PROVISION OF DIABETES CARE IN PRIMARY HEALTH CARE CENTER IN THE UNITED ARAB EMIRATES
Dr. Buthaina Abdullah Bin Belaila1, Dr. Aisha Abdulla Mohammed Abdulla2, Dr. Ibtihal Fadhil3, Hira Abdul Razzak4
1 Head of non-communicable Diseases Section, Ministry of Health and Prevention, Dubai, United Arab Emirates
2Director of primary health care department, Ministry of Health and Prevention, Dubai, United Arab Emirates
3Public health Specialist, Non-communicable Diseases, Ministry of Health and Prevention, Dubai, United Arab Emirates
4Research Specialist, Statistics and Research Center, Ministry of Health and Prevention, Dubai, United Arab Emirates


ABSTRACT
Background: Non communicable diseases have evolved as a public health concern and are one of the leading causes of mortality in the United Arab Emirates. Data also indicate that the prevalence of diabetes in the UAE is rising and expected to double to 2.2 million by 2040. The UAE national agenda 2021 is a turning point for scaling up diabetes care at primary care level. The national agenda 2021 includes a set of long-term indicators, focusing on national priorities including diabetes care aiming to reduce diabetes prevalence and mortality 30% by the year 2021. Building on the vital role of primary health care in diabetes screening and management, Ministry of Health and Prevention, launched its initiative to integrate NCD screening and management into PHC across UAE. The initiative focused on improving diabetes care using the WHO/ISH risk prediction chart and national diabetes guideline for screening and effective management. 
Aims:  This study aims to assess implementation of the total cardiovascular (CVD) risk approach and diabetes national guideline, determining enabling factors that should accompany Ministry of health and prevention’s attempt to expand coverage.  
Methods: Analysis was undertaken by using patient records from UAE primary health care centers. All patients who attended the non-communicable disease clinics from January 2016 - July-2017 constituted our study population. 

Findings: Between January 2016 and July 2017, 12296 individual were registered.  Majorities were national 89% and 68% were female. Average age was 58.9 years of age, of which 49.6% had diabetes mellitus, and 43.3% had hypertension. Body Mass Index was above the normal threshold in 82% of registered patients. Out of the registered patients, around 26.6% had the 10-years cardiovascular risk  between 10–20% as compared to  2.74% having a 10-year cardiovascular risk>30%. HbA1c level was controlled in 37.3% of diabetic patients; systolic blood pressure was controlled in 44. 5% of hypertensive patients, cholesterol were controlled in 30%.
  
Conclusion: The introduction of CVDs risk stratification at primary health care proved to be a useful tool to improve diabetes screening and management at primary health care centers, and make best utilization of resources available for the purpose of reducing diabetes morbidity and mortality through early detection of individuals who are at a higher risk. Regular auditing of diabetes care, enhancing counseling skills of PHC providers and scaling up self-management programs are needed in the future.