Initiation of Type 2 Diabetes Mellitus Medications in the NGHA Healthcare System in Saudi Arabia: Contemporary Trends.
Level 4 - case-series / case-control
Cross-sectional electronic health record review without comparator groups or longitudinal clinical outcome assessment.
PubMed 40894464 · doi:10.1016/j.curtheres.2025.100809
What was done
A cross-sectional study analyzed electronic medical records from the National Guard Health Affairs (NGHA) healthcare system in Saudi Arabia. The study evaluated 433 patients diagnosed with type 2 diabetes mellitus (T2DM) who initiated antidiabetic therapy (metformin, insulin, sulfonylureas, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists, or SGLT-2 inhibitors) between January 2018 and May 2022. Patient characteristics and prescribing patterns were analyzed descriptively.
What was found
Among 433 patients (mean age 53.29 ± 15.22 years, 55.66% female, 61.20% obese): - Monotherapy was the most commonly initiated approach (66.28%), with insulin being the most prescribed monotherapy (29.10%). - Metformin was the most frequently initiated medication overall, accounting for 37.12% of all prescriptions. - Metformin plus a sulfonylurea was the most common initial combination regimen (7.16%). - In newly diagnosed patients in 2021, initiation of newer classes reached 11.11% for SGLT-2 inhibitors and 8.70% for GLP-1 receptor agonists.
Why it matters
This study documents real-world adoption of newer antidiabetic drug classes alongside continued reliance on traditional agents like metformin and insulin in a Saudi healthcare system.
Limits
The study is limited by a cross-sectional single-system design and a modest sample size (n = 433). The abstract reports no longitudinal outcomes, measures of glycemic control (e.g., HbA1c), adverse events, or clinical rationales guiding drug selection.
Cited by
- supports Metformin is the most commonly prescribed drug for type 2 diabetes.