Rate and pattern of prescription for osteoporosis and non- alcoholic fatty liver disease among patients with diabetes mellitus in Tabuk City, Saudi Arabia

Background: Diabetes mellitus, non-alcoholic fatty liver disease (NAFLD) and osteoporosis are common serious diseases with high morbidity and mortality. When co-exist they increase each other deleterious consequences. This is the first study to assess the same in Saudi Arabia. Objectives: The study aimed to assess the rate and pattern of prescription for osteoporosis and NAFLD among patients with diabetes mellitus in Saudi Arabia. Methods: This cross-sectional study was conducted among 84 diabetic patients (above 60 years of age) at the Diabetes Center, Tabuk City, Saudi Arabia during the period from August 2022 to January 2023. A structured questionnaire based on demographic data, duration of diabetes, exercise, HbA1c, macro vascular complications, smoking and Dual-energy x-ray absorptiometry (DEXA) scan was used. The Q-fracture risk was used to assess the risk of fracture, and NAFLD was assessed using ultrasonography. Results: There were 84 diabetic patients (52.4% were women and 80.5% were obese or overweight, central adiposity was found in 77.8%); mean age, 62.38 +/- 7.56 years, NAFLD was found in 45.2%, osteoporosis and osteopenia were present in 28.6% and 41.7% respectively. No patient was receiving osteoporosis treatment and the uptake of glucagon-like peptide agonists (GLP-1) agonists and sodium-glucose co transporter's inhibitors (SGLT-2) was negligible (4.8% and 7.1% respectively). Conclusion: Osteoporosis, osteopenia and NAFLD were prevalent among patients with diabetes in Tabuk city, Saudi Arabia. The uptake of osteoporosis treatment, GLP-1 agonists and SGLT-2 inhibitors was low. Physicians might need to strictly follow the treatment guidelines and screen patients with diabetes mellitus for osteoporosis.