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

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.