Assessing the Compliance of Physicians With the American Diabetes Association (ADA) Guidelines in Prescribing Cardioprotective Antihyperglycemic Agents to Diabetic Patients at a University Hospital in Jeddah, Saudi Arabia

Background and objective Diabetes is a major risk factor for the development of cardiovascular diseases. To tackle this issue, guidelines have emphasized the use of cardioprotective antihyperglycemic agents [glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose co-transporter-2 (SGLT2) inhibitors] among type 2 diabetic patients at high risk of/with established atherosclerotic cardiovascular disease (ASCVD) or heart failure to curb morbidity and mortality in such individuals. The aim of this study was to assess physicians' adherence to the American Diabetes Association’s (ADA) recommendations on the use of cardioprotective antihyperglycemic agents among such patients. Methods This study involved a retrospective records review of physicians' treatment plans for all type 2 diabetic patients aged 18 years and older and attending outpatient clinics from the year 2019 to 2022 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, who (a) were at high risk of/with established ASCVD as defined by the American Diabetes Association (ADA) or (b) had heart failure with reduced ejection fraction (HFrEF) and required cardioprotective antihyperglycemic agents. Results We reviewed physicians' treatment plans for 202 type 2 diabetic patients in this study. All patients were either at high risk of or had established ASCVD. In addition, 36 (17.8%) of these patients had HFrEF. Although all patients were candidates for cardioprotective antihyperglycemic agents, only 56.9% of them received treatment as recommended by the ADA guidelines. Conclusion Despite being suitable candidates for cardioprotective antihyperglycemics, a significant number of patients were not treated based on the ADA guidelines, and this demonstrates a lack of adherence to the guidelines by physicians.