Longitudinal assessment of the quality of life and patterns of antidiabetic medication use in patients with type 2 diabetes, Saudi Arabia perspective, DISCOVER study

Al‐Rubeaan, Khalid; Banah, Faisal; Alruwaily, Fayez G; Sheshah, Eman; Alnaqeb, Dhekra; Al-Qahtani, Awad Mohammed; Ewais, Diaa; Juhani, Nassr Al; Hassan, Abdul-Hameed; Youssef, Amira M.

doi:10.1080/03007995.2022.2144052

Cited by 4 publications

(6 citation statements)

References 36 publications

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“…The rates of complications at baseline obtained in our study are comparatively lower than a few other RW studies conducted in the KSA [ 13 , 15 , 30 ] and in the MENA countries (including the KSA) [ 28 ]. The DISCOVER study reported 20% (microvascular) and 11% (macrovascular) rates of complications at baseline among non-insulin users initiating a 2nd LoT [ 13 ]. AlSlail and Akil reported rates of complications varying between 3.8% (nephropathy) and 12.3% (CVD) [ 30 ].…”

Section: Discussioncontrasting

confidence: 79%

“…AlSlail and Akil reported rates of complications varying between 3.8% (nephropathy) and 12.3% (CVD) [ 30 ]. The DAR-MENA T2DM study showed baseline rates of 32.8%, 9.2% and 8.9% for neuropathy, retinopathy and nephropathy, respectively [ 13 , 28 ]. These opposing results could be attributed to the differences in study design and patient eligibility criteria.…”

Section: Discussionmentioning

confidence: 99%

“…These treatment patterns for T2DM may differ in real-world (RW) practice as a result of several factors such as drug efficacy and safety, medicine cost, patient’s choices, drug side effects and physicians’ choices for drugs based on their individual experience [ 13 , 14 ]. Anyhow, only about a quarter of patients with T2DM achieve the recommended HbA1c level (< 7%) in the KSA [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Burden of Illness of Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia: A Five-Year Longitudinal Study

AlHarbi,

Othman,

Nahari

et al. 2024

Adv Ther

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Introduction Type 2 diabetes mellitus (T2DM) is associated with huge clinical and economic burden in the Kingdom of Saudi Arabia (KSA) which can be curtailed by efficacious treatment. In order to achieve this, current treatment pathways for T2DM and associated costs need to be assessed. Methods A longitudinal cohort review was conducted to collect country-specific and patient-specific clinical data, over a minimum observation period of 5 years in the KSA. Patient demographics, clinical characteristics and treatment patterns were recorded. The IQVIA Core Diabetes Model (CDM) version 9.5 Plus was used to assess the burden of illness, which included long-term projections of clinical (life expectancy [LE], quality-adjusted life-years [QALYs], event rates of diabetes-related complications) and direct medical cost (per-patient annual or lifelong [50 years]) outcomes of the most commonly used first-line (1st-line) regimens for T2DM from a payer perspective in the KSA. Results Data were collected from a subpopulation of 638 patients from 15 participating centres. There was an equal gender representation with a majority of the patients belonging to Arabian/Saudi ethnicity (71.0%). Biguanides (81.5%), sulfonylureas (51.6%), dipeptidyl peptidase 4 (DPP4) inhibitors (26.2%) and fast-acting insulins (17.2%) were the most prescribed 1st-line agents. The most frequently used 1st-line regimens resulted in an estimated LE of 25–28 years, QALYs of 18–21 years and lifelong total cost of illness of 201,377–437,371 Saudi Arabian riyal (53,700–116,632 US dollars). Conclusion Our study addresses gaps in the current research by providing a complete landscape of baseline demographic, clinical characteristics and treatment patterns from a heterogeneous group of patients with T2DM in the KSA. Additionally, the burden of illness analysis using CDM showed substantially higher cost of T2DM care from a payer perspective in the KSA. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02772-y.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Burden of Illness of Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia: A Five-Year Longitudinal Study

AlHarbi,

Othman,

Nahari

et al. 2024

Adv Ther

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“…13 The second-line treatments chosen for glycaemic control by the treating physicians were not associated with the risk of weight gain or significant severe hypoglycaemia as observed in other studies. 13 This could be due to the fact that the most commonly prescribed hypoglycaemic medications as a second-line therapy among this cohort, as reported in a previous publication, 14 were dipeptidyl peptidase 4 inhibitors, which are known for their weight neutrality and low risk of hypoglycaemia. 15 The delay in the introduction of second-line therapy, mainly insulin, observed in this study could be described as clinical inertia.…”

Section: Discussionmentioning

confidence: 78%

Metabolic control and incidence of hypoglycaemia, hospitalisation and complications among Saudi patients with type 2 diabetes initiating second-line therapy: an analysis of the Saudi Arabia data from the DISCOVER Observational Study programme

Al Rubeaan,

Banah,

Alruwaily

et al. 2023

BMJ Open

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ObjectivesThe aim of the global DISCOVERing Treatment Reality of Type 2 Diabetes in Real World Settings (DISCOVER) Study was to provide a comprehensive real world assessment of the treatment pattern changes for patients with type 2 diabetes. The aim of this analysis was to assess the metabolic control and the annual incidence of hypoglycaemia, hospitalisation and complications among Saudi patients with type 2 diabetes initiating second-line therapy.DesignThis study is part of the observational, longitudinal, prospective multinational DISCOVER Study.SettingGovernmental and private health sectors from different regions within Saudi Arabia.ParticipantsThe study recruited 519 patients with type 2 diabetes aged ≥18 years who were switching to second-line therapy. Patients who were already using insulin/injectable agents, patients with type 1 diabetes, pregnant women, and patients undergoing dialysis or with a history of renal transplantation were excluded.Primary and secondary outcome measuresMetabolic control among patients with type 2 diabetes mellitus; fear of hypoglycaemia; quality of life; and the incidence of complications, hypoglycaemic events and/or hospitalisations. Data were analysed using descriptive statistics.ResultsA total of 519 patients were recruited with a mean age of 52.4±11 years. Of these participants, 54.7% were male and 45.3% were female. The incidence of hypoglycaemia was 56.72/1000 patient-years. The Hypoglycemia Fear Survey II showed a significant increase in patient worry related to hypoglycaemia from 6.4±11.9 at baseline to (p=0.0446) at the 36-month follow-up. The incidence of hospitalisation was 30.81/1000 patient-years. There was a moderate improvement in glycaemic control, represented as an HbA1c reduction from 8.8% at baseline to 8.2% at the 36-month follow-up. The incidence of macroangiopathy was 24.51/1000 patient-years and the incidence of microvascular complications such as retinopathy and albuminuria was 47.00/1000 patient-years and 221.71/1000 patient-years, respectively. The mean score of fear of hypoglycaemia showed an increase with 13.0±21.5 at baseline to 16.1±22.2 at the 36-month follow-up. When assessing the patients’ quality of life, there was an improvement in the mental component score from 47.4±9.1 at baseline to 53.0±6.7 at the 36-month follow-up.ConclusionsTreatment intensification decisions should be made individually, weighing the benefit of good glycaemic control against the risk of hypoglycaemia.Trial registration numberNCT02322762 and NCT02226822.

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“…Diabetes is further amplified by inflammation, atherosclerosis and dyslipidemia. Patients must maintain their glycemic levels through food and treatment in order to avoid adverse effects [ 1 – 3 ]. If glycemic levels are not maintained, many secondary consequences such as cardiovascular diseases, retinopathy, nephropathy, and neuropathy occurs [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Cordycepin from Cordyceps militaris ameliorates diabetic nephropathy via the miR-193b-5p/MCL-1 axis

Zheng,

Zhang,

Song

et al. 2023

Chin Med

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Background Diabetic nephropathy (DN) is a chronic kidney disease that develops in patients with diabetes mellitus. Cordycepin (CRD), a secondary metabolite produced by Cordyceps militaris, has a variety of bioactive properties. In this study, DN mice and high glucose (HG)-treated HK-2 were used to evaluate the diagnostic value of CRD. Methods Quantitative real-time PCR (qRT-PCR), western blotting, immunofluorescence analysis, and immunohistochemical staining were used to assess changes in mRNA and protein expression. Oxidative stress was evaluated by detecting the production of reactive oxygen species (ROS) and the activity of antioxidant enzymes. Cell apoptosis was detected by the TUNEL and flow cytometric methods. The interaction of miR-193b-5p and myeloid leukemia 1 (MCL-1) was examined by bioinformatics analysis and luciferase reporter assay. The protective effects of CRD on DN mice were evaluated by examining DN related biochemical indicators and renal histopathology. Results In response to HG, the level of miR-193b-5p was elevated, whilst the level of MCL-1 was downregulated, and CRD therapy reversed this behavior. MCL-1 was further identified to be miR-193b-5p target. CRD attenuated HG-induced cell damage, inflammation and abnormal energy metabolism. Mechanistic investigations on in vitro models confirmed that protective effect of CRD against HG challenge to HK-2 cells is mediated through the regulation of expression of miR-193b-5p/MCL-1 axis. By examining DN related biochemical markers and renal histopathology, the protective effects of CRD on DN mice was assessed. Conclusions In summary, CRD decreased oxidative stress and inflammation by increasing miR-193b-5p and inactivating downstream MCL-1 in DN, hinting the pivotal values of CRD and miR-193b-5p in the management of DN.

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Longitudinal assessment of the quality of life and patterns of antidiabetic medication use in patients with type 2 diabetes, Saudi Arabia perspective, DISCOVER study

Cited by 4 publications

References 36 publications

Burden of Illness of Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia: A Five-Year Longitudinal Study

Burden of Illness of Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia: A Five-Year Longitudinal Study

Metabolic control and incidence of hypoglycaemia, hospitalisation and complications among Saudi patients with type 2 diabetes initiating second-line therapy: an analysis of the Saudi Arabia data from the DISCOVER Observational Study programme

Cordycepin from Cordyceps militaris ameliorates diabetic nephropathy via the miR-193b-5p/MCL-1 axis

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