title: Adherence of Healthcare Professionals to American Diabetes Association 2004 guidelines for the care of patients with type 2 diabetes at Peripheral Diabetes Clinics in Karachi, Pakistan.
abstract: OBJECTIVE
  To observe the adherence of Healthcare Professionals to American Diabetes Association (ADA) 2004 guidelines for the care of patients with type 2 diabetes at Peripheral Diabetes Clinics (PDCs) in Karachi, Pakistan.
  
  
  METHODS
  The study was conducted using a retrospective medical chart review of patients with type 2 diabetes at four PDCs in four townships of Karachi district from January 2005 to December 2006. Entire medical records of patients were evaluated for the evidence of documentation of testing and treatment.
  
  
  RESULTS
  Medical records of 691 patients (332 males and 359 females) with type 2 diabetes were reviewed. Mean age of the patients was 50.79 ± 10.75 years. Deficiencies were observed in most areas of diabetes care. Blood pressure was documented in 85.81% patients, whereas, serum creatinine, HbA1c and lipid profile were noted in 56%, 44.57% and 40.08% of the patients respectively. Similarly, lower leg examination was registered in 44% patients, while in 30.53% of the patients fundoscopic examination was recorded. Co-morbid conditions like hypertension and hyperlipidemia were documented in 92.7% and 84.6% patients respectively. HbA1c < 7% was achieved by 59.04% patients, while 27.50% of the patients attained the recommended level of serum cholesterol. Likewise, ADA recommended goal for blood pressure and LDL was achieved by13.02% and 12.16% patients respectively.
  
  
  CONCLUSIONS
  The study showed that adherence of healthcare professionals to ADA guidelines was suboptimal. Moreover, insufficient documentation of medical records reflected inadequate care of patients with type 2 diabetes.
authors.affiliation: Farzana Muzaffar, M. Phil, Research Officer, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Farzana
authors.initials: F
authors.lastname: Muzaffar
authors.affiliation: Nimra Fatima, B.E (Bio Engineering), Research Officer, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Nimra
authors.initials: N
authors.lastname: Fatima
authors.affiliation: Asher Fawwad, MBBS, M.phil,Assistant Professor, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Asher
authors.initials: A
authors.lastname: Fawwad
authors.affiliation: Mussarat Riaz, FCPS, Consultant Physician, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Mussarat
authors.initials: M
authors.lastname: Riaz
keywords: ADA 2004 guidelines; Healthcare professionals; Peripheral Diabetes Clinics; Type 2 Diabetes