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Objectives: A key aspect for the prevention of vascular complications in diabetes is control of hyperlipidemia, and that has always been a global challenge. The prevalence of diabetes mellitus in the UAE is estimated to be 18.98%. However, despite this high prevalence, very few studies have evaluated the control of lipids in patients with diabetes in our region. We sought to assess lipid control in patients with diabetes across the different sectors of the Dubai Health Authority (DHA) over five years (2012–2016). Additionally, we aimed to compare lipids control in both primary and tertiary care as well as between nationalities and diabetes types. Methods: We conducted a retrospective analysis of the electronic medical records of all patients within the DHA over five years. All patients with diabetes were included, and evaluation of lipids panel control was done according to the American Diabetes Association standards. Results: This review includes a total of 26 447 patients. The mean low-density lipoprotein (LDL) was lower in tertiary care patients across the years. Annual means of all lipid parameters were higher in primary care patients. Around 60.5% of patients achieved LDL levels < 100 mg/dL. Non-high-density lipoprotein cholesterol levels < 130 mg/dL were achieved in 67.9% of patients in tertiary care in 2012 compared to 60.9% in primary care. UAE nationals had better lipids control across the study duration compared to expatriates. Conclusions: This is the largest cohort of patients evaluated for diabetes and lipids control in the UAE and the Middle East region. The percentage of patients with diabetes across the DHA primary and tertiary health care centers achieving lipid targets is amongst the highest reported in the region and, perhaps, globally. Significantly better lipid control indices were achieved in tertiary care compared to primary care.

Objectives: In the UAE, the comparative prevalence of diabetes is reported as 18.98%, but there are very few studies evaluating glycemic control. Attaining the optimum glycemic control has been a global challenge over the years. However, there is a trend of global improvement with the availability of newer options of antidiabetic medications, increasing numbers of physicians, and patient awareness. Our primary aim was to assess the level of glycemic control across Dubai Health Authority points of care over the past five years. Additionally, we aimed to compare the differences in glycemic control between primary and tertiary centers, between nationalities, and type I and II diabetes. Methods: We conducted a retrospective analysis of the electronic medical records of all patients who attended primary and tertiary care centers within the Dubai Health Authority between 2012 and 2016. All patients with any type of diabetes were included in this assessment. Results: A total of 26 447 patients were included in the study; of these, 73.8% (n = 19 508) were UAE nationals while the other nationalities accounted for 26.2% (n = 6939) of patients. The overall mean glycated hemoglobin (HbA1c) levels from 2012 to 2016 was 7.76%. Patients attending primary care clinics had a mean HbA1c of 7.64% compared to 7.68% for the tertiary care cohort. Out of the total population, 37.7% achieved HbA1c < 7%. Over 40% of the patients attending primary care centers achieved HbA1c < 7% compared to 34.9% of those who attended tertiary care centers. Conclusions: Optimum glycemic target was achieved by less than 40% of patients. Glycemic control is still below the desired levels. However, there has been a trend of improvement in the last few years and we are achieving the international average targets. Further collaborative actions from clinical, educational, and strategic sectors are needed to improve our goals further.

Objectives: Sodium-glucose cotransporter 2 inhibitors (SGLT2-I) are a new class of antidiabetic drugs that might increase the risk of dehydration and hypoglycemia, particularly during the month of Ramadan in which Muslims abstain from eating and drinking for 14–16 hours daily. We aimed to provide real-life evidence about the safety of SGLT2-I during Ramadan. Methods: All patients over the age of 18 years on SGLT2-I before Ramadan 2016 who would be fasting during Ramadan were included. Demographic data, detailed medical history including comorbidities and medication profile, and laboratory results were collected before and after Ramadan. We also conducted a phone interview to evaluate the frequency and severity of hypoglycemia and dehydration. Results: Of the total of 417 patients, 113 (27.0%) experienced hypoglycemic events, and 93 of these (82.3%) checked their blood glucose using a glucometer. Confirmed hypoglycemia (< 70 mg/dL) was observed in 78 (83.8%). The hypoglycemic events were significantly more frequent in the SGLT2-I plus insulin-treated group than in those treated with SGLT2-I plus oral hypoglycemic agents group (p < 0.001). Confirmed hypoglycemic events were more frequent in those using SGLT2-I plus intensive insulin compared to those using SGLT2-I plus basal insulin (p = 0.020). Symptoms of dehydration were seen in 9.3% (n = 39) of the total population. We observed statistically significant reductions in glycated hemoglobin and weight by the end of Ramadan (p < 0.001). There were no significant changes in lipid profile and creatinine levels by the end of the study. Conclusions: The use of insulin in combination with SGLT2-I increases the risk of hypoglycemia during Ramadan. Hypoglycemic events were mild and did not require hospital admission. However, careful monitoring during prolonged fasting is warranted. No significant harmful effects on renal function result from treatment with SGLT2-I during Ramadan.