--- title: "Real-world antidiabetic treatment patterns and adherence among privately insured patients with T2D" id: "bmj-open-6-real-world-treatment-patterns-and-adherence-among-privately-insured-patients" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-6-real-world-treatment-patterns-and-adherence-among-privately-insured-patients" content_type: "clinical_feed_article" specialty: "Endocrinology" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/8/e118711?rss=1" published_at: "2026-08-10T10:07:51.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Real-world antidiabetic treatment patterns and adherence among privately insured patients with T2D ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-6-real-world-treatment-patterns-and-adherence-among-privately-insured-patients - **Specialty:** [Endocrinology](https://medichelpline.com/clinical-feed/endocrinology.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/8/e118711?rss=1) - **Published At:** 2026-08-10T10:07:51.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - This longitudinal retrospective cohort study used national claims from the National Platform for Health Information Exchange Services (NPHIES) to assess real-world antidiabetic treatment patterns among privately insured patients with **Type 2 diabetes mellitus (T2DM)** in the Kingdom of Saudi Arabia (KSA). - The study period covered 1 September 2022 to 31 December 2024 and included 187,797 privately insured individuals aged ≥15 years with at least one T2DM claim (ICD-10-AM code E11) and continuous insurance enrollment of ≥12 months (≥180 days pre- and post-index). - The index date was the earliest observed antidiabetic prescription within the study window. Claims were standardized by linking NPHIES product/service codes to the Council of Health Insurance product dictionary; extraction used SQL queries and Python for transformation. - Mean patient age was 53.7 years. Observed T2DM rates were 47.4 per 1,000 insured men and 43.8 per 1,000 insured women in the dataset. - Initial regimens: **combination therapy** comprised 29.4% of initial antidiabetic regimens among eligible patients. - Treatment modifications: among biguanide monotherapy users, switching occurred in 9% and escalation in 7%; 35% of **sulfonylurea** users experienced escalation. Discontinuation rates were 22% for combination therapies, 22% for **SGLT2 inhibitor** users, and 19% for sulfonylurea users. - Medication adherence: the medication possession ratio for **insulin** users was 0.87. - Glycaemic laboratory monitoring: 61% of patients had at least one glycaemic test in the 6 months prior to therapy initiation; testing increased to 73% after therapy initiation. Reported tests included **HbA1c**, plasma glucose, and oral glucose tolerance test. - The authors conclude that integrated national claims platforms with standardized coding and e-prescribing can support real-world evidence generation to inform diabetes management strategies in KSA and the MENA region. ## Clinical Analysis & Structured Key Points Objectives Type 2 diabetes mellitus (T2DM) imposes clinical and economic burdens worldwide, with the Kingdom of Saudi Arabia (KSA) reporting among the highest prevalence rates in the Middle East and North Africa (MENA) region. Despite national diabetes initiatives under Vision 2030 and recent guideline implementation, evidence on T2DM management among privately insured beneficiaries remains limited. This study aimed to provide one of the first real-world assessments of antidiabetic treatment patterns, therapy modifications, medication adherence and guideline-recommended glycaemic monitoring among privately insured patients with T2DM in KSA. Design Longitudinal retrospective cohort study. Setting A national claims-based analysis was conducted using the National Platform for Health Information Exchange Services (NPHIES), covering privately insured beneficiaries across KSA. The study period spanned from 1 September 2022 to 31 December 2024. Participants Eligible participants were privately insured individuals aged ≥15 years with a diagnosis of T2DM, defined as having at least one medical claim of T2DM (International Classification of Diseases, 10th Revision, Australian Modification code E11) and continuous insurance enrolment for a minimum of 12 months (including ≥180 days pre-index and ≥180 days post-index). The index date was defined as the earliest observed antidiabetic prescription within the study window. A total of 187 797 patients met the inclusion criteria and were included in the final analysis. Primary and secondary outcome measures The primary outcomes were antidiabetic real-world treatment patterns and therapy modifications, including treatment escalation, switching, early discontinuation and medication adherence. Secondary outcomes included guideline-recommended laboratory testing of glycaemic control for haemoglobin A1c (HbA1c), plasma glucose tests and oral glucose tolerance test. Claims were linked to the Council of Health Insurance's internal product dictionary using the NPHIES product/service code to retrieve the standardised product name and activity type. Data extraction used Structured Query Language-based queries and Python transformation. Results Patients had a mean age of 53.7 years, while T2DM rates reached 47.4 per 1000 insured men and 43.8 per 1000 insured women. Combination therapy accounted for 29.4% of initial treatment regimens among eligible patients with T2DM. Biguanide monotherapy users exhibited switching and escalation rates of 9% and 7%, respectively, while 35% of sulfonylurea users exhibited escalation. Treatment discontinuation was observed in 22% of users of combination therapies, 22% of SGLT2 inhibitor users and 19% of sulfonylurea users. The medication possession ratio was 0.87 for insulin users. Regarding laboratory monitoring, 61% of patients had at least one glycaemic test 6 months prior to therapy initiation. Laboratory testing reached 73% following therapy initiation. Conclusion The Saudi experience suggests that integrated national claims platforms, supported by standardised coding and e-prescribing, can play a critical role in advancing real-world evidence generation and informing diabetes management strategies in KSA and across MENA health systems. ## Related Clinical Research - [Thyroid Function and MAFLD in Type 2 Diabetes: Case-Control Study of FT3 and TSH Associations](https://medichelpline.com/clinical-feed/pubmed-42664128.md) (DOI: 10.7417/CT.2026.2108) - [Omnipod 5 Automated Insulin Delivery: 12-Month Extension Outcomes in Adults with Type 1 Diabetes](https://medichelpline.com/clinical-feed/pubmed-42671087.md) (DOI: 10.1002/edm2.70321) - [Antidiabetic regimens and risk of cognitive disorders in type 2 diabetes: large retrospective coho](https://medichelpline.com/clinical-feed/plos-one-23-antidiabetic-medications-and-risk-of-cognitive-disorders-in-type-2-diabetes-a.md) - [Nonlinear association of sleep quality (PSQI) with type 2 diabetes prevalence in community chronic](https://medichelpline.com/clinical-feed/plos-one-18-nonlinear-relationship-between-sleep-quality-and-prevalence-of-type-2-diabetes.md) - [GLP-1 receptor agonists and PMOS: evidence, mechanisms, and who may benefit](https://medichelpline.com/clinical-feed/medical-news-today-0-can-glp-1s-really-help-treat-pmos-experts-answer-3-key-questions.md) ## Navigation - [← Back to Endocrinology Feed](https://medichelpline.com/clinical-feed/endocrinology.md) - [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md) ## Medical & Regulatory Disclaimer > [!CAUTION] > MedicHelpline content is structured for research, educational, and professional discovery purposes. 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