Quality of Care of Diabetes Mellitus Type II patients in Iran

Diabetes is a relatively common ill-health condition in Iran with a prevalence of 7.7% in the age range of 25 - 64 years and with a rather high burden. It is not only a chronic devastating disease which causes high rates of death directly, but also a strong risk factor for some other common chronic conditions, e.g., cardiovascular diseases. The worst complications of diabetes develop when quality healthcare services are not provided to patients or are not used by them. This study was conducted to depict the first national picture of quality of care provided for known diabetic patients in Iran. The study was conducted alongside the "Iran's National Noncommunicable Diseases Risk Factor Surveillance survey" of 2005; a cross-sectional study with a multistage cluster sampling approach which targeted Iranians older than 15 years of age. Only 6.4% of the respondents had a HbA1c test during the year before questioning and 25.7% reported to have undertaken a lipid profile examination in the same period of time. Positive responses for eye and foot examinations in the year leading to survey were 39.8% and 20.5%, respectively. About 97.4% of the patients had poor control according to their most recent HbA1c levels. About 25% needed an improvement in diabetes control according to their blood levels of low-density lipoproteins, and 45% of them were hypertensive. All measures of quality of care of diabetes type II were poor in Iranian diabetic patients except for eye examination. Healthcare system of the country needs to focus on patients' easier and better access to laboratory facilities together with a strong training program for care providers and patients to help with better implementation of clinical guidelines and standards of care. A follow-up mechanism is needed to check the trend of quality of care of diabetes in Iran.