Adherence to Treatment Guidelines Among Patients With Type 2 Diabetes Attending a Tertiary Hospital in Jeddah, Saudi Arabia.

INTRODUCTION

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.

METHODOLOGY

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.

RESULTS

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.

CONCLUSION

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.