Radi Suhaib, Alsolami Hatem A, Bader Mahmoud W, Almazmumi Mohammed K, Alsahafi Abdulrahman H, Habeeballah Jehad H, Ibrahim Rashed I, Alosaimi Hamad A, Alzahrani Jehad A, Ahmed Mohamed E
Department of Endocrinology, Ministry of National Guard Health Affairs, Jeddah, SAU.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Cureus. 2024 Nov 17;16(11):e73850. doi: 10.7759/cureus.73850. eCollection 2024 Nov.
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease that is associated with many complications if untreated. Guidelines, including those from the American Diabetes Association (ADA), are published regularly to enhance the management of diabetes in all aspects of care including regular screening of diabetic complications and encouraging the use of newer medications such as sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1a). This study aims to assess the adherence to ADA guidelines at a tertiary care center in Saudi Arabia.
The study employed an observational, retrospective chart review design, utilizing medical records and patient charts from the Diabetic Center at the National Guard Health Affairs (NGHA) Hospital in the western region. The study included a sample of 384 patients from a total population of 3,985 individuals. Participants were adults over 18 years of age with T2DM who were being treated at the diabetic center.
The study included 384 patients, with 56% being female (215 patients), and the mean age was 62.8(±11) years. The mean duration of DM was 17.6(±9.6) years and the mean body mass index (BMI) was 31 kg/m(±6.3). SGLT2i and GLP-1a were prescribed in 226 (59%) and 196 (51%) of cases, respectively. Two hundred and ninety-six (76.6%) patients measured their glycated hemoglobin (HbA1c) twice annually which meets with ADA recommendations, and the mean HbA1c was 7.8(±1.6) which is lower than two local and two regional studies. Blood pressure (BP) was controlled (<130/80) in 40% of patients, which is in between according to three local studies. Lipid profile was checked annually in 95% of patients, but only 27% met the ADA primary or secondary prevention goals. Regarding urine albumin-to-creatinine ratio (ACR), it was done annually in 75% of patients, and 89% of patients have seen an ophthalmologist which indicates better adherence than other studies.
The results conclude that the diabetic center at the NGHA Hospital in Jeddah generally provides good quality of care with high adherence to ADA guidelines; however, some aspects of care need to be improved including hypertension and dyslipidemia management. Moreover, further research should aim to be more specific when addressing the use of newer medications including SGLT2i and GLP-1a and its outcome in diabetes complications and patients' satisfaction.
2型糖尿病（T2DM）是一种慢性代谢性疾病，若不治疗会引发多种并发症。包括美国糖尿病协会（ADA）发布的指南会定期更新，以加强糖尿病各方面的管理，包括定期筛查糖尿病并发症以及鼓励使用新型药物，如钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）和胰高血糖素样肽1受体激动剂（GLP-1a）。本研究旨在评估沙特阿拉伯一家三级医疗中心对ADA指南的遵循情况。
本研究采用观察性、回顾性病历审查设计，利用西部地区国民警卫队卫生事务（NGHA）医院糖尿病中心的医疗记录和患者病历。研究样本包括3985名患者中的384名。参与者为在糖尿病中心接受治疗的18岁以上成年T2DM患者。
该研究纳入384名患者，其中56%为女性（215名患者），平均年龄为62.8（±11）岁。糖尿病平均病程为17.6（±9.6）年，平均体重指数（BMI）为31kg/m（±6.3）。分别有226例（59%）和196例（51%）患者使用了SGLT2i和GLP-1a。296例（76.6%）患者每年测量两次糖化血红蛋白（HbA1c），符合ADA建议，平均HbA1c为7.8（±1.6），低于两项本地和两项地区研究的结果。40%的患者血压得到控制（<130/80），根据三项本地研究，该比例处于中间水平。95%的患者每年检查血脂，但只有27%的患者达到ADA一级或二级预防目标。关于尿白蛋白与肌酐比值（ACR），75%的患者每年进行此项检查，89%的患者看过眼科医生，这表明其遵循情况优于其他研究。
结果表明，吉达NGHA医院的糖尿病中心总体上提供了高质量的护理，对ADA指南的遵循程度较高；然而，护理的某些方面仍需改进，包括高血压和血脂异常的管理。此外，在研究新型药物（包括SGLT2i和GLP-1a）的使用及其对糖尿病并发症和患者满意度的影响时，进一步的研究应更具针对性。
