	Prevalence of diagnosed and undiagnosed diabetes mellitus in adults aged 19 years and older in Basrah, Iraq Mansour AA, Al-Maliky AA, Kasem B, Jabar A, Mosbeh KA Diabetes Metab Syndr Obes 2014. 7:139-144
	Epidemiology of diabetes mellitus - a global and regional perspective Howarth FC, Adeghate E Hamdan Med J 2013. 6(1):51-58
	Characteristics, management, and in-hospital outcomes of diabetic patients with acute coronary syndrome in the United Arab Emirates Shehab A, Al-Dabbagh B, Almahmeed W, Bustani N, Agrawal A, Yusufali A, Wassef A, Alnaeemi A, Alsheikh-Ali AA Sci World J 2012. 2012:698597
	Prevalence of abnormal glycemic and lipidemic status in an urban population of Bangladesh Das M, Hassan Z, Faruque O, Parial R, Khalequzzaman M, Ali L J Bio Sci 2011. 19:1-6