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

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Abstract
The Review of Diabetic Studies,2010,7,4,293-302.
Published:February 2011
Type:Original Article
Authors:
Author(s) affiliations:

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, and Elsadig Kazam1

1Department of Internal Medicine, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.

2Department of Internal Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

3Department of Family Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

4Department of Community Medicine, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.

5Department of Laboratory Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

Abstract:

Aim: 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. Conclusion: 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.