title: Reported Benefits of Insulin Therapy for Better Glycemic Control in Type 2 Diabetic Patients-Is This Applicable in Saudi Patients?
abstract: OBJECTIVE
  To compare the effect of different treatment regimens (oral hypoglycemic agents [OHGs], insulin therapy, and combination of both) on glycemic control and other cardiometabolic risk factors in type 2 diabetes mellitus (T2DM) patients in Saudi.
  
  
  METHODS
  Patients with T2DM, but no serious diabetic complications, were randomly recruited from the diabetes clinics at two large hospitals in Jeddah, Saudi Arabia, during June 2013 to July 2014. Only those without change in treatment modality for the last 18 months were included. Blood pressure and anthropometric measurements were measured. Treatment plan was recorded from the patients' files. Fasting blood sample was obtained to measure glucose, HbA1c, and lipid profile.
  
  
  RESULTS
  A total of 197 patients were recruited; 41.1% were men and 58.9% were women. The mean (±SD) age was 58.5 ± 10.5 years. Most patients (60.7%) were on OHGs, 11.5% on insulin therapy, and 27.7% were using a combination of insulin and OHGs. The mean HbA1c was lower in patients using OHGs only, compared with means in those using insulin, or combined therapy in patients with disease duration of ≤10 years (P = 0.001) and also in those with a longer duration of the disease (P < 0.001). A lower mean diastolic and systolic blood pressure was found among patients on insulin alone (P < 0.01). No significant differences were found in lipid profiles among the groups.
  
  
  CONCLUSIONS
  Insulin therapy, without adequate diabetes education, fails to control hyperglycemia adequately in Saudi T2DM patients. There is a challenge to find out reasons for poor control and the ways as to how to improve glycemic control in T2DM.
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Wafaa
authors.initials: W
authors.lastname: AlSaggaf
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Asiri
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Balgees
authors.initials: B
authors.lastname: Ajlan
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Alaa Bin
authors.initials: AB
authors.lastname: Afif
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Roaa
authors.initials: R
authors.lastname: Khalil
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Anas Bin
authors.initials: AB
authors.lastname: Salman
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alghamdi
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Osama
authors.initials: O
authors.lastname: Bashawieh
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Atheer
authors.initials: A
authors.lastname: Alamoudi
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Abeer
authors.initials: A
authors.lastname: Aljahdali
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Nouf
authors.initials: N
authors.lastname: Aljahdali
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Hussam
authors.initials: H
authors.lastname: Patwa
authors.affiliation: Medical Student, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia.; Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Bakhaidar
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Suhad M
authors.initials: SM
authors.lastname: Bahijri
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Maimoona
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Shali
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; King Fahad Armed Forces Hospital (KFAFH), Jeddah, Saudi Arabia.
authors.forename: Samia
authors.initials: S
authors.lastname: Bokhari
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Amani
authors.initials: A
authors.lastname: Alhozali
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
authors.forename: Anwar
authors.initials: A
authors.lastname: Borai
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Ghada
authors.initials: G
authors.lastname: Ajabnoor
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.; Center for Vascular Prevention, Danube University Krems, Krems, Austria.; Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.; Dasman Diabetes Institute, Dasman, Kuwait.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
keywords: glycated hemoglobin; glycemic control; hypoglycemic agents; insulin; treatment regimen; type 2 diabetes mellitus