Longitudinal assessment of the quality of life and patterns of antidiabetic medication use in patients with type 2 diabetes, Saudi Arabia perspective, DISCOVER study

Figures & data

Figure 1. The percentages of stopped and started anti-diabetic agents according to the classes during point time follow-up.

Figure 2. Bubble chart presenting the relationship between the start and stop of different anti-diabetic drugs when chosen as the second choice.

Table 1. Reason for changing previous therapies and choosing the new therapy during the study follow-up.

Reason	Reason for changing previous therapy				Reason for choosing the new therapy
	6 months n = 88 (%)	12 months n = 92 (%)	24 months n = 87 (%)	36 months n = 103 (%)	6 months n = 88	12 months n = 92	24 months n = 87	36 months n = 103
Drug efficacy	47 (53.4)	39 (42.4)	43 (49.4)	37 (35.9)	56 (63.6)	45 (48.9)	48 (55.2)	54 (52.4)
Access to drugs	7 (8.0)	26 (28.3)	32 (36.8)	30 (29.1)	8 (9.1)	28 (30.4)	32 (36.8)	27 (26.2)
Physician preference	10 (11.4)	4 (4.3)	4 (4.6)	7 (6.8)	NA	NA	NA	NA
Side effect	5 (5.7)	3 (3.3)	4 (4.6)	4 (3.9)	NA	NA	NA	NA
Drug tolerate/adherence	7 (8.0)	2 (2.2)	0	3 (2.9)	17 (19.3)	14 (15.2)	10 (11.5)	11 (10.7)
Weight gain	1 (1.1)	1 (1.1)	1 (1.1)	4 (3.9)	4 (4.5)	7 (7.6)	6 (6.9)	7 (6.8)
Hypoglycemic events	6 (6.8)	2 (2.2)	2 (2.3)	2 (1.9)	11 (12.5)	7 (7.6)	3 (3.4)	5 (4.9)
Patient’s request	4 (4.5)	6 (6.5)	0	3 (2.9)	4 (4.5)	3 (3.3)	3 (3.4)	5 (4.9)
Patient’s convenience	6 (6.8)	2 (2.2)	1 (1.1)	2 (1.9)	5 (5.7)	4 (4.3)	3 (3.4)	3 (2.9)
Cost of drug	NA	NA	NA	NA	1 (1.1)	1 (1.1)	0	0
Other reasons	2 (2.2)*	0	3 (3.4)*	2 (1.9)*	12 (13.6)	8 (8.7)	3 (3.4)	15 (14.6)

Abbreviation. NA: not applicable. Patients with no treatment changes are excluded from this table.

*Acute or chronic disease, self-administration, and drug interaction.

Table 2. Non-diabetic medications were used by the study participants over the follow-up period.

Therapy	Follow-up time point
	Baseline n = 519 (%)	6 months n = 470 (%)	12 months n = 478 (%)	24 months n = 473 (%)	36 months n = 477 (%)
Antihypertensives
Total	185 (35.6)	199 (42.3)	215 (45.0)	239 (50.5)	262 (54.9)
ACEIs	156 (30.1)	167 (35.5)	181 (37.9)	196 (41.4)	221 (46.3)
Beta-blocker	45 (8.7)	45 (9.6)	56 (11.7)	62 (13.1)	70 (14.7)
Calcium channel antagonist	44 (8.5)	55 (11.7)	61 (12.8)	71 (15.0)	75 (15.7)
Diuretic	29 (5.6)	36 (7.7)	41 (8.6)	49 (10.4)	56 (11.7)
Other	1 (0.2)	3 (0.6)	2 (0.4)	3 (0.6)	2 (0.4)
Lipid lower agents
Total	280 (53.9)	321 (68.3)	370 (77.4)	388 (82.0)	411 (86.2)
High statin	75 (14.5)	86 (18.3)	101 (21.1)	114 (24.1)	114 (23.9)
Low statin	198 (38.2)	229 (48.7)	259 (54.2)	270 (57.1)	295 (61.8)
Fibrate	14 (2.7)	14 (3.0)	17 (3.6)	10 (2.1)	8 (1.7)
Niacin	0	0	1 (0.2)	1 (0.2)	1 (0.2)
Other	3 (0.6)	4 (0.9)	7 (1.5)	5 (1.1)	6 (1.3)
Antiplatelets
Total	181 (34.9)	201 (42.8)	250 (52.3)	278 (58.8)	288 (60.4)
Aspirin	178 (34.3)	198 (42.1)	247 (51.7)	274 (57.9)	283 (59.3)
Clopidogrel	14 (2.7)	14 (3.0)	15 (3.1)	17 (3.6)	20 (4.2)
Other	0	0	0	0	1 (0.2)
Anticoagulants
Total	3 (0.6)	3 (0.6)	4 (0.8)	8 (1.7)	8 (1.7)
Warfarin	2 (0.4)	2 (0.4)	3 (0.6)	4 (0.8)	3 (0.6)
Novel Anticoagulants	0	0	0	3 (0.6)	4 (0.8)
Other	0	1 (0.2)	1 (0.2)	1 (0.2)	1 (0.2)
Anti-depressant	14 (2.7)	12 (2.6)	18 (3.8)	19 (4.0)	19 (4.0)
Anti-inflammatory	6 (1.2)	8 (1.7)	13 (2.7)	10 (2.1)	10 (2.1)
PPIs	39 (7.5)	56 (11.9)	65 (13.6)	73 (15.4)	76 (15.9)
Thyroid medication	39 (7.5)	40 (8.5)	48 (10.0)	48 (10.1)	54 (11.3)

Abbreviations. ACEs: angiotensin-converting enzyme inhibitors; PPIs: proton pump inhibitors.

Table 3. The patient’s quality of life score was reported during each follow-up visit using a quality of life questionnaire (SF-36v2 Health Survey).

Quality of life questionnaire (SF-36v2 Health Survey)	Follow-up time point					p-Value
	Baseline n = 519	6 months n = 470	12 months n = 478	24 months n = 473	36 months n = 477
Physical functioning score
Mean ± SD	48.5 ± 8.4	42.9 ± 11.7	42.2 ± 12.1	43.3 ± 11.5	43.1 ± 10.9	<.0001
Median (IQR)	49.9 (44.1, 55.7)	44.1 (36.4, 53.7)	44.1 (34.5, 51.8)	44.1 (38.3, 53.7)	45.1 (36.4, 51.8)
Role-physical score
Mean ± SD	48.5 ± 8.5	49.4 ± 7.8	50.0 ± 7.0	51.8 ± 6.0	51.6 ± 5.9	<.0001
Median (IQR)	49.4 (39.5, 57.1)	48.3 (43.9, 57.1)	50.5 (48.3, 57.1)	54.9 (48.3, 57.1)	54.9 (48.3, 57.1)
Bodily pain score
Mean ± SD	50.5 ± 9.2	52.4 ± 8.0	52.9 ± 7.5	54.7 ± 7.0	53.5 ± 6.7	<.0001
Median (IQR)	50.6 (41.9, 60.9)	50.6 (49.8, 60.9)	50.6 (49.8, 60.9)	54.6 (50.6, 60.9)	53.0 (50.6, 60.9)
General health score
Mean ± SD	52.2 ± 7.8	53.1 ± 6.8	55.4 ± 7.6	55.9 ± 6.6	54.8 ± 6.0	<.0001
Median (IQR)	53.1 (46.4, 58.8)	53.1 (50.9, 57.5)	55.3 (50.9, 63.2)	55.3 (53.1, 61.9)	55.3 (52.2, 57.5)
Vitality score
Mean ± SD	51.9 ± 7.3	54.6 ± 7.0	55.6 ± 7.6	56.0 ± 6.9	55.1 ± 6.7	<.0001
Median (IQR)	52.8 (47.4, 58.3)	55.5 (50.1, 58.3)	55.5 (50.1, 63.7)	55.5 (50.1, 61.0)	55.5 (50.1, 61.0)
Social functioning score
Mean ± SD	49.2 ± 8.4	50.3 ± 7.1	50.6 ± 6.7	52.3 ± 6.2	51.2 ± 5.9	<.0001
Median (IQR)	51.8 (41.9, 56.7)	51.8 (46.9, 56.7)	51.8 (46.9, 56.7)	56.7 (46.9, 56.7)	51.8 (46.9, 56.7)
Role-emotional score
Mean ± SD	44.9 ± 11.6	46.3 ± 9.6	47.6 ± 9.3	49.5 ± 8.2	48.3 ± 7.9	<.0001
Median (IQR)	48.0 (32.7, 55.6)	48.0 (40.4, 55.6)	51.8 (44.2, 55.6)	51.8 (44.2, 55.6)	51.8 (44.2, 55.6)
Mental health score
Mean ± SD	47.8 ± 9.4	50.8 ± 7.5	51.9 ± 7.4	52.4 ± 6.3	52.4 ± 6.7	<.0001
Median (IQR)	47.8 (40.4, 55.2)	50.3 (47.8, 55.2)	52.8 (47.8, 57.7)	52.8 (47.8, 57.7)	50.3 (47.8, 57.7)
Physical component score
Mean ± SD	51.0 ± 7.0	49.0 ± 7.0	49.2 ± 6.2	50.4 ± 5.7	49.8 ± 5.3	.0025
Median (IQR)	51.9 (47.0, 56.0)	50.4 (43.2, 54.2)	49.3 (44.2, 54.2)	51.0 (46.0, 54.9)	50.6 (45.9, 54.1)
Mental component score
Mean ± SD	47.4 ± 9.1	51.4 ± 8.0	52.8 ± 8.4	53.8 ± 7.1	53.0 ± 6.7	<.0001
Median (IQR)	48.6 (40.9, 54.4)	52.5 (47.3, 57.4)	53.7 (48.5, 59.4)	54.8 (49.5, 58.5)	53.7 (49.1, 57.1)

Data availability statement

The data that support the findings of this study are available from the DISCOVER study database, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.