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Objectives: To determine the prevalence of macrovascular and microvascular complications of type 2 diabetes mellitus and its associated determinants. Methods: We evaluated the online medical records of patients with type 2 diabetes mellitus who have been seen in chronic disease unit between April and June 2014. Seven hundred and forty-eight participants satisfied the inclusion criteria. Of these, 317 (42.4%) were males with a mean age of 57.9 years, 681 (64.3%) were obese with body mass index (BMI) of greater than 30, while only 9.6% had normal BMI (less than 25). Results: Only 158 (21.1%) had controlled hemoglobin A1c level. Retinopathy prevalence was 14.8% and neuropathy was 5.6%. Macrovascular complications accounted for 12.1%. Patients’ age and duration of diabetes were main predictors of developing complications. Patients with more than 20 years history of diabetes have 30% more odds of developing the complications when compared to patients with less than 10 years of diabetes history. Each increment in age by one year increases the odds of developing microvascular complications by 4% and macro vascular complication by 2%. Conclusion: Our results showed diabetic patients with poor glycemic control, and longer duration of diabetic history had higher prevalence of both macrovascular and microvascular. Saudi Med J 2016; Vol. 37 (12): 1408-1411 doi: 10.15537/smj.2016.12.17062

Background Long intervals between patient visits and limited time with patients can result in clinical inertia and suboptimal achievement of treatment goals. These obstacles can be improved with a multidisciplinary care program. The present study aimed to assess the impact of such a program on glycemic control and cardiovascular risk factors. Methods In a randomized, parallel-group trial, we assigned 263 patients with poorly controlled type 2 diabetes mellitus (T2DM) to either a control group, standard care program, or a multidisciplinary care program involving a senior family physician, clinical pharmacy specialist, dietician, diabetic educator, health educator, and social worker. The participants were followed for a median of 10 months, between September 2013 and September 2014. Glycated hemoglobin (HbA1c), fasting blood glucose (FBG), lipid profiles, and blood pressure (BP) were measured. The assignment was blinded for the assessors of the study outcomes. The study registry number is. Results In the intervention group, there were statistically significant (p

Ayla M Tourkmani,1 Turki J Alharbi,1 Osama Abdelhay,2 Hesham I Alkhashan,1 Aljoharah H Alobaikan,1 Aboud F Alaboud,1 Ahmed Bakhiet,1 Hala Alqahtani,1 Saad M Albattal,1 Nawaf M Abanami1 1Family and Community Medicine Department, Prince Sultan Military Medical City, 2Research Unit, MSD, Riyadh, Saudi Arabia Aim: Despite the safety warnings issued for pioglitazone, its utilization continued in several countries. However, an individualized patient risk–benefit assessment has been advised before the use of pioglitazone. The objectives of the current study are to assess the adherence to pioglitazone safety monitoring and determine the reasons for pioglitazone discontinuation. Methods: Retrospective cohort study of patients with type 2 diabetes was carried out for patients who have been started on oral pioglitazone at the Al-Wazarat primary care center between ­January 2011 until the end of 2014. Adverse events and pioglitazone discontinuation were monitored during patient visits scheduled in 12-month period following the start of pioglitazone. The Chronic Disease Unit at the Al-Wazarat primary care center designed a monitoring data sheet. The safety-monitoring sheet included patients’ demographics (age and gender), history of bladder cancer, current bladder cancer, and current bladder diseases. The patient’s weight, edema status, liver function test (LFT), electrocardiogram (ECG), bone mass density (BMD), and hematuria were recorded at pioglitazone initiation and weeks 12, 24, and 48. Results: A total of 183 patients (78 males and 105 females) were included in the cohort. The side effect that was associated with highest monitoring adherence (two or more times during the study) was weight gain (94.5%), followed by LFTs (47.5%), edema (31.1%), bone mineral density (18.0%), and ECG (16.4%). Approximately 47.4% had one or more adverse events, with the most common side effect being weight gain (35.1%), followed by osteoporosis (10.5%), edema (8.8%), hypoglycemia (7.0%), elevated liver enzymes (3.5%), and osteopenia (3.5%). Approximately 63.9% discontinued pioglitazone, with the common reasons being shifting to insulin therapy (28.2%), weight gain (25.6%), loss to follow-up (15.4%), hypoglycemia (10.2%), and osteoporosis (8.4%). This reports an appropriate initiation of pioglitazone but suboptimal adherence to pioglitazone safety monitoring in a primary care setting. Keywords: hypoglycemia, primary care, adverse effects, diabetes care, follow-up

Background.Antibiotics are responsible for most dramatic improvement in medical therapy in history. These medications contributed significantly to the decreasing mortality and morbidity when prescribed based on evidence of microbial infection.Objective.The aim of this study was to determine the prevalence and predictors of self-prescription with antibiotics in Al Wazarat Health Center, Riyadh City, Kingdom of Saudi Arabia.Material and Methods.Cross-sectional study was conducted in Al Wazarat Health Center between February 2014 and November 2014. Respondents were randomly selected using a multistage clustered random sampling technique. Data was entered into SPSS version 21 and analyzed. Descriptive statistics and multiple logistic regression models were applied.Results.A total of 681 patients have participated in this study with a response rate of 92%. The prevalence of self-prescription with antibiotics in Al Wazarat Health Center was 78.7%. Amoxicillin was the most used self-prescribed antibiotic with prevalence of (22.3%). Friend advice on self-prescription of antibiotics use (p=0.000) and pharmacy near to the participants (p=0.002) were the most common predictors for self-prescription with antibiotics.Conclusion.The level of self-prescribing antibiotics is relatively high among participants. Health education on the appropriate use of antibiotics is highly recommended. The proper use of treatment guidelines for antibiotic therapy will significantly reduce self-prescription with antibiotics.