# Knowledge of Primary Health Care Physicians About the Novel Class of Type 2 Diabetes Medication in Qassim Province, Saudi Arabia

## TL;DR

This study examines how well primary care physicians in Saudi Arabia understand new diabetes medications and finds significant gaps in their training and knowledge.

## Contribution

The study identifies knowledge gaps in novel diabetes medications among primary health care physicians in Qassim province and highlights the need for targeted continuing education.

## Key findings

- Only 36.1% of physicians received training on novel diabetes medications despite frequent patient encounters.
- Family medicine specialists and consultants showed higher familiarity with American Diabetes Association guidelines compared to general physicians.
- GLP-1 RAs were recognized as having the greatest HbA1c reduction and cardiovascular benefits.

## Abstract

Background: Type 2 diabetes mellitus (T2DM) is a worldwide issue, stemming from multiple factors, primarily environmental and lifestyle habits. New medications are constantly emerging due to the chronic nature of the disease and its impact on various organ systems. The competitive market requires primary health care center (PHCC) physicians to use accurate doses, treatment durations, and novel medication practices to benefit their patients. This study aims to assess Qassim PHCC physicians' knowledge of a new class of T2DM medication.

Methods: A cross-sectional study was conducted among 230 PHCC physicians using a semi-structured self-administered questionnaire, and 191 responded. A simple random method was applied to select 11 governorates from Qassim province. Then, the self-administered questionnaire link was distributed through WhatsApp, and direct messages were sent in a convenient manner to each governorate supervisor and PHCC physician. Data analysis was performed using Statistical Program for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY), and the chi-square test was applied for categorical analysis.

Results: The study revealed that the mean age of Qassim PHCC physicians was 33.66±7.6 years, with 72.3% aged 25-35 years. Males comprised 62.3% of the group, and professional classifications included 22.5% general physicians (GPs), 33.5% family medicine (FM) residents, 28.3% FM specialists, and 15.7% FM consultants. While 88% encountered type 2 diabetes daily, only 36.1% received continued medical education (CME) training on novel medications. Awareness of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) (94.8%), dipeptidyl peptidase-4 inhibitors (DPP-4is) (83.8%), and sodium-glucose co-transporter-2 inhibitors (SGLT-2is) (86.9%) was high, yet American Diabetes Association (ADA) guideline familiarity varied, significantly higher among FM specialists and consultants. GLP-1 RAs were linked to the greatest glycated hemoglobin (HbA1c) reduction (2.07% ± 0.92), while SGLT-2i and DPP-4i followed with 1.53% ± 0.78 and 1.25% ± 1.01 reductions, respectively. Most physicians (92.7%) recognize the cardiovascular benefits of GLP-1 RAs, but educational needs are required. There are significant awareness disparities between professional roles (FM specialist and FM consultant versus GP and FM residents) and with all three novel medications (p<0.05).

Conclusions: The study highlights significant gaps in CME among Qassim PHCC physicians, with only 36.1% trained in novel diabetes medications despite daily encounters with patients with T2DM. While awareness of GLP-1 RAs and other medications was high, variations in ADA guideline familiarity indicate a need for role-specific educational interventions. Physicians acknowledged GLP-1 RAs' superior HbA1c reduction and cardiovascular benefits. Policymakers should prioritize targeted CME programs, enhance access to updated guidelines, and promote tailored training to bridge knowledge and practice gaps.