Alfayez Osamah M, Alfuraih Sumaia N, Alsalamah Basmah I, Almendeel Hadeel M, Alkhezi Omar S, Alharbi Saad, Alwohaibi Naief A, Kamran Rasheed Muhammad
Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia.
College of Pharmacy, Qassim University, Qassim, Saudi Arabia.
Saudi Pharm J. 2023 Sep;31(9):101694. doi: 10.1016/j.jsps.2023.06.027. Epub 2023 Jul 3.
The high prevalence of prediabetes and diabetes mellitus and its secondary complications in Saudi Arabia is a major healthcare concern. Evidence suggests that despite evidence-based efficacy and safety, metformin is underutilized in prediabetic obese patients. Thus, the aim of this study was to investigate the use of metformin in prediabetic obese patients in the Qassim region of Saudi Arabia.
Prediabetic patients' electronic health records were accessed and screened from 2017 to 2021. The inclusion criteria were patients with obesity (BMI ≥ 35) diagnosed with prediabetes, and who received metformin. Patients with chronic kidney disease and those using metformin for other diseases were excluded. The first major endpoint of this study was the rate of metformin use among obese, prediabetic individuals. The second major endpoint was the factors associated with metformin prescribing in our cohort. Descriptive statistics were used to report the primary and secondary outcomes. Data are presented as percentages, means, standard deviations (SDs), medians, and interquartile ranges, as appropriate. All analyses were conducted using Stata version 16.1.
A total of 304 prediabetic patients were included in this study after screening the records of 1,789 patients. The average age was found to be 40, and the majority were female (72%). The average BMI was found to be 39.4 kg/m, while the average HbA1c was 5.8%. In the entire sample, only 25 (8.22%) obese patients received metformin for diabetes prevention. Among obese patients with a BMI ≥ 30, 19 patients (8.7%) received metformin. Metformin users had higher odds of being on statins (OR 2.72, 95% CI 1.01 to 7.36; p = 0.049).
According to the study, metformin is not frequently prescribed to prediabetic obese individuals in the Qassim region of Saudi Arabia. This prevention strategy is a missed opportunity in the management of prediabetes in high-risk patients. Future studies are needed to investigate the root causes of the underuse of metformin and potential interventions to promote evidence-based practice in Saudi Arabia.
沙特阿拉伯糖尿病前期和糖尿病及其继发并发症的高患病率是一个主要的医疗保健问题。有证据表明，尽管二甲双胍具有循证疗效和安全性，但在糖尿病前期肥胖患者中未得到充分利用。因此，本研究的目的是调查沙特阿拉伯卡西姆地区糖尿病前期肥胖患者使用二甲双胍的情况。
检索并筛选了2017年至2021年糖尿病前期患者的电子健康记录。纳入标准为诊断为糖尿病前期的肥胖患者（BMI≥35）且接受二甲双胍治疗。排除患有慢性肾病的患者以及因其他疾病使用二甲双胍的患者。本研究的第一个主要终点是肥胖糖尿病前期个体中二甲双胍的使用比例。第二个主要终点是我们队列中与二甲双胍处方相关的因素。采用描述性统计报告主要和次要结果。数据以百分比、均值、标准差（SD）、中位数和四分位间距（视情况而定）表示。所有分析均使用Stata 16.1版本进行。
在筛查了1789例患者的记录后，本研究共纳入304例糖尿病前期患者。发现平均年龄为40岁，大多数为女性（72%）。平均BMI为39.4kg/m，而平均糖化血红蛋白（HbA1c）为5.8%。在整个样本中，只有25例（8.22%）肥胖患者接受二甲双胍以预防糖尿病。在BMI≥30的肥胖患者中，19例（8.7%）接受了二甲双胍治疗。二甲双胍使用者使用他汀类药物的几率更高（比值比2.72，95%置信区间1.01至7.36；p=0.049）。
根据该研究，在沙特阿拉伯卡西姆地区，糖尿病前期肥胖个体中二甲双胍的处方并不常见。这种预防策略在高危患者的糖尿病前期管理中是一个错失的机会。未来需要开展研究，以调查二甲双胍使用不足的根本原因以及促进沙特阿拉伯循证实践的潜在干预措施。
