Atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), chronic kidney disease (CKD), and obesity are associated with increased morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Nonetheless, their prevalence among patients with T2DM in Saudi Arabia (SA) remains unknown. As current guidelines recommend, these comorbidities require adding certain antidiabetic agents with cardiorenal benefits. However, the prescribers' adherence to these recommendations remains unclear. A two-center retrospective cross-sectional study was conducted including adult patients (≥18 years) with T2DM admitted to hospital or seen at outpatient clinics between January and December 2020. Patients were classified into two groups based on the presence or absence of ASCVD. Patients with no prior ASCVD history were further classified based on the 10-year ASCVD risk estimation. Endpoints of interest included the prevalence of ASCVD, HF, CKD, and obesity in patients with T2DM. We also evaluated the characteristics of the utilized antidiabetic agents, statin, and aspirin therapies.. Of the 1,218 included patients with T2DM, the majority were female (57.0 %), and aged 45–64 years (53.0 %) with a mean age of 59.3 ± 13.1 years. Hypertension and dyslipidemia were the most prevalent comorbidities (67.7 % and 69.0 %, respectively). Among all patients, 18.6 % had an established ASCVD and the prevalence of HF, CKD, and obesity were 5.1 %, 8.7 %, and 58.3 %, respectively. The most common types of ASCVD witnessed were revascularization (42.3 %), myocardial infarction (36.6 %), and stroke (33.9 %); with an increased prevalence of ASCVD as the age increases (52.8 % at age ≥ 65 years). In the non‐ASCVD group, the 10-year ASCVD risk was intermediate or high in 62.7 % of these patients. The rates of utilization of guidelines-recommended therapies were 83.6 % for metformin, 9.4 % for GLP-1 RA, 10.8 % for SGLT2i, 35.2 % for aspirin alone or in combination with clopidogrel, and 79.7 % for statin therapy. ASCVD, HF, CKD, and obesity are common complications in patients with T2DM in SA, with low overall utilization of the recommended guidelines-recommended medical therapies. Multimodal strategies should be utilized to assess T2DM and its complications, and to improve prescribers' adherence to guidelines-recommended therapies.

中文翻译：

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2型糖尿病患者心血管疾病、慢性肾病和肥胖的患病率以及同期治疗的描述：沙特阿拉伯的一项两中心回顾性横断面研究

动脉粥样硬化性心血管疾病 (ASCVD)、心力衰竭 (HF)、慢性肾病 (CKD) 和肥胖与 2 型糖尿病 (T2DM) 患者发病率和死亡率增加相关。尽管如此，沙特阿拉伯 (SA) T2DM 患者中的患病率仍不清楚。正如目前的指南所建议的，这些合并症需要添加某些对心肾有益的抗糖尿病药物。然而，处方医生是否遵守这些建议仍不清楚。开展了一项两中心回顾性横断面研究，纳入 2020 年 1 月至 12 月期间入院或门诊就诊的 T2DM 成年患者（≥18 岁）。根据是否存在 ASCVD 将患者分为两组。既往无 ASCVD 病史的患者根据 10 年 ASCVD 风险评估进一步分类。感兴趣的终点包括 T2DM 患者 ASCVD、HF、CKD 和肥胖的患病率。我们还评估了所使用的抗糖尿病药物、他汀类药物和阿司匹林疗法的特点。在 1,218 名 T2DM 患者中，大多数为女性 (57.0%)，年龄为 45-64 岁 (53.0%)，平均年龄为59.3±13.1岁。高血压和血脂异常是最常见的合并症（分别为 67.7% 和 69.0%）。在所有患者中，18.6% 的患者患有 ASCVD，HF、CKD 和肥胖的患病率分别为 5.1%、8.7% 和 58.3%。最常见的 ASCVD 类型是血运重建 (42.3%)、心肌梗死 (36.6%) 和中风 (33.9%)； ASCVD 患病率随着年龄的增加而增加（≥ 65 岁时为 52.8%）。在非 ASCVD 组中，62.7% 的患者 10 年 ASCVD 风险为中度或高度。指南推荐疗法的使用率为二甲双胍83.6%、GLP-1 RA 9.4%、SGLT2i 10.8%、单独阿司匹林或与氯吡格雷联用为35.2%、他汀类药物治疗为79.7%。 ASCVD、心力衰竭、慢性肾病和肥胖是南澳州 T2DM 患者的常见并发症，指南推荐的药物治疗的总体利用率较低。应采用多模式策略来评估 T2DM 及其并发症，并提高处方者对指南推荐治疗的依从性。