title: Are adults diagnosed with diabetes achieving the American Diabetes Association clinical practice recommendations?
abstract: OBJECTIVE
  This study assessed the proportion of adults with previously diagnosed diabetes mellitus (DM) who met selected preventive practices and treatment goals according to the American Diabetes Association (ADA) standards of medical care.
  
  
  METHODS
  A secondary analysis of data collected for a previous epidemiologic study that used a probability cluster design to select 859 persons aged 21-79 years in the San Juan metropolitan area was undertaken. This study focused on 136 (15.8%) adults who self-reported DM. The Standards of Medical Care in Diabetes published by the ADA in 2011 were used to determine the proportion of adults achieving selected clinical practice recommendations.
  
  
  RESULTS
  Less than half of adults achieved recommended treatment goals for LDL-cholesterol (47.8%), HDL-cholesterol (44.1%), blood pressure (41.2%) and HbAlc (28.7%). The percentage of adults achieving recommended levels of HbAlc, blood pressure and LDL-cholesterol simultaneously was 6.6%; the percentage achieving HbA1c, blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides and albumin-to-creatinine ratio target levels was only 2.2%. More than half (60.2%) reported daily self-monitoring of foot ulcers and HbAlc testing at least twice over the past year (52.3%). However, less than half reported annual dilated eye examination (49.2%), annual comprehensive foot examination (43.8%), daily self-monitoring blood glucose (37.5%), moderate or vigorous physical activity (33.8%), and self-management DM education (28.9%).
  
  
  CONCLUSIONS
  This study showed that a substantial proportion of adults with DM did not achieve ADA recommendations on selected preventive practices and treatment goals. Strategies to improve DM medical care and surveillance of preventive-care practices and treatment goals among affected individuals are essential for planning further initiatives that contribute to reduce the burden of DM complications.
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan, Puerto Rico. cynthia.perezl@upr.edu
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.forename: Isaedmarie
authors.initials: I
authors.lastname: Febo-Vázquez
authors.forename: Manuel
authors.initials: M
authors.lastname: Guzmán
authors.forename: Ana Patricia
authors.initials: AP
authors.lastname: Ortiz
authors.forename: Erick
authors.initials: E
authors.lastname: Suárez
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult