Skip to main content
Top
Published in: BMC Primary Care 1/2022

Open Access 01-12-2022 | Diabetes | Research

Adherence of physicians to evidence-based management guidelines for treating type 2 diabetes and atherosclerotic cardiovascular disease in Ajman, United Arab Emirates

Authors: Farah Jabbar Ali Alliabi, Ammar Ali Saleh Jaber, Mahir Khalil Ibrahim Jallo, Mirza R. Baig

Published in: BMC Primary Care | Issue 1/2022

Login to get access

Abstract

Background

Good adherence by physicians to treatment guidelines for type II diabetes mellitus (T2DM) could improve therapy outcome for patients. In this retrospective, cross-sectional study, we assessed physicians’ adherence to evidence-based guidelines for T2DM management in adult patients (aged ≥18 years) with either confirmed atherosclerotic cardiovascular disease (ASCVD) or those at high risk of developing ASCVD at the Thumbay Academic Health Center, United Arab Emirates (UAE).

Methods

Relevant data was obtained from patients’ medical records, assessed, and compared based on the 2018 diabetes guidelines of the American Diabetes Association and European Association for the Study of Diabetes.

Results

A total of 218 patients (186 males and 32 females) were included in the analysis. Of these, 122 were prescribed either sodium-glucose co-transporter-2(SGLT2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists and 34 were prescribed both. The overall adherence to the guidelines was 56%, which was significantly influenced by body mass index (BMI), hemoglobin A1c (HbA1c) levels, and estimated average glucose (eAG).

Conclusions

Adherence to guidelines was significantly high when treating patients with elevated levels of HbA1c and eAG, suggesting that physicians are more likely to prescribe SGLT2 inhibitors or/and GLP-1 receptor agonists to such patients. Physicians’ adherence to guidelines was significantly correlated with patients’ BMI and the levels of HbA1c and eAG. To the best of our knowledge, this is the first study conducted on diabetes and its risk factors in UAE.
Literature
1.
go back to reference NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387:1513–30.CrossRef NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387:1513–30.CrossRef
2.
go back to reference International Diabetes Federation. IDF Diabetes Atlas. 4th ed. Brussels: International Diabetes Federation; 2009. International Diabetes Federation. IDF Diabetes Atlas. 4th ed. Brussels: International Diabetes Federation; 2009.
3.
go back to reference Wang CC, Shah AC. In: Alexandria VA, editor. Medical management of type 1 diabetes: American Diabetes Association; 2017. Wang CC, Shah AC. In: Alexandria VA, editor. Medical management of type 1 diabetes: American Diabetes Association; 2017.
4.
go back to reference American Diabetes Association. Cardiovascular disease and risk management: Standards of medical care in diabetes - 2018. Diabetes Care. 2018;41:S86–104.CrossRef American Diabetes Association. Cardiovascular disease and risk management: Standards of medical care in diabetes - 2018. Diabetes Care. 2018;41:S86–104.CrossRef
5.
go back to reference Gæde P, Oellgaard J, Carstensen B, Rossing P, Lund-Andersen H, Parving HH, et al. Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial. Diabetologia. 2016;59:2298–307.CrossRef Gæde P, Oellgaard J, Carstensen B, Rossing P, Lund-Andersen H, Parving HH, et al. Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial. Diabetologia. 2016;59:2298–307.CrossRef
6.
go back to reference Khunti K, Kosiborod M, Ray KK. Legacy benefits of blood glucose, blood pressure and lipid control in individuals with diabetes and cardiovascular disease: time to overcome multifactorial therapeutic inertia? Diabetes Obes Metab. 2018;20:1337–41.CrossRef Khunti K, Kosiborod M, Ray KK. Legacy benefits of blood glucose, blood pressure and lipid control in individuals with diabetes and cardiovascular disease: time to overcome multifactorial therapeutic inertia? Diabetes Obes Metab. 2018;20:1337–41.CrossRef
7.
go back to reference Gregg EW, Sattar N, Ali MK. The changing face of diabetes complications. Lancet Diabetes Endocrinol. 2016;4:537–47.CrossRef Gregg EW, Sattar N, Ali MK. The changing face of diabetes complications. Lancet Diabetes Endocrinol. 2016;4:537–47.CrossRef
8.
go back to reference Li R, Zhang P, Barker LE, Chowdhury FM, Zhang X. Cost-effectiveness of interventions to prevent and control diabetes mellitus: a systematic review. Diabetes Care. 2010;33:1872–94.CrossRef Li R, Zhang P, Barker LE, Chowdhury FM, Zhang X. Cost-effectiveness of interventions to prevent and control diabetes mellitus: a systematic review. Diabetes Care. 2010;33:1872–94.CrossRef
9.
go back to reference Burant CF, Young LA. In: Alexandria VA, editor. Medical management of type 2 diabetes: American Diabetes Association; 2012. Burant CF, Young LA. In: Alexandria VA, editor. Medical management of type 2 diabetes: American Diabetes Association; 2012.
10.
go back to reference Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2018;42:S1–325.CrossRef Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2018;42:S1–325.CrossRef
11.
go back to reference Zhu Y, Xu J, Zhang D, Mu X, Shi Y, Chen S, et al. Efficacy and Safety of GLP-1 Receptor Agonists in Patients With Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Front Endocrinol. 2021:1–13. https://doi.org/10.3389/fendo.2021.769069. Zhu Y, Xu J, Zhang D, Mu X, Shi Y, Chen S, et al. Efficacy and Safety of GLP-1 Receptor Agonists in Patients With Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Front Endocrinol. 2021:1–13. https://​doi.​org/​10.​3389/​fendo.​2021.​769069.
12.
go back to reference Theodorou M, Stafylas P, Kourlaba G, Kaitelidou D, Maniadakis N, Papademetriou V. Physicians' perceptions and adherence to guidelines for the management of hypertension: a national, multicentre, prospective study. Int. J Hypertens. 2012;2012:503821. Theodorou M, Stafylas P, Kourlaba G, Kaitelidou D, Maniadakis N, Papademetriou V. Physicians' perceptions and adherence to guidelines for the management of hypertension: a national, multicentre, prospective study. Int. J Hypertens. 2012;2012:503821.
13.
go back to reference Adjemian J, Prevots DR, Gallagher J, Heap K, Gupta R, Griffith D. Lack of adherence to evidence-based treatment guidelines for nontuberculous mycobacterial lung disease. Ann Am Thorac. 2014;11:9–16.CrossRef Adjemian J, Prevots DR, Gallagher J, Heap K, Gupta R, Griffith D. Lack of adherence to evidence-based treatment guidelines for nontuberculous mycobacterial lung disease. Ann Am Thorac. 2014;11:9–16.CrossRef
14.
go back to reference Goldberg SL, Akard LP, Dugan MJ, Faderl S, Pecora AL. Barriers to physician adherence to evidence-based monitoring guidelines in chronic myelogenous leukemia. J Oncol Pract. 2015;11:e398–404.CrossRef Goldberg SL, Akard LP, Dugan MJ, Faderl S, Pecora AL. Barriers to physician adherence to evidence-based monitoring guidelines in chronic myelogenous leukemia. J Oncol Pract. 2015;11:e398–404.CrossRef
15.
go back to reference Savona-Ventura C, Vassallo J. MGSD-Education Study Group. Healthcare professionals’ perceptions of type 2 diabetes mellitus care in the Mediterranean region. Diabetes. Therapy. 2019;10:1909–20. Savona-Ventura C, Vassallo J. MGSD-Education Study Group. Healthcare professionals’ perceptions of type 2 diabetes mellitus care in the Mediterranean region. Diabetes. Therapy. 2019;10:1909–20.
16.
go back to reference Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2018;2018(61):2461–98.CrossRef Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2018;2018(61):2461–98.CrossRef
17.
go back to reference Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019;394:121–30.CrossRef Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019;394:121–30.CrossRef
18.
go back to reference Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834–44.CrossRef Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834–44.CrossRef
19.
go back to reference American Diabetes Association. Cardiovascular disease and risk management. Diabetes Care. 2016;39:S60–71.CrossRef American Diabetes Association. Cardiovascular disease and risk management. Diabetes Care. 2016;39:S60–71.CrossRef
Metadata
Title
Adherence of physicians to evidence-based management guidelines for treating type 2 diabetes and atherosclerotic cardiovascular disease in Ajman, United Arab Emirates
Authors
Farah Jabbar Ali Alliabi
Ammar Ali Saleh Jaber
Mahir Khalil Ibrahim Jallo
Mirza R. Baig
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2022
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-022-01672-4

Other articles of this Issue 1/2022

BMC Primary Care 1/2022 Go to the issue