Background: Diabetes Mellitus Type 2 and its associated complications are highly prevalent in Saudi Arabia and are linked to duration of disease and disease control. This study aims to study the rate of glycemic control and diabetes associated complications among patients in Riyadh, Saudi Arabia.

Methods: this is a 5-year retrospective chart review including 319 diabetic patients in a tertiary care center and linked primary healthcare clinics in Riyadh, Saudi Arabia from January 2016 to December 2020.

Results: of the 319 patients included, 58.6% were females (n=187). Mean age was 67.74± 12.63 years. Mean HgA1c during the study period was 8.30 mmol/L± 1.9. 9.1% had myocardial infarction, and of those screened 29.9% and 15% had microalbuminuria and retinopathy, respectively. 7.2% had neuropathy. 2.2% had diabetic foot and of those 42.9% progressed into amputation. Mortality was 6% over the study period.

Conclusion: Our study found the control of diabetes mellitus in a tertiary care center and primary care clinics to be suboptimal, with a significant association between HbA1c levels and LDL level control, retinopathy, and neuropathy among type 2 diabetic patients in Saudi Arabia. More research is needed to stratify causes for poor control as well as management strategies to reduce the burden of diabetes complications.

1. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes research and clinical practice. 2019;157:107843.Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9 th edition - PubMed (nih.gov)
2. Alotaibi A, Perry L, Gholizadeh L, Al-Ganmi A. Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An overview. Journal of epidemiology and global health. 2017;7(4):211-8.Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An overview - PubMed (nih.gov)
3. Statistics General Authority. The fourteenth Guide for Administrative Region services. Riyadh: General Authority for Statistics; 2012. https://www.stats.gov.sa/sites/default/files/riyadhen.xlsx
4. Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Yousef M, Sabico SL, et al. Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic. BMC medicine. 2011;9:76.Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic. - Abstract - Europe PMC
5. Alhowaish AK. Economic costs of diabetes in Saudi Arabia. Journal of family & community medicine. 2013;20(1):1-7. Economic costs of diabetes in Saudi Arabia - PubMed (nih.gov)
6. Standards of Medical Care in Diabetes—2020. 2020;43(Supplement 1):S1-S2.Introduction: Standards of Medical Care in Diabetes—2020 | Diabetes Care | American Diabetes Association (diabetesjournals.org)
7. Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker insights. 2016;11:95-104.Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients - PubMed (nih.gov)
8. Hoerger TJ, Segel JE, Gregg EW, Saaddine JB. Is glycemic control improving in U.S. adults? Diabetes care. 2008;31(1):81-6.Is glycemic control improving in U.S. adults? - PubMed (nih.gov)
9. Mazen Ferwana IA, Wedad H Madani, Aida Aldughaither, Mohammed Alrowaily, Bader Al Bader, Abdullah Al Owayyed, Ali Al Farhan. Glycemic Control and Accompanying Risk Factors: 4-Year Primary Care Study. Journal of Diabetes and Metabolism. 2015; 06(04).(PDF) Glycemic Control and Accompanying Risk Factors: 4-Year Primary Care Study (researchgate.net)
10. Alramadan MJ, Magliano DJ, Almigbal TH, Batais MA, Afroz A, Alramadhan HJ, et al. Glycaemic control for people with type 2 diabetes in Saudi Arabia - an urgent need for a review of management plan. BMC endocrine disorders. 2018;18(1):62. Glycaemic control for people with type 2 diabetes in Saudi Arabia - an urgent need for a review of management plan. - Abstract - Europe PMC
11. Epidemiology, clinical and complications profile of diabetes in Saudi Arabia: a review - PubMed (nih.gov)
12. Al Slamah, T., Nicholl, B., Alslail, F., Harris, L., Kinnear, D. and Melville, C., 2020. Correlates of type 2 diabetes and glycaemic control in adults in Saudi Arabia a secondary data analysis of the Saudi health interview survey. BMC Public Health, 20(1).Correlates of type 2 diabetes and glycaemic control in adults in Saudi Arabia a secondary data analysis of the Saudi health interview survey - PubMed (nih.gov)
13. Alzaheb, R. and Altemani, A., 2018. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 11, pp.15-21. 14The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia - PubMed (nih.gov)
14. Alammar M, Alsoghayer S, El-Abd K, Alkhenizan A. <p>Diagnostic Accuracy of Body Mass Index (BMI) When Diagnosing Obesity in a Saudi Adult Population in a Primary Care Setting, Cross Sectional, Retrospective Study</p>. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2020;Volume 13:2515-2520.(PDF) Diagnostic Accuracy of Body Mass Index (BMI) When Diagnosing Obesity in a Saudi Adult Population in a Primary Care Setting, Cross Sectional, Retrospective Study (researchgate.net)
15. Hussain A, Ali I, Ijaz M, Rahim A. Correlation between hemoglobin A1c and serum lipid profile in Afghani patients with type 2 diabetes: hemoglobin A1c prognosticates dyslipidemia. Ther Adv Endocrinol Metab. 2017 Apr;8(4):51-57. doi: 10.1177/2042018817692296. Epub 2017 Mar 20. PMID: 28507727; PMCID: PMC5415005.Correlation between hemoglobin A1c and serum lipid profile in Afghani patients with type 2 diabetes: hemoglobin A1c prognosticates dyslipidemia - PubMed (nih.gov)
16. Begum A, Irfan SR, Hoque MR, Habib SH, Parvin S, Malek R, Akhter S, Sattar S, Sarkar S. Relationship between HbA1c and Lipid Profile Seen in Bangladeshi Type 2 Diabetes Mellitus Patients Attending BIRDEM Hospital: A Cross-Sectional Study. Mymensingh Med J. 2019 Jan;28(1):91-95. PMID: 30755556. Evaluation of the lipid profile in type 2 diabetes mellitus patients in Greece. - Abstract - Europe PMC
17. Aljabri, K., Bokhari, S., Alshareef, M. and Khan, P., 2018. Frequency of Microalbuminuria in Saudi Adults with Type 2 Diabetes Mellitus. EC Endocrinology and Metabolic Research,. Prevalence of Metabolic Syndrome in Obese Saudi Population|crimson publishers.com
18. Ahmed, R., Khalil, S. and Al-Qahtani, M., 2016. Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia. Journal of Family and Community Medicine, 23(1), p.18.Diabetic retinopathy and the associated risk factors in diabetes type 2 patients in Abha, Saudi Arabia - PubMed (nih.gov)
19. Sendi RA, Mahrus AM, Saeed RM, Mohammed MA, Al-Dubai SAR. Diabetic peripheral neuropathy among Saudi diabetic patients: A multicenter cross-sectional study at primary health care setting. J Family Med Prim Care. 2020 Jan 28;9(1):197-Diabetic peripheral neuropathy among Saudi diabetic patients: A multicenter cross-sectional study at primary health care setting - PubMed (nih.gov)

Lama Al Luhidan