A Clinical Audit on Diabetes Care in Patients with Type 2 Diabetes in Al-Ain, United Arab Emirates

OBJECTIVES To implement a prospective interventional clinical audit to evaluate the current clinical practice and the effect of standard interventions on the management of type 2 diabetes (T2DM). METHODS 254 patients with T2DM where recruited in a specialized diabetes care center in Al-Ain, UAE. The diabetes care components were audited before (baseline) and after (3 and 6 months) implementation of Institute of Clinical System Improvement (ICSI) guidelines. Data was compared against international guidelines to achieve target goals of normoglycemia, blood pressure (BP), and low density lipoprotein-cholesterol (LDL-C). We measured changes in mean scores of patient satisfaction level regarding diabetes care at similar intervals, by validated Patient Satisfaction Questionnaire (PSQ-18). RESULTS We observed a significant reduction in fasting blood glucose (FBG; mean± SD; 9.3 ± 0.03 vs 7.4 ± 0.3mmol/l; P=0.03), and HbA1c (8.7 ± 0.02 vs 8.1 ± 0.02 %; P=0.04) levels after 6 months compared with baseline. Patients who achieved target FBG and HbA1c levels improved significantly (45.7 vs 81.1%; P=0.03), and (40.1 vs 73.6%; P=0.04), respectively. The LDL-C levels improved, though this was not statistically significant. Patients achieving target of BP control improved significantly (SBP 142±7.6 and DBP 95±6.2 vs SBP 136±8.2 and DBP 87±5.8 mmHg;P=0.05). CONCLUSIONS The results of this interventional audit were generally positive and emphasized the feasibility of improving the current clinical practice. Our individualized approach has helped us to achieve a better target in glycemic and BP control as well as patient satisfaction. Further research is needed to understand the long-term impact of our structured approach to improve the quality of T2DM care in the UAE.