Adherence to the American Diabetes Association standards of care among patients with type 2 diabetes in primary care in Saudi Arabia

Harbi, Turki J. Al; Tourkmani, Ayla M.; Al-Khashan, Hesham I.; Mishriky, Adel M.; Qahtani, Hala Al; Bakhiet, Ahmed

doi:10.15537/smj.2015.2.9603

Cited by 24 publications

(33 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We obtained the cut-point value of 4.39 mmol/L. Following the ADA criteria, some studies showed that only 58.5 % of the patients reached the target LDLc value during treatment, while 7.2% achieved the target values for both LDLc and HbA1c simultaneously 22 . In favor of and in addition to previously stated, the treatment of dyslipidemia in the DM patients should be commenced earlier, from the very onset of the disease.…”

Section: Discussionmentioning

confidence: 99%

Criterion validity of metabolic and anthropometric predictors in diabetic foot syndrome

2019

View full text Add to dashboard Cite

Background/Aim. The diabetic foot syndrome (DFS) appears in 15% of diabetes mellitus (DM) patients and is the most common cause of hospitalization, prolonged hospital stay and lower extremity amputation. This study assesses the discriminant validity of the indicators of glycemic control, lipoprotein status and the body mass index (BMI) in diagnosing DFS in the DM patients. Methods. A comparative observational study was conducted with the study group composed of patients diagnosed with DM and DFS and a control group, composed of healthy volunteers. Metabolic predictors measured in the study were: fasting glycaemia (FG), postprandial glycaemia (PPG), glycated hemoglobin (HbA1c), total cholesterol, total triglyceride, low density lipoprotein (LDLc) and high density lipoprotein (HDLc). The BMI was measured as an anthropometric variable. The validity criterion of both metabolic and anthropometric variables was estimated by the Receiver Operating Characteristic (ROC) procedure. Results. A total of 70 patients with DM and 60 healthy volunteers were observed. Using the ROC procedure, five significant predictors of DFS were proved. The validity criterion for HbA1c, FG, PPG, LDLc and the BMI were in the following order: 6.3%, 6.3 mmol/L, 7.1 mmol/L, 4.39 mmol/L and 25 kg/m 2 , respectively. Significantly larger surfaces were found under the curve for all glycometabolic variables, compared to the surface under the curve for LDLc, as well as relative to the surface under the curve for BMI. Conclusion. Preventing DFS in patients with DM has to include intensification of diet measures along with the treatment of the increased value of fasting glycaemia, postprandial glycaemia and LDLc, even when they lower compared to the current recommended values for the patients with DM. Lowering body fat in the patients with DM has to be approached in the period of their pre-obesity. ApstraktUvod/Cilj. Sindrom dijabetesnog stopala (SDS) javlja se kod skoro 15% pacijenata sa dijabetes melitusom (DM) i najčešći je uzrok njihove hospitalizacije, prolongiranog bolničkog lečenja i amputacija donjih ekstremiteta. U studiji je procenjena diskriminaciona validnost pokazatelja glikoregulacije, lipoproteinskog statusa i indeksa telesne mase (ITM) u detekciji SDS kod pacijenata sa DM. Metode. U uporednoj, opservacionoj studiji, ispitivanu grupu sačinjavali su pacijenti sa DM i SDS, a kontrolnu zdravi dobrovoljci. Metabolički prediktori izmereni u studiji bili su: glikemija našte (GN), post-prandijalna glikemija (PPG), glikozilirani hemoglobin (HbA1c), ukupni holesterol, ukupni trigliceridi, lipoproteini male gustine (LDLc) i lipoproteni visoke gusti-ne (HDLc). ITM je izmeren kao antropometrijska varijabla. Kriterijumska validnost metaboličkih i antropometrijskih varijabli procenjena je procedurom prijemno operativnih karakteristika. Rezultati. Ukupno je opservirano 70 pacijenata sa DM i 60 zdravih dobrovoljaca. Procedurom prijemno operativnih karakteristika dokazano je pet značajnih prediktora SDS. Kriterijumske vrednosti za HbA1c, GN, PPG, LDLc i IT...

show abstract

Section: Discussionmentioning

confidence: 99%

Criterion validity of metabolic and anthropometric predictors in diabetic foot syndrome

2019

View full text Add to dashboard Cite

show abstract

“…In our study, frequent FP attendance has no positive impact on guideline adherence. Frequent patient attendance has been found positively associated with better guideline adherence by the studies carried out in Australia [32], Saudi Arabia [33]. The relationship between the higher performance and frequent attendance raises doubts about the efficiency of a diabetes patient management pattern.…”

Section: Discussionmentioning

confidence: 99%

Guideline Adherence and the Factors Associated with Better Care for Type 2 Diabetes Mellitus Patients in Lithuanian PHC: Diabetes Mellitus Guideline Adherence in Lithuania PHC

Raila¹,

Ida²,

Lina³

et al. 2019

MEDJ

View full text Add to dashboard Cite

Background: Type 2 diabetes mellitus is one of the most common chronic conditions, which requires appropriate management and care at PHC level, which is described in guidelines. However, guideline adherence at the international arena is insufficient and little is known about the reasons for guideline non-adherence. Objective: The aim of the survey was to analyse to what extent the Lithuanian family practitioners adhere to diabetes guidelines in order to compare to international data and to discover the factors associated with better diabetes care. Methods: The present study is a part of EUPRIMECARE Project, which sets out to develop a framework aiming at the analysis of PHC across Europe. The sample strategy was based on an unequal probability sampling design. An audit of 4 public and 6 private PHC medical records of the year 2011 was carried out in Kaunas region, clinical records of 382 diabetes type 2 patients were reviewed. Demography, diseases and diabetes performance indicators data were collected using a uniform template. Binary and multivariable logistic regression analyses were used in the investigation of the factors related to better diabetes guideline adherence. Results: Three guideline adherence levels were identified: high performance (performed in more than 90% cases) - BP measurement and HbA1c exam; good performance (performed in more than 50% cases) - ECG examination and serum creatinine check; insufficient performance (performed in less than 50% of cases) - annual endocrinologist consultation, eye fundus and foot examinations, LDL check and BMI calculation. Insufficient glycaemic control was positive associated with increased endocrinologist consultation and foot exam rates, elevated BP demonstrated the positive effect to creatinine check rate, multimorbidity had positive association to the annual eye, ECG, creatinine check rates; frequent FP attendance showed no positive effect on process indicators. Rural patients have a negative association to foot and ECG exam rates compared to urban patients. In a stepwise logistic regression model, 3 dependent variables had statistically significant impact on overall diabetes care indicator performance: negative - rural location of patients (OR 0.4, 95% CI 0.2-0.8), elevated mean BP (OR 0.6, 95% CI 0.4-0.9); positive - multimorbidity (OR 2.0, 95% CI 1.2-3.4). Conclusion: Guideline adherence for T2DM is not optimal in Lithuanian PHC. The best are BP and HbA1c checks. Suboptimal are BMI and LDL annual checks. The situation with these is almost the same as in other European countries. The better guideline adherence has been observed in urban (foot exam, ECG exam), multimorbidity (eye, ECG, creatinine exams), controlled by means of BP patients (serum creatinine test).

show abstract

“…10 Two studies reported that inadequate control of blood glucose levels are due to minimal adherence of prescribers to standard guidelines. 11,12 However, many studies revealed that after publishing AACE/ACE guidelines there was significant difference in drug therapy based on A1c levels prescribed by physicians in United States of america. 13 Another study published that there was optimal adherence to guidelines in Sweden in home health care settings than residents at nursing homes.…”

Section: Discussionmentioning

confidence: 99%

An Assessment of Anti-hyperglycemic Drug Utilization Patterns and Adherence to AACE/ACE 2015 Guidelines in South Indian Tertiary Care Teaching Hospital

Nuthakki¹,

Pendyala²,

Vallabhu³

et al. 2016

IJOPP

View full text Add to dashboard Cite

Aim:To compare adherence to American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) 2015 guidelines for diabetes care in a tertiary care teaching hospital in India. Method: In this prospective observational study, 415 prescriptions of type 2 diabetes mellitus (T2DM) patients were collected in Dr. Pinnamaneni Siddhartha Institute of Medical Sciences (PSIMS) hospital from January 2015 and June 2015. Medication adherence to AACE/ACE guidelines was assessed based on glycated haemoglobin (HbA1C) values. Results: A total of 201 (48.4%) male and 214 (51.6%) female patients were identified. The mean age was 53.57 ± 10.77 years (male) and 53.69 ± 10.71 years (females). Patients with HbA1C <7.5% (37.3%, male; 45.3%, female) were predominant followed by HbA1C 7.5% -9% (32.3%, male; 35.3%, female) and HbA1C > 9.0% (30.4%, male; 19.2%, female). Hypertension (HTN) (39.8%, male; 39.7%, female) is the most predominant co-morbidity, followed by patients with both HTN and cardio vascular diseases (CVDs) (9.4%, male; 9.8%, female). Insulin was prescribed to control hyperglycaemia in most of the cases (40.0%) followed by dual therapy (26.9%) and triple therapy (17.8%). The overall adherence rate was 88.3% for patients with HbA1C <7.5% (P< 0.0001); 98.7% for patients with HbA1C 7.5%-9%(P<0.0001)and 100% for patients with HbA1C >9%(P<0.0001). Conclusion: Optimal medication adherence is the ultimate goal to control the hyperglycemia in DM. The present study results revealed that the anti-diabetic medication adherence to AACE/ACE 2015 guidelines were optimal by the prescribers.

show abstract

Adherence to the American Diabetes Association standards of care among patients with type 2 diabetes in primary care in Saudi Arabia

Cited by 24 publications

References 27 publications

Criterion validity of metabolic and anthropometric predictors in diabetic foot syndrome

Criterion validity of metabolic and anthropometric predictors in diabetic foot syndrome

Guideline Adherence and the Factors Associated with Better Care for Type 2 Diabetes Mellitus Patients in Lithuanian PHC: Diabetes Mellitus Guideline Adherence in Lithuania PHC

An Assessment of Anti-hyperglycemic Drug Utilization Patterns and Adherence to AACE/ACE 2015 Guidelines in South Indian Tertiary Care Teaching Hospital

Contact Info

Product

Resources

About