Abstract

Objective: This study aimed to estimate the prevalence of polypharmacy among adults with diabetes attending care and to evaluate its association with glycemic control.
Methods: A descriptive cross-sectional study was conducted at King Saud University Medical City (Riyadh, Saudi Arabia) in May 2025. Consecutive adults with diabetes completed an electronic questionnaire, and their most recent glycated hemoglobin (HbA1c) was abstracted from the clinic record. Polypharmacy was defined as the concurrent use of ≥5 medications. Factors associated with polypharmacy were examined using multivariable logistic regression, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported.
Results: A total of 308 participants (52.6% female) were analyzed. Polypharmacy was 72.7%. Adjusted models showed associations with age >60 years (AOR, 2.901; 95% CI, 1.592-5.285; p-value = 0.001), diabetes duration >10 years (AOR, 2.623; 95% CI, 1.517-4.535; p-value = 0.001), hypertension (AOR, 9.031; 95% CI, 4.989-16.347), dyslipidemia (AOR, 4.215; 95% CI, 2.376-7.476), cardiovascular disease (AOR, 6.530; 95% CI, 2.513-16.971), uncontrolled HbA1c >7% (AOR, 2.197; 95% CI, 1.311-3.682; p-value 0.003), and diabetes complications (AOR, 3.821; 95% CI, 2.077-7.030). Sex, occupation, diet, physical activity, and home glucose monitoring were not significant.
Conclusion: Polypharmacy was frequent and clustered with older age, longer diabetes duration, multimorbidity, complications, and uncontrolled HbA1c. Findings support systematic medication reviews and deprescribing strategies, integrated with lifestyle and glycemic management, to reduce unnecessary regimen complexity while maintaining clinical control.

Key words: Polypharmacy, diabetes, HbA1c, comorbidity, Saudi Arabia.