title: Adherence to the American Diabetes Association standards of care among patients with type 2 diabetes in primary care in Saudi Arabia.
abstract: OBJECTIVE
  To assess adherence to 11 American Diabetes Association (ADA) standards of diabetic care.
  
  
  METHODS
  We conducted this one-year historical prospective study between October 2010 and September 2011 on 450 adult type 2 diabetes patients in a primary care center in Saudi Arabia. We used the definitions of the 2010 ADA standards of diabetic care processes and targets.
  
  
  RESULTS
  Four-hundred and fifty medical files were valid. The adherence to ADA process standards of measurement of glycated hemoglobin (HbA1c) was 68.7%, 92.9% for blood pressure, and 80.2% for serum lipids. Screening was lowest for nephropathy (35.6%), and highest for diabetic foot (72%). Adherence to medications ranged between 82.2% for antiplatelets, and 92.4% for dyslipidemia. For outcome standards, 24.2% of the patients had an HbA1c &lt;7%, and 32.2% had controlled blood pressure (&lt;130/80 mm Hg); and 58.5% achieved targeted low-density lipoproteins (LDL). Only 7.2% had glycemic control in addition to controlled blood pressure and targeted LDL level. An increasing trend of patients achieving glycemic control (&lt;7%) was shown throughout follow-up (p=0.003).
  
  
  CONCLUSIONS
  We found suboptimal adherence with many ADA standards of diabetic care among patients with type 2 diabetes treated at a primary care center in Saudi Arabia. The achievement of outcome standards, either singly or combined, is lower than the adherence rates. However, the figures show improvement in adherence during the follow-up period.
authors.affiliation: Department of Family and Community Medicine, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail. turkifcm@yahoo.com.
authors.forename: Turki J
authors.initials: TJ
authors.lastname: Al Harbi
authors.forename: Ayla M
authors.initials: AM
authors.lastname: Tourkmani
authors.forename: Hesham I
authors.initials: HI
authors.lastname: Al-Khashan
authors.forename: Adel M
authors.initials: AM
authors.lastname: Mishriky
authors.forename: Hala
authors.initials: H
authors.lastname: Al Qahtani
authors.forename: Ahmed
authors.initials: A
authors.lastname: Bakhiet
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards*; D012529:Saudi Arabia; D012955:Societies, Medical