Abstract
Objective: This study is to assess the glycemic control and the other risk factors like LDL, blood pressure readings and body mass index for type 2 diabetes mellitus (T2DM) in 8 primary care centers over 4 years of time. Methods: An observational, retrospective cohort, multicenter study which was conducted in 8 National Guard primary health care centers. Four of the centers were located in Riyadh; while the others are from different regions in Saudi Arabia. A stratified random sampling method was used according to number of diabetic patients at each center The main study outcomes were to measure the mean HbA1c, LDL levels, blood pressure and BMI readings and the percentage of diabetic patients who reached the ADA goal of HbA1c, LDL, and blood pressure and how it changed during 4 years of time. Also the percentage of adults with diabetes who have HbA1c<0.07 and the changes of controlled patients within the study period. Results: Total number of type-2 diabetic patients of this study was 778, with mean age of 55.03 ± 11.4, 62.7% of them were females. The mean of the HbA1c was 8.7 on 2006 and reduced to 8.6 within four years, 16.6% of diabetic patients had their last HbA1c reading reached the HbA1c goal (≤7%). The LDL and diastolic blood pressure decreased also within the follow up years insignificantly (-0.299 and -1.37). While the systolic blood pressure and BMI increased over 4 years of time (+0.58 and +0.27). HbA1c level shows a significant relation with the education levels in 2007 and 2008. HbA1c also prove a significant relation with LDL for three years in sequence. Age and BMI had a significant relation with the systolic blood pressure. Conclusion: Poor glycemic control has serious impact not only on patients but on the society. The primary health care setting and structure were not well-prepared to properly manage diabetes and its related comorbidities.
Highlights
Diabetes is a chronic disease with complex causes, manifestations, complication, and management
The study was conducted on medical records collected from 8 primary health care centers belonging to National Guard Health Affairs-Saudi Arabia
Diabetic patients who reached the Hemoglobin A1c (HbA1c) goal increased from 12.6% in 2006 to 16.6% in 2009 with P value0.09) reduced from 63.8% in 2006 to 46.9% in 2009 with P value
Summary
Diabetes is a chronic disease with complex causes, manifestations, complication, and management. It is a chronic disease which is considered a major cause of death, illness and reduce quality of life [1]. Diabetes is gradually becoming a global health issue. The disease imposes huge public health and economic burdens that affect the society before the individuals. As estimated by International Diabetes Federation, there were 366 million people suffering from diabetes worldwide in 2011, and most probably by 2030 this figure will rise to 552 million. Diabetes caused 4.6 million deaths and at least 465 billion US dollars in healthcare expenditures [2]. The prevalence of type 2 diabetes is increasing dramatically in the Middle East and North Africa region [3]
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