The Prediabetes Outcome at National Guard Primary Health Care Centers in Riyadh, Saudi Arabia: Retrospective Chart Review

Abstract

Objectives To identify the outcome of prediabetes and the interventions that have been implemented for prediabetic patients at primary healthcare centers (PHCs) affiliated with King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methodology This retrospective chart-review study was carried out using the BestCare electronic health records (EHRs) system. Data from the PHCs of King Abdulaziz Medical City, Riyadh, Saudi Arabia were extracted. Inclusion criteria were patients with prediabetes who were diagnosed between January 2015 and December 2016, with at least one follow-up visit. Variables included demographics, comorbidities, blood sugar lab results, and lipid profile measurements at each visit and intervention at the time of the initial diagnosis. Fisher's Exact test, sign test, and Kruskal-Wallis test were used to assess the differences for non-normally-distributed variables, while a paired t-test was conducted for paired and normally distributed continuous variables. Data were analyzed using the statistical program SAS, version 9.4 (SAS Institute Inc. Cary, NC). Result Of the 92 patients followed up with for three years, 76.08% remained in the prediabetic range, while 16.4% regressed to a normal glycemic state (NGS) and 7.6% progressed to the diabetic range after intervention and follow-up for three years. Metformin use was not significant in the glycemic outcome. In comparison to the baseline, there was a considerable reduction in fasting blood sugar (FBS) and glycosylated hemoglobulin A1c (HbA1c) at the end of the follow-up. Conclusion We found that most of the patients remained in the prediabetic range after the three-year follow-up, with or without intervention. A commonly prescribed pharmacological intervention like metformin showed no regression benefit in most patients. More extensive prospective studies are needed to evaluate the outcome and adherence to different interventions.