Physicians' choices in the first- and second-line management of type 2 diabetes in the Kingdom of Saudi Arabia

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

doi:10.1016/j.jsps.2020.01.014

Cited by 10 publications

(13 citation statements)

References 22 publications

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“…[4] The most notable improvement compared to the 2002 study was HbA1c, as none of the participants had ever checked HbA1c in Roaeid and Kablan study, as HbA1c was available but in private labs only, [4] The mean HbA1c in this study was 8.3% ± 1.7%. This result is higher than what was reported by Allaghi et al [12] 7.8% ± 1.6%, but less than what was reported by Al-Rubeaan et al; [7] 8.8 ± 1.7%.…”

Section: Discussioncontrasting

confidence: 69%

“…[6] In contrast, the mean BMI is lower than BMI reported in Saudi Arabia. [7] Obesity reflected in BMI ≥30 kg/m 2 was found in 48.2% in the present study, less frequent than that described in another institution in the same city (68% in Benghazi Medical Center by Buzaid and Nagem [8] and in Bahrain (56.5%) [9] but higher than in Sudan (23.9%). [10] The proportion of patients achieving higher education levels are similar.…”

Section: Discussioncontrasting

confidence: 55%

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Profiles of diabetes care, control and complications in Benghazi, Libya 2020: A cross sectional study

Alfalah

Eljazwi

Buzaid

2021

Ibnosina Journal of Medicine and Biomedical Sciences

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Background: Diabetes mellitus is one of the growing health problems worldwide. Comprehensive medical evaluation, screening for complications, and proper diabetes care are crucial to improve outcome. Objectives: We aimed to study the profile of diabetes in Benghazi city and assess the changes since the last study of 2002. Patients and Methods: This study is a descriptive cross-sectional study of 504 persons with diabetes who were following at Benghazi diabetes center during June and July in 2020. Results: The age was, mean ± standard deviation; 57.8 ±12.3 years. with equal sex split. A quarter (24.8%) of participants graduated from a university/college. About half of the patients were obese (48.4%) Hypertension and dyslipidemia were found in 35.1% and 42.1%. respectively. The mean glycated hemoglobin A1c (HbA1c) was 8.3% ±1.7%. Self-monitoring of blood glucose (SMBG) was practiced by 20.2% of all patients, Less than two thirds (63.5%) of all patients had diabetes eye screening within the previous year. However, none of the participants had ever had a comprehensive feet examination. Ramadan fasting was observed by most of participants (95.4%). Conclusions: There is an improvement regarding annual eye examination, taking the medications regularly, SMBG, assessment of lipid profile, and regular follow-up with HbA1c in comparison with the practice in 2002. On the other hand, there is a decline in having comprehensive feet examination, practicing regular exercise, and diet control. The uncovered gaps in diabetes care need urgent attention.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussioncontrasting

confidence: 55%

Profiles of diabetes care, control and complications in Benghazi, Libya 2020: A cross sectional study

Alfalah

Eljazwi

Buzaid

2021

Ibnosina Journal of Medicine and Biomedical Sciences

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“…Potential reasons for this finding may differ depending on prior treatment. People in the OAD-only subgroup may have been switched from high doses of sulfonylureas (especially in Saudi Arabia and India, where there is a strong preference for this treatment approach), which are associated with weight gain [16][17][18][19]. The lower total daily insulin dose in prior basal-bolus insulin users (-13.8 U) may also have contributed to the weight loss observed in this subgroup.…”

Section: Discussionmentioning

confidence: 99%

Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes: A Real-World, Prospective, Non-interventional Study Across Six Countries

Fulcher

Akhtar²,

Aljaser

et al. 2022

Adv Ther

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Introduction Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec (a basal insulin) and insulin aspart (a prandial insulin). The aim of this study was to investigate clinical outcomes in people with type 2 diabetes (T2D) after initiating IDegAsp treatment in a real-world setting. Methods This 26-week, open-label, non-interventional study was conducted in Australia, India, Malaysia, Philippines, Saudi Arabia, and South Africa. Data were obtained from 1102 adults with T2D initiating or switching to IDegAsp from antidiabetic treatments (including oral antidiabetic drugs, basal insulin, basal–bolus insulin, premix insulin, and glucagon-like peptide 1 receptor agonist) per local clinical practice. Results Compared with baseline, there was significant improvement in HbA1c at end of study (EOS, first visit within weeks 26–36; estimated change − 1.4% [95% CI − 1.51; − 1.29]; P < 0.0001 [primary outcome]). From baseline to EOS, there were significant reductions in fasting plasma glucose (− 2.7 mmol/L [95% CI − 2.98; − 2.46]; P < 0.0001), body weight (− 1.0 kg [95% CI − 1.51; − 0.52]; P < 0.0001), and basal insulin dose in insulin-experienced participants (− 2.3 units [95% CI − 3.51; − 1.01]; P < 0.001). The incidence rates of non-severe (overall and nocturnal) and severe hypoglycaemia decreased significantly ( P < 0.001) between the period before baseline and before EOS. Conclusion In adults with T2D, initiating or switching to IDegAsp from previous antidiabetic treatment was associated with improved glycaemic control, lower basal insulin dose (in insulin-experienced participants), and lower rates of hypoglycaemia. Trial Registration Clinical trial registration NCT04042441. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02212-3.

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“…Since GCC healthcare services are provided free to residents and expatriates by the government or insurance companies, literature allowing cost comparisons of DM drugs is limited. In Saudi Arabia for instance, the cost of DM drugs is not a major factor when the physician needs to choose or switch therapies; such decisions are driven mostly by efficacy, tolerability, favorable effects on weight gain, and risk reduction for symptomatic hypoglycemia [89]. Despite an underinvestment in healthcare services compared to most developed nations [90], treatment prevalence is relatively high in GCC countries ([ 80%) [4], and improvements in national policies over the years have helped to reduce the economic burden of diabetes [5].…”

Section: Cost Comparisonmentioning

confidence: 99%

Sulfonylureas in the Current Practice of Type 2 Diabetes Management: Are They All the Same? Consensus from the Gulf Cooperation Council (GCC) Countries Advisory Board on Sulfonylureas

et al. 2021

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Since their inception in the commercial market in the mid-twentieth century, sulfonylureas (SUs) have remained a therapeutic option in the management of type 2 diabetes (T2D). Despite their established glucose-lowering effects, there is no consensus among global experts and modern guidelines regarding the priority of SUs in relation to other therapeutic options, given the lack of evidence that SUs are associated with a low risk of macrovascular events and excess mortality. However, findings from recent trials and real-time observations have resolved this contentious issue somewhat, albeit to varying degrees. The present consensus discusses the role of SUs in contemporary diabetes management in the Gulf Cooperation Council (GCC) countries. Regional experts from these countries gathered virtually to formulate a consensus following presentations of topics relevant to SU therapy with an emphasis on gliclazide, Yousef Al-Saleh and Shaun Sabico are co-first authors of the manuscript.

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Physicians' choices in the first- and second-line management of type 2 diabetes in the Kingdom of Saudi Arabia

Cited by 10 publications

References 22 publications

Profiles of diabetes care, control and complications in Benghazi, Libya 2020: A cross sectional study

Profiles of diabetes care, control and complications in Benghazi, Libya 2020: A cross sectional study

Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes: A Real-World, Prospective, Non-interventional Study Across Six Countries

Sulfonylureas in the Current Practice of Type 2 Diabetes Management: Are They All the Same? Consensus from the Gulf Cooperation Council (GCC) Countries Advisory Board on Sulfonylureas

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