title: Prevalence of undiagnosed diabetes and quality of care in diabetic patients followed at primary and tertiary clinics in Abu Dhabi, United Arab Emirates.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Internal Medicine, UAE University, Al Ain, United Arab Emirates. saadih@uaeu.ac.ae
authors.forename: Hussein
authors.initials: H
authors.lastname: Saadi
authors.forename: Jumaa
authors.initials: J
authors.lastname: Al-Kaabi
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Benbarka
authors.forename: Ali
authors.initials: A
authors.lastname: Khalili
authors.forename: Wael
authors.initials: W
authors.lastname: Almahmeed
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Nagelkerke
authors.forename: Laila
authors.initials: L
authors.lastname: Abdel-Wareth
authors.forename: Awad
authors.initials: A
authors.lastname: Al Essa
authors.forename: Javed
authors.initials: J
authors.lastname: Yasin
authors.forename: Bayan
authors.initials: B
authors.lastname: Al-Dabbagh
authors.forename: Elsadig
authors.initials: E
authors.lastname: Kazam
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D001794:Blood Pressure / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D014479:United Arab Emirates / Q000453:epidemiology