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Yammine K, Akiki S, Assi C, Hayek Md F. Amputation as a First Treatment is Highly Associated With Late Presentation: An Underestimated Modifiable Major Risk Factor for Diabetic Foot Ulcer. Foot Ankle Spec 2024; 17:474-478. [PMID: 34967230 DOI: 10.1177/19386400211067625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Several risk factors for lower extremity amputation in diabetic patients have been identified; however, late presentation has been poorly investigated. Very few studies looked at the impact of such risk factor. As none has investigated the link between admission to amputation and late presentation in this population, we investigated such association. METHODS The study is a retrospective comparative cohort of continuous series of patients admitted for amputation related to diabetic foot ulcer (DFU) as a first treatment. A late presentation was defined as a period of 3 weeks or more from the onset of the ulcer. RESULTS Forty-six patients admitted for amputation and all wounds were infected and located on the plantar forefoot in 32 cases (69.5%), on the toes in 10 cases (21.7%), and in the heel area in 4 cases (8.8%). The mean duration to admission was 5.2 ±1.8 weeks (range 4-10 weeks). Late presentation was recorded in 42 (91.3%) patients. CONCLUSION This study demonstrates that amputation due to DFU is highly associated with late presentation. Educational campaigns targeting patient and first-line health care providers and highlighting the urgency of diabetic ulcers are needed to impact this major modifiable risk factor. LEVELS OF EVIDENCE Therapeutic, Level III: Retrospective Comparative.
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Affiliation(s)
- Kaissar Yammine
- Department of Orthopedic Surgery, LAU Medical Center-Rizk Hospital, School of Medicine, Lebanese American University, Beirut, Lebanon (KY, CA)
| | - Sandra Akiki
- Diabetic Foot Clinic, LAU Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon (KY)
| | - Chahine Assi
- Center for Evidence-Based Anatomy, Sport & Orthopedics Research (KY, CA)
| | - Fady Hayek Md
- Department of Clinical Nutrition, LAU Medical Center-Rizk Hospital, School of Medicine, Lebanese American University, Beirut, Lebanon (SA); and Division of Vascular Surgery, Department of Surgery, LAU Medical Center-Rizk Hospital, School of Medicine, Lebanese American University, Beirut, Lebanon (FH)
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Hamad NA, Rahim HFA, Shi Z. Association between dietary patterns and depression symptoms among adults with or without diabetes in Qatar: a population-based study. BMC Public Health 2024; 24:2260. [PMID: 39164668 PMCID: PMC11337602 DOI: 10.1186/s12889-024-19716-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 08/07/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Diabetes is a major public health problem in Qatar and is associated with an increased risk of depression. However, no study has been conducted in Qatar on the relationship between dietary patterns and depression symptoms in adults. The aim of this study was to assess the association between dietary patterns and depression symptoms among adults with or without diabetes in Qatar. METHODS A total of 1000 participants from the Qatar Biobank (QBB) were included in this cross-sectional study. Food intake was assessed using a computer-administered food frequency questionnaire (FFQ), and dietary patterns were identified using factor analysis. Depression symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9). RESULTS Depression symptoms were present in 13.5% of the sample. Two dietary patterns were identified: "unhealthy" (high consumption of fast food, biryani, mixed dish (chicken/meat/fish), croissant) and "prudent" (high consumption of fresh fruit, salads/raw vegetables, canned/dried fruit, and dates). After adjusting for sociodemographic, lifestyle factors (smoking and physical activity), diabetes and medication use for diabetes and hypertension, a high intake of "unhealthy" pattern was associated with an increased prevalence of depressive symptoms in individuals with diabetes (prevalence ratio, PR = 1.41; 95% CI = 1.28, 1.56; p-value < 0.001), while there was no statistically significant association between depressive symptoms and the "prudent" dietary pattern. The "prudent" pattern was inversely and significantly associated with depressive symptoms in individuals with a normal body weight (PR = 0.21; 95% CI = 0.06, 0.76; p-value = 0.018). CONCLUSION The "unhealthy" dietary pattern was positively associated with depression symptoms in those with diabetes, whereas the "prudent" dietary pattern was inversely associated with depression symptoms in those with a normal body weight. Promoting healthy eating habits should be considered in the prevention and management of depression.
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Affiliation(s)
- Noor Ahmed Hamad
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Hanan F Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
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Alhumsi IM. Knowledge, attitude, and practice of primary care physicians for pretravel counseling for type 2 diabetes patients in Jazan Region, Kingdom of Saudi Arabia. J Family Med Prim Care 2023; 12:1268-1275. [PMID: 37649759 PMCID: PMC10465030 DOI: 10.4103/jfmpc.jfmpc_1529_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 09/01/2023] Open
Abstract
Background and Objective Pretravel advice given by the primary healthcare (PHC) physicians is of vital importance to diabetic patients to maintain their glycemic status during their travel as many of them are not aware of the risks of travel on their health status. Our objective was to assess the status of pretravel counseling for type 2 diabetic patients (knowledge, attitude, and practice) in Jazan Region, Kingdom of Saudi Arabia (KSA) among the PHC physicians. Materials and Methods A cross-sectional study was carried out among a sample of PHC physicians working at the PHC centers in Jazan Region, KSA. The data were collected using a validated self-administered questionnaire. Results The study included 250 PHC physicians. The age of 45.2% of them ranged between 30 and 39 years, and males represented 56.2% of them. Overall, the knowledge score ranged between 0 and 10 with a median (interquartile range [IQR]) of 6 (5-7). Physicians aged 40-49 years (P < 0.001), non-Saudis (P = 0.005), and more experienced physicians (>15 years) (P < 0.001) were more knowledgeable than their counterparts. The attitude score ranged between 6 and 30 with a median (IQR) of 25 (22-27). Saudi physicians were more likely than non-Saudis to have more positive attitude toward pretravel counseling for diabetic patients (P = 0.007). The practice score ranged between 1 and 13 with a median (IQR) of 6 (5-8). Conclusion The PHC physicians in Jazan Region, KSA, had a moderate level of knowledge and practice as well as encouraging attitude concerning pretravel counseling for type 2 diabetic patients. However, their knowledge and attitude from one side were not associated with their practice from the other side.
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Affiliation(s)
- Ibrahim M. Alhumsi
- Family Medicine Specialist, Primary Health Care - Jazan Region, Kingdom of Saudi Arabia
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Alenezi YM, Harris R, Morling J, Card T. Prevalence of Non-alcoholic Fatty Liver Disease (NAFLD) in Saudi Arabia: Systematic Review and Meta-analysis. Cureus 2023; 15:e40308. [PMID: 37448425 PMCID: PMC10337700 DOI: 10.7759/cureus.40308] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Liver disease is fast emerging as a global health priority. Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries, with an increasing prevalence associated with the rising prevalence of diabetes mellitus and obesity. The worldwide prevalence of NAFLD may be in the order of 25%, but in the Middle East, it may be even higher. This study aimed to estimate the prevalence of NAFLD in the Kingdom of Saudi Arabia (KSA). A systematic review and meta-analysis were undertaken. Electronic searches were carried out through Medline, EMBASE, CINAHL, Web of Science, and Google Scholar, for articles from inception to April 2020. Studies conducted on adult populations in any setting reporting NAFLD prevalence were included. Pooled proportions and associated 95% confidence intervals (CIs) were presented in forest plots using a random effect model. Eight studies, including 4045 participants, were included. The pooled prevalence of NAFLD among all adult populations in KSA was 16.8% (11.1%-22.5%). Amongst those with type 2 diabetes, the prevalence was 58.0% (45.0%-70.9%). There were no true general population studies of the prevalence of NAFLD in KSA available. This review suggests that NAFLD is common in the KSA, and that type 2 diabetes is a risk factor in KSA as identified elsewhere in the world.
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Affiliation(s)
- Yusef M Alenezi
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- Family and Community Medicine, College of Medicine, Northern Borders University, Arar, SAU
| | - Rebecca Harris
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
| | - Joanne Morling
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
| | - Tim Card
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
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Sonmez A, Sabbour H, Echtay A, Rahmah AM, Alhozali AM, al Sabaan FS, Haddad FH, Iraqi H, Elebrashy I, Assaad SN, Bayat Z, Osar Siva Z, Hassanein M. Current gaps in management and timely referral of cardiorenal complications among people with type 2 diabetes mellitus in the Middle East and African countries: Expert recommendations. J Diabetes 2022; 14:315-333. [PMID: 35434900 PMCID: PMC9366572 DOI: 10.1111/1753-0407.13266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 03/05/2022] [Accepted: 03/13/2022] [Indexed: 12/11/2022] Open
Abstract
The upsurge of type 2 diabetes mellitus is a major public health concern in the Middle East and North Africa (MENA) and Africa (AFR) region, with cardiorenal complications (CRCs) being the predominant cause of premature morbidity and mortality. High prevalence of cardiometabolic risk factors, lack of awareness among patients and physicians, deficient infrastructure, and economic constraints lead to a cascade of CRCs at a significantly earlier age in MENA and AFR. In this review, we present consensus recommendations by experts in MENA and AFR, highlighting region-specific challenges and potential solutions for management of CRCs. Health professionals who understand sociocultural barriers can significantly increase patient awareness and encourage health-seeking behavior through simple educational tools. Increasing physician knowledge on early identification of CRCs and personalized treatment based on risk stratification, alongside optimum glycemic control, can mitigate therapeutic inertia. Early diagnosis of high-risk people with regular and systematic monitoring of cardiorenal parameters, development of region-specific care pathways for timely referral to specialists, followed by guideline-recommended care with novel antidiabetics are imperative. Adherence to guideline-recommended care can catalyze utilization of sodium glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists with demonstrated cardiorenal benefits-thus paving the way for overcoming care gaps in a cost-effective manner. Leveraging digital technology like electronic medical records can help generate real-world data and provide insights on voids in adoption of newer antidiabetic medications. A patient-centric approach, collaborative care among physicians from different specialties, alongside involvement of policy makers are key for improving patient outcomes and quality of care in MENA and AFR.
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Affiliation(s)
- Alper Sonmez
- Department of Endocrinology and MetabolismGulhane School of Medicine, University of Health SciencesAnkaraTurkey
| | - Hani Sabbour
- Heart & Vascular Institute Cleveland ClinicAbu DhabiUAE
- Brown University Warren Alpert School of MedicineProvidenceRhode IslandUSA
| | - Akram Echtay
- School of MedicineLebanese UniversityHadathLebanon
| | - Abbas Mahdi Rahmah
- National Centre for DiabetesCollege of Medicine, Al‐Mustansriya UniversityBaghdadIraq
| | | | | | - Fares H. Haddad
- Endocrine & Diabetes, Abdali Hospital/Endocrine & Diabetes ClinicAmmanJordan
| | - Hinde Iraqi
- Faculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | | | | | - Zaheer Bayat
- Division of Endocrinology and Metabolism, Department of Internal MedicineHelen Joseph HospitalRossmore, JohannesburgSouth Africa
| | | | - Mohamed Hassanein
- Dubai Hospital, DHADubaiUAE
- Gulf Medical UniversityAjmanUAE
- Cardiff UniversityCardiffUK
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Mak KH, Vidal-Petiot E, Young R, Sorbets E, Greenlaw N, Ford I, Tendera M, Ferrari R, Tardif JC, Udell JA, Escobedo J, Fox KM, Steg PG. Prevalence of diabetes and impact on cardiovascular events and mortality in patients with chronic coronary syndromes, across multiple geographical regions and ethnicities. Eur J Prev Cardiol 2022; 28:1795-1806. [DOI: 10.1093/eurjpc/zwab011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/20/2020] [Accepted: 01/11/2021] [Indexed: 01/01/2023]
Abstract
Abstract
Background
In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity.
Methods and results
CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure.
Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest.
Conclusion
In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes.
ClinicalTrials identifier
ISRCTN43070564
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Affiliation(s)
- Koon-Hou Mak
- Mak Heart Clinic, Gleneagles Medical Centre, 6 Napier Road, # 08-13, 258499, Singapore
| | - Emmanuelle Vidal-Petiot
- Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat and INSERM U1149, Centre for Research in Inflammation, 46 rue Henri Huchard, Paris 75018, France
- Université de Paris, 16 rue Henri Huchard, 75018 Paris, France
| | - Robin Young
- Robertson Centre for Biostatistics, Boyd Orr Building, University Avenue, University of Glasgow, Glasgow G12 8QQ, UK
| | - Emmanuel Sorbets
- Université de Paris, 16 rue Henri Huchard, 75018 Paris, France
- Centre de Diagnostic et de Thérapeutique, Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel Dieu, 1, place du Parvis Notre Dame, Paris 75004, France
- FACT (French Alliance for Cardiovascular Trials) and INSERM U1148, Laboratory for Vascular Translational Science, 46, rue Henri Huchard, Paris 75018, France
| | - Nicola Greenlaw
- Robertson Centre for Biostatistics, Boyd Orr Building, University Avenue, University of Glasgow, Glasgow G12 8QQ, UK
| | - Ian Ford
- Robertson Centre for Biostatistics, Boyd Orr Building, University Avenue, University of Glasgow, Glasgow G12 8QQ, UK
| | - Michal Tendera
- Department of Cardiology and Structural Heart Disease, Medical University of Silesia, Ziolowa Str. 45/47, 40-635 Katowice, Poland
| | - Roberto Ferrari
- Cardiovascular Centre, University of Ferrara, Via Aldo Moro 8, 44124 Cona (FE), Italy
- Maria Cecilia Hospital, GVM Care & Research, Via Corriera 1 48033 Cotignola (RA), Italy
| | - Jean-Claude Tardif
- Department of Medicine, Montreal Heart Institute, Université de Montreal, 5000 Belanger Street, Montreal, PQ H1T1C8, Canada
| | - Jacob A Udell
- Women’s College Research Institute, Women’s College Hospital, University of Toronto, 76 Grenville St, Toronto, ON M5S 1B1, Canada
| | - Jorge Escobedo
- Unidad de Investigación en Epidemiología Clínica, Hospital General Regional 1, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Kim M Fox
- NHLI Imperial College, Dovehouse Street, London SW3 6LP ICMS, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
| | - Philippe Gabriel Steg
- Université de Paris, 16 rue Henri Huchard, 75018 Paris, France
- FACT (French Alliance for Cardiovascular Trials) and INSERM U1148, Laboratory for Vascular Translational Science, 46, rue Henri Huchard, Paris 75018, France
- NHLI Imperial College, Dovehouse Street, London SW3 6LP ICMS, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
- Cardiology Department, Assistance Publique-Hôpitaux de Paris, Hopital Bichat, Paris 75018, France
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Diabetes prevalence is associated with obesity, hypertension, dyslipidemia, and sociodemographic factors in adults living in Casablanca-Settat and Rabat-Sale-Kenitra regions, Morocco. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Body fat patterning and blood pressure levels: a comparative study between the Rai and the Lepcha in Sikkim. ANTHROPOLOGICAL REVIEW 2021. [DOI: 10.2478/anre-2021-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
We compared the perception of two ethnic groups in relation to health, obesity and blood pressure problems and its management, and to compare the body fat patterning and blood pressure levels between Rai and Lepcha ethnic groups. We chose Rai and Lepcha ethnic groups living in Ranka, a place which is 16 kilometres away from the city of Gangtok, Sikkim. The study involved 160 males (Rai = 80 and Lepcha = 80) of age 25–35 years. The participants were initially interviewed about their perception towards health, obesity and blood pressure problems and its management along with other socio-demographic and lifestyle variables. Later, body fat patterning and blood pressure levels of the participants were measured and compared between these two groups. Multiple linear regression analysis was performed to understand the association of body fat patterning and blood pressure levels with socio-demographic and lifestyle variables. Multivariate analysis of covariance (MANCOVA) was used to examine the relationship of ethnicity with both body fat patterning and blood pressure levels. We found a noticeable difference between Lepcha and Rai ethnic groups in perception towards health and obesity, blood pressure problems and its management. Similarly, a significant difference was observed in body fat patterning and blood pressure levels between Rai and Lepcha participants. MANCOVA revealed that the measures of body fat pattering and blood pressure levels differed significantly between these two ethnic groups, after controlling for lifestyle variables and age of the participants at time of interview. We concluded that there remains ethnic diversity, embedded in cultural behaviours and practices concerning health and obesity, hypertension and associated lifestyle patterns. Such practices, rooted in the belief system of an ethnic group is likely to inform the health condition of group members.
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Rahman S, Jan G, Jan FG, Rahim HU. Phytochemical Screening and Antidiabetic, Antihyperlipidemic, and Antioxidant Effects of Leptopus Cordifolius Decne. In Diabetic Mice. Front Pharmacol 2021; 12:643242. [PMID: 33897432 PMCID: PMC8060645 DOI: 10.3389/fphar.2021.643242] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/10/2021] [Indexed: 12/12/2022] Open
Abstract
Plants are well known in traditional herbal medicines for their hypoglycemic and hypolipidemic activities and are often used due to their accessibility, affordability, and corollary effects. Leptopus cordifolius has been reported to control diabetes in folkloric medicine, but no known scientific research has been conducted to assess the plausibility of this assertion. Therefore, the current study is aimed to investigate the antidiabetic and hypolipidemic effects of Leptopus cordifolius leaves in alloxan-induced diabetic mice. The antidiabetic and antihyperlipidemic evaluation was conducted in Swiss albino mice at doses of 150-250°mg/kg for 15°days. The blood glucose, total cholesterol, triglyceride, LDL, HDL, creatinine, ALP, SGPT, and SGOT levels were estimated according to standard procedures. Phytochemicals of leaves were analyzed using GC-MS analysis. Enzymatic antioxidant activity of the plant was investigated spectrophotometrically by carrying out superoxide dismutase, peroxidase, and catalase assays. The membrane stabilization potential of L. cordifolius leaf extracts was carried out using an in vitro haemolytic assay. The results revealed a dose response effect with the methanolic extract of L. cordifolius which had significant antihyperglycemic effects at 150-250°mg/kg in alloxan treated mice, although less than the positive control (glibenclamide). Hyperlipidemic activity was significant at 250 mg/kg. The biochemical parameters, such as total cholesterol, triglyceride, LDL, HDL, creatinine, ALP, SGPT, and SGOT, were significantly improved (p < 0.01) by the methanolic extract of 250 mg/kg compared to the diabetic group. Treatment for 15 days showed significant elevation (p < 0.01) of antioxidant enzymes. GC-MS analysis provided tentative identifications of 52 compounds in the methanolic extract of L. cordifolius, of which 12 compounds have reported antidiabetic activity. In conclusion, methanolic extract of L. cordifolius of 150 and 250°mg/kg body weight showed significant antidiabetic and antihyperlipidemic activities in alloxan-induced diabetic mice and, with further work, has the potential to be used to manage blood glucose and cholesterol levels.
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Affiliation(s)
- Shahid Rahman
- Pharmacology Lab, Department of Botany, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Gul Jan
- Pharmacology Lab, Department of Botany, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Farzana Gul Jan
- Pharmacology Lab, Department of Botany, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Hafeez Ur Rahim
- Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), School of Environmental Science and Technology, Dalian University of Technology, Dalian, China
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Dietary Management of Type 2 Diabetes in the MENA Region: A Review of the Evidence. Nutrients 2021; 13:nu13041060. [PMID: 33805161 PMCID: PMC8064070 DOI: 10.3390/nu13041060] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/21/2021] [Accepted: 03/21/2021] [Indexed: 12/11/2022] Open
Abstract
The alarmingly rising trend of type 2 diabetes constitutes a major global public health challenge particularly in the Middle Eastern and North African (MENA) region where the prevalence is among the highest in the world with a projection to increase by 96% by 2045. The economic boom in the MENA region over the past decades has brought exceptionally rapid shifts in eating habits characterized by divergence from the traditional Mediterranean diet towards a more westernized unhealthy dietary pattern, thought to be leading to the dramatic rises in obesity and non-communicable diseases. Research efforts have brought a greater understanding of the different pathways through which diet and obesity may affect diabetes clinical outcomes, emphasizing the crucial role of dietary interventions and weight loss in the prevention and management of diabetes. The purpose of this review is to explore the mechanistic pathways linking obesity with diabetes and to summarize the most recent evidence on the association of the intake of different macronutrients and food groups with the risk of type 2 diabetes. We also summarize the most recent evidence on the effectiveness of different macronutrient manipulations in the prevention and management of diabetes while highlighting the possible underlying mechanisms of action and latest evidence-based recommendations. We finally discuss the need to adequately integrate dietetic services in diabetes care specific to the MENA region and conclude with recommendations to improve dietetic care for diabetes in the region.
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Dankoly US, Vissers D, El Farkouch Z, Kolasa E, Ziyyat A, Rompaey BV, Maamri A. Perceived Barriers, Benefits, Facilitators, and Attitudes of Health Professionals Towards Multidisciplinary Team Care in Type 2 Diabetes Management: A Systematic Review. Curr Diabetes Rev 2021; 17:e111020187812. [PMID: 33176659 DOI: 10.2174/1573399816999201110200126] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/01/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The need for a multidisciplinary team approach to provide physical exercise, diet, behavioral change, and insulin therapy in type 2 diabetes mellitus (T2DM) treatment has long been recognized. However, often patients with T2DM do not have access to a multidisciplinary team. INTRODUCTION In developing countries, most patients with T2DM receive their diabetes care in the office of an internist or family practice physician or in a primary level health center with a general practitioner. Knowledge of healthcare professionals regarding the perceived barriers, attitudes, facilitators, and benefits of a multidisciplinary team approach in T2DM treatment can help facilitate the implementation of multidisciplinary care in T2DM. METHODS A systematic search strategy was performed in six databases (PubMed, Web of Science, CINAHL, EMBASE, MEDLINE, and Cochrane) using different keyword combinations to identify studies describing the healthcare professionals' views of multidisciplinary team care in T2DM. A textual narrative synthesis was used to analyze data. The Critical Appraisals Skills Programme (CASP) tool for qualitative studies was used to assess the risk of bias and transferability. RESULTS The views of health professionals about multidisciplinary team care in T2DM were categorized into six major factors, namely working collaboratively to foster supportive relationships; strong committed organizational and team leadership; diversity in expertise, with team members tailored to local circumstances; shared goals and approaches to ensure consistency of message; clear and open communication with the team and with patients; and the patient at the center of decision- making. CONCLUSION There is a huge gap in shared roles among health professionals in T2DM therapy. Hence, there is a need for allied health professionals such as physiotherapists, dieticians, and psychologists with expertise in diabetes to explore primary healthcare, barriers and facilitators to the successful integration of multidisciplinary team, seamlessly distributedinto three hierarchal levels, namely health management, health professionals, and diabetic patients.
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Affiliation(s)
- Usman Sani Dankoly
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Zainab El Farkouch
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Esther Kolasa
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Abderrahim Ziyyat
- Department of Biology, Faculty of Sciences, University Mohammed Premier, Oujda, Morocco
| | - Bart Van Rompaey
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Abdellatif Maamri
- Department of Biology, Faculty of Sciences, University Mohammed Premier, Oujda, Morocco
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Shahwan M, Hassan N, Shaheen RA, Gaili A, Jairoun AA, Shahwan M, Najjar O, Jamshed S. Diabetes Mellitus and Renal Function: Current Medical Research and Opinion. Curr Diabetes Rev 2021; 17:e011121190176. [PMID: 33430750 DOI: 10.2174/1573399817999210111205532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/22/2022]
Abstract
Diabetes mellitus (DM), which is defined as high blood glucose level, is a major public health issue worldwide. An enormous amount of data has been gathered regarding DM as populations have been living with it for more than a decade; however, continually updating our knowledge of DM remains important. Comorbidities are among the major challenges associated with DM. Poorly controlled DM, especially type 2 DM (T2DM), is considered a risk factor for many diseases, including but not limited to chronic kidney disease (CKD). Complications might appear over time as the aging process changes body functions; moreover, a significant number of antidiabetic medications are eventually cleared by the kidneys, thereby increasing the burden on kidney function and placing diabetic patients at risk. The significantly high number of patients with uncontrolled diabetes resulting from kidney disease shows the impact of this condition on the quality of life of patients. This review presents an overview of the pathophysiology, etiology, and prevalence of CKD and abnormal renal parameters correlated with poorly controlled T2DM, with an emphasis on clinical studies involving the association between vitamin D insufficiency/deficiency and CKD among patients with T2DM.
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Affiliation(s)
- Moyad Shahwan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Nageeb Hassan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Rima Ahd Shaheen
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Ahmed Gaili
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | | | - Monzer Shahwan
- Diabetes Clinic, Al-Swity Center for Dermatology and Chronic Diseases, Palestinian Territory, Occupied
| | - Osama Najjar
- General Directorate of Allied Health Professions, Ministry of Health, Palestinian Territory, Occupied
| | - Shazia Jamshed
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA) Besut Campus, Kuala terraenganu, Malaysia
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13
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Zalan A, Sheikh-Muhammad A, Khatib M, Sharkia R. The Current and Forecasted Status of Type 2 Diabetes in the Arab Society of Israel. Curr Diabetes Rev 2021; 17:e050421192659. [PMID: 33820521 DOI: 10.2174/1573399817666210405100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/20/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is considered one of the main causes of mortality, morbidity, and health care expenditures. Effectively treating this disease is of crucial importance and imposes a global challenge. The incidence of Type 2 DM (T2DM) is rapidly rising in both developing and developed countries. The Arab community in Israel is a distinct ethnic group with unique characteristics. Recently, this community has undergone major changes in its lifestyle, adopting the Westernized one, which could have caused an increase in the T2DM incidence rate. OBJECTIVE This review aims to shed light on various studies undertaken to explore the prevalence of diabetes and determine its current status in the Arab society of Israel, resting on previous and current data. It is presented to highlight the status of diabetes globally and to focus on its current situation in the Arab society of Israel, attempting to forecast its direction in the upcoming decade. METHODS Data were obtained from our previous comprehensive socio-economic and health crosssectional surveys for successive periods from 2004 to 2017. These surveys were conducted on the Arab society of Israel by the Galilee Society. RESULTS Our results showed a progressive increase in the prevalence of T2DM from 3.4% to 7.6% in the Arab society of Israel. This trend is expected to continue rising in the coming decade, and based on our predictions, may exceed 12% in 2030. CONCLUSION Substantial and practical health-related actions must be initiated to prevent an increasing number of adults from developing diabetes and its complications.
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Affiliation(s)
- Abdelnaser Zalan
- Unit of Human Biology and Genetics, The Triangle Regional Research and Development Center, Kfar-Qari, Israel
| | - Ahmad Sheikh-Muhammad
- The Galilee Society - The Arab National Society for Research and Health Services, Shefa-Amr, Israel
| | - Mohammad Khatib
- The Galilee Society - The Arab National Society for Research and Health Services, Shefa-Amr, Israel
| | - Rajech Sharkia
- Unit of Human Biology and Genetics, The Triangle Regional Research and Development Center, Kfar-Qari, Israel
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14
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Agbaria N, Nubani-Husseini M, Barakat RA, Leiter E, Greenberg KL, Karjawally M, Keidar O, Donchin M, Zwas DR. Two-Phase Evaluation of a Community-Based Lifestyle Intervention for Palestinian Women in East Jerusalem: A Quasi-Experimental Study Followed by Dissemination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9184. [PMID: 33316905 PMCID: PMC7763328 DOI: 10.3390/ijerph17249184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 01/06/2023]
Abstract
Palestinian-Arab women are at increased risk of cardiovascular disease due to high prevalence of diabetes and other risk factors. The current study investigates the effectiveness of an intensive group-based intervention on lifestyle habits that can prevent diabetes and cardiovascular disease. To that end, we conducted a group-based intervention based on the diabetes prevention program in two consecutive phases. The first phase consisted of a quasi-experimental study and the second phase included community-wide dissemination, with a 6-month follow-up. Findings from the quasi-experiment indicate increased consumption of fruit, vegetables and whole grains, weight reduction (-2.21 kg, p < 0.01), and a significant increase in the average daily steps in the intervention group (from 4456 to 6404). Findings from the dissemination indicate that average daily vegetables consumption increased from 1.76 to 2.32/day as did physical activity and average daily steps (from 4804 to 5827). There was a significant reduction in blood pressure, total cholesterol and LDL. These gains were sustained over 6 months following the intervention. This community-based, culturally adapted, health-promotion intervention led to improved nutrition and physical activity which were maintained after 6 months. Collaboration with community centers and local community partners created an effective channel for dissemination of the program to pre-clinical individuals.
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Affiliation(s)
- Nisreen Agbaria
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Maha Nubani-Husseini
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Raghda A. Barakat
- The Nutrition Division, The Israeli Ministry of Health, Jerusalem 91011002, Israel;
| | - Elisheva Leiter
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Keren L. Greenberg
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Mayada Karjawally
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
| | - Osnat Keidar
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem-Hadassah, Jerusalem 91120, Israel; (O.K.); (M.D.)
| | - Milka Donchin
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem-Hadassah, Jerusalem 91120, Israel; (O.K.); (M.D.)
| | - Donna R. Zwas
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 91120, Israel; (M.N.-H.); (E.L.); (K.L.G.); (M.K.); (D.R.Z.)
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15
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Abdullah A, Alkandari A, Longenecker JC, Devarajan S, Alkhatib A, Al-Wotayan R, Al-Duwairi Q, Tuomilehto J. Glycemic control in Kuwaiti diabetes patients treated with glucose-lowering medication. Prim Care Diabetes 2020; 14:311-316. [PMID: 31911041 DOI: 10.1016/j.pcd.2019.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/24/2019] [Accepted: 12/12/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Diabetes is prevalent in Kuwait. We aimed to assess the level of glycemic control in Kuwaiti adults with diabetes. METHODS The World Health Organization's STEPS non-communicable disease risk factor survey was conducted in Kuwait in 2014. Participants' demographics, medical history, physical measurements and blood biochemistry were assessed. A total of 2561 Kuwaiti men and women aged 18-69 years completed all three survey steps. Glycemic control in 278 individuals with diabetes who were on glucose-lowering medication was determined using the US National Institutes of Health guidelines of fasting plasma glucose (FPG) ≤7.2mmol/l and the American Diabetes Association guidelines of glycated hemoglobin (HbA1c) <7% (53mmol/mol). RESULTS Adequate glycemic control in people with drug-treated diabetes was 34.5% when determined by HbA1c, 37.8% when determined by FPG level, and 24.5% when both criteria were met. Mean body-mass index and fasting serum triglycerides were significantly higher and serum high-density lipoprotein-cholesterol significantly lower in individuals with an inadequate glycemic control than in those with adequate control. Women with diabetes were almost twice as likely to have inadequate HbA1c levels as men with diabetes (OR, 1.9, [95% CI, 1.03, 3.5]). CONCLUSIONS Glycemic control in Kuwaiti adults with treated diabetes is low. A systemic, multi-disciplinary public health approach is needed to improve diabetes education and adherence to treatment.
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Affiliation(s)
| | | | | | | | - Ahmad Alkhatib
- Dasman Diabetes Institute, Kuwait City, Kuwait; School of Health and Life Sciences, Teesside University, United Kingdom
| | | | | | - Jaakko Tuomilehto
- Dasman Diabetes Institute, Kuwait City, Kuwait; Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.
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16
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Radwan H, Hasan H, Hamadeh R, Hashim M, AbdulWahid Z, Hassanzadeh Gerashi M, Al Hilali M, Naja F. Complementary and alternative medicine use among patients with type 2 diabetes living in the United Arab Emirates. BMC Complement Med Ther 2020; 20:216. [PMID: 32650773 PMCID: PMC7350641 DOI: 10.1186/s12906-020-03011-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of Complementary and Alternative Medicine (CAM) among Type 2 Diabetes Mellitus (T2DM) patients is increasing to manage the complexities of their condition, enhance their health, and ease complications. The burden of T2DM in the United Arab Emirates (UAE) coupled with the high prevalence of CAM use and its associated risks among patients with T2DM necessitated the investigation of the use of CAM by this patients' population. The aim of this study is to examine the prevalence, types, and correlates of CAM use among T2DM patients in the UAE. METHODS Patients with T2DM attending the outpatient clinics in the two governmental hospitals in Dubai and Sharjah, UAE were invited to participate in a cross-sectional survey. Face-to-face interviews were conducted with participants to complete a multi-component questionnaire. The questionnaire comprised of three main sections: demographic data, diabetes-related information, and CAM use details. Data analysis employed descriptive statistics, univariate and multivariate logistic regression to assess the prevalence and correlates of CAM use. RESULTS Two hundred forty-four T2DM patients completed the questionnaire (response rate: 80%). A total of 39.3% of participants were CAM users since diagnosis. After adjustment; the logistic regression results showed that CAM use was significantly associated with age, sex, education, employment, and having health insurance. The most commonly used type of CAM by participants were folk foods and herbs followed by spiritual and natural healing and vitamins and minerals supplements. The majority of CAM users were referred or encouraged to use CAM by family (42.7%), friends (25%) or social media (17.7%). Only 13.5% of participants used CAM because it was suggested by health care practitioners. Only 1 in four of CAM users disclosed CAM use to their treating physician. CONCLUSION CAM use among T2DM patients in the UAE is considerably high. Health policy and decision-makers are encouraged to dedicate particular attention to facilitating proper regulation and integration of CAM within conventional medicine to protect the health and wellbeing of patients. A concerted effort by medical schools and public health authorities should be committed to educating health care providers and patients on the safe and effective use of CAM therapies.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Rena Hamadeh
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Zeenat AbdulWahid
- Endocrinology and Diabetes Department, Al Qassimi Hospital-Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Mahboobeh Hassanzadeh Gerashi
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Marwa Al Hilali
- Clinical Nutrition Department, Al Qassimi Hospital-Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates. .,Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon.
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17
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Kader F, Ghai M, Zhou M. Ethnicity, age and disease-associated variation in body fluid-specific CpG sites in a diverse South African cohort. Forensic Sci Int 2020; 314:110372. [PMID: 32623090 DOI: 10.1016/j.forsciint.2020.110372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/12/2020] [Accepted: 06/14/2020] [Indexed: 12/11/2022]
Abstract
Tissue-specific differential DNA methylation has been an attractive target for the development of markers for discrimination of body fluids found at crime scenes. Though mostly stable, DNA methylation patterns have been shown to vary between different ethnic groups, in different age groups as well as between healthy and diseased individuals. To the best of our knowledge, none of the markers for body fluid identification have been applied to different ethnic groups to ascertain if variability exists. In the present study, saliva and blood were collected to determine the effects of ethnicity (Blacks, Whites, Coloureds and Indians), age (20-30 years, 40-50years and above 60 years) and diabetes on methylation profiles of potential saliva- and blood-specific DMSs. Both DMSs were previously shown to exhibit hypermethylation in their target body fluids at single CpG sites, however in the present study, additional CpG sites flanking the reported sites were also screened. Bisulfite sequencing revealed that Coloureds showed highest methylation levels for both body fluids, and blacks displayed significant differences between other ethnic groups in the blood-specific CpG sites. A decline in methylation for both potential DMRs was observed with increasing age. Heavily methylated CpG sites in different ethnic groups and previously reported DMSs displayed hypomethylation with increasing age and disease status. Diabetic status did not show any significant difference in methylation when compared to healthy counterparts. Thus, the use of methylation markers for forensics needs thorough investigation of influence of external factors and ideally, several CpG sites should be co-analysed instead of a single DMS.
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Affiliation(s)
- Farzeen Kader
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
| | - Meenu Ghai
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
| | - Marvellous Zhou
- South African Sugarcane Research Institute, Mount Edgecombe, Durban, South Africa; University of KwaZulu-Natal, Scottsville, Pietermaritzburg, South Africa.
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18
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Mujammami MH, Alodhayani AA, AlJabri MI, Alanazi AA, Alanazi SS, Alanazi AG, Ekhzaimy AA. Knowledge, awareness and perceptions of diabetes mellitus among the Saudi population. J Comp Eff Res 2020; 9:413-422. [PMID: 32253916 DOI: 10.2217/cer-2019-0137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: High prevalence of undiagnosed cases of diabetes mellitus (DM) has increased over the last two decades, most patients with DM only become aware of their condition once they develop a complication. Limited data are available regarding the knowledge and awareness about DM and the associated risk factors, complications and management in Saudi society. Aim: This study aimed to assess knowledge of DM in general Saudi society and among Saudi healthcare workers. Results: Only 37.3% of the participants were aware of the current DM prevalence. Obesity was the most frequently identified risk factor for DM. Most comparisons indicated better awareness among health workers. Conclusion: A significant lack of knowledge about DM in Saudi society was identified. Social media and educational curriculum can improve knowledge and awareness of DM.
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Affiliation(s)
- Muhammad H Mujammami
- Endocrinology & Diabetes Unit, Department of Medicine, King Khalid University Hospital & College of Medicine, King Saud University, Riyadh, Saudi Arabia.,University Diabetes Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia.,Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Alodhayani
- Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | - Aishah Ali Ekhzaimy
- Endocrinology & Diabetes Unit, Department of Medicine, King Khalid University Hospital & College of Medicine, King Saud University, Riyadh, Saudi Arabia
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19
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Bardus M, Awada N, Ghandour LA, Fares EJ, Gherbal T, Al-Zanati T, Stoyanov SR. The Arabic Version of the Mobile App Rating Scale: Development and Validation Study. JMIR Mhealth Uhealth 2020; 8:e16956. [PMID: 32130183 PMCID: PMC7078658 DOI: 10.2196/16956] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 12/22/2022] Open
Abstract
Background With thousands of health apps in app stores globally, it is crucial to systemically and thoroughly evaluate the quality of these apps due to their potential influence on health decisions and outcomes. The Mobile App Rating Scale (MARS) is the only currently available tool that provides a comprehensive, multidimensional evaluation of app quality, which has been used to compare medical apps from American and European app stores in various areas, available in English, Italian, Spanish, and German. However, this tool is not available in Arabic. Objective This study aimed to translate and adapt MARS to Arabic and validate the tool with a sample of health apps aimed at managing or preventing obesity and associated disorders. Methods We followed a well-established and defined “universalist” process of cross-cultural adaptation using a mixed methods approach. Early translations of the tool, accompanied by confirmation of the contents by two rounds of separate discussions, were included and culminated in a final version, which was then back-translated into English. Two trained researchers piloted the MARS in Arabic (MARS-Ar) with a sample of 10 weight management apps obtained from Google Play and the App Store. Interrater reliability was established using intraclass correlation coefficients (ICCs). After reliability was ascertained, the two researchers independently evaluated a set of additional 56 apps. Results MARS-Ar was highly aligned with the original English version. The ICCs for MARS-Ar (0.836, 95% CI 0.817-0.853) and MARS English (0.838, 95% CI 0.819-0.855) were good. The MARS-Ar subscales were highly correlated with the original counterparts (P<.001). The lowest correlation was observed in the area of usability (r=0.685), followed by aesthetics (r=0.827), information quality (r=0.854), engagement (r=0.894), and total app quality (r=0.897). Subjective quality was also highly correlated (r=0.820). Conclusions MARS-Ar is a valid instrument to assess app quality among trained Arabic-speaking users of health and fitness apps. Researchers and public health professionals in the Arab world can use the overall MARS score and its subscales to reliably evaluate the quality of weight management apps. Further research is necessary to test the MARS-Ar on apps addressing various health issues, such as attention or anxiety prevention, or sexual and reproductive health.
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Affiliation(s)
- Marco Bardus
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nathalie Awada
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elie-Jacques Fares
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Tarek Gherbal
- University Sports, Office of Student Affairs, American University of Beirut, Beirut, Lebanon
| | | | - Stoyan R Stoyanov
- School of Design, Creative Industries Faculty, Queensland University of Technology, Brisbane, Australia
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20
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Wani K, Alfawaz H, Alnaami AM, Sabico S, Khattak MNK, Al-Attas O, Alokail MS, Alharbi M, Chrousos G, Kumar S, Al-Daghri NM. Effects of A 12-Month Intensive Lifestyle Monitoring Program in Predominantly Overweight/Obese Arab Adults with Prediabetes. Nutrients 2020; 12:nu12020464. [PMID: 32059477 PMCID: PMC7071332 DOI: 10.3390/nu12020464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/05/2020] [Accepted: 02/10/2020] [Indexed: 01/04/2023] Open
Abstract
This 12-month, randomized, controlled lifestyle intervention study was aimed at assessing the effectiveness of a lifestyle intervention in terms of (1) the reduction of at least 5% of body weight compared to baseline and (2) the percentage of participants in which fasting blood glucose (FBG) normalizes (<5.6 mmol/L) post-intervention, in predominantly overweight/obese Saudi adults with impaired fasting glucose. A total of 300 Saudi adults with prediabetes at baseline (FBG 5.6–6.9 mmol/L) were enrolled to receive either general advice (GA) or a rigorous, self-monitored, lifestyle modification program (intervention group, IG) for 12 months, focused on food choices, physical activity, and weight loss. Anthropometric and biochemical estimations were analyzed at baseline, 6, and 12 months. At baseline, 136/150 in the GA group (90.7%) and 127/150 in the IG group (84.7%) were either overweight or obese. A total of 14% (n = 21) of the subjects in the IG arm discontinued, compared to 8% (n = 12) in the GA arm. Data from completers (92% (n = 138) and 86% (n= 129) participants in GA and IG arms, respectively) were considered for the final analysis. Post-intervention, 37.2% (n = 48) of participants in the IG group had ≥5% weight reduction, as compared to 12.3% (n = 17) in the GA group (p < 0.01). Similarly, the percentage of participants who normalized their FBG post-intervention was 46.5% (n = 60) in the IG group compared to 21.7% (n = 30) in the GA group (p < 0.01). A 12-month Diabetes Prevention Program (DPP)-styled intensive lifestyle program translated effectively in decreasing weight and improving fasting glucose compared to the GA group in predominantly overweight/obese Saudi adults with prediabetes, suggesting that in the case of guided intervention programs, people are willing to participate and possibly change a sedentary lifestyle.
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Affiliation(s)
- Kaiser Wani
- Biochemistry Department, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.); (S.S.); (M.N.K.K.); (O.A.-A.); (M.S.A.)
| | - Hanan Alfawaz
- Department of Food Science and Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Abdullah M. Alnaami
- Biochemistry Department, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.); (S.S.); (M.N.K.K.); (O.A.-A.); (M.S.A.)
| | - Shaun Sabico
- Biochemistry Department, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.); (S.S.); (M.N.K.K.); (O.A.-A.); (M.S.A.)
| | - Malak Nawaz Khan Khattak
- Biochemistry Department, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.); (S.S.); (M.N.K.K.); (O.A.-A.); (M.S.A.)
| | - Omar Al-Attas
- Biochemistry Department, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.); (S.S.); (M.N.K.K.); (O.A.-A.); (M.S.A.)
| | - Majed S. Alokail
- Biochemistry Department, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.); (S.S.); (M.N.K.K.); (O.A.-A.); (M.S.A.)
| | - Mohammed Alharbi
- Diabetes Centres and Units Administration, Ministry of Health, Riyadh 11176, Saudi Arabia;
| | - George Chrousos
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Sudhesh Kumar
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7HL, UK;
| | - Nasser M. Al-Daghri
- Biochemistry Department, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (A.M.A.); (S.S.); (M.N.K.K.); (O.A.-A.); (M.S.A.)
- Correspondence: ; Tel.: +966-1467-5939; Fax: +966-1467-5931
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Al Arawi WA, Al Shaman US, Albalawi WAM, Siddhachettiar PA, El-kannishy SMH, Bagalagel A, Diri R, Aljabri A, Hamdan AM. Association of Demographic Variables with the Awareness of Type 2 Diabetes Mellitus Patients (T2DM) among the Northwest Population in Saudi Arabia. J Diabetes Res 2020; 2020:9408316. [PMID: 32733971 PMCID: PMC7372291 DOI: 10.1155/2020/9408316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/11/2020] [Accepted: 06/27/2020] [Indexed: 11/17/2022] Open
Abstract
The chronic hyperglycemia in diabetes is associated with long-term damage, dysfunction, and failure of different organs. Lack of patient education and knowledge about these complications can worsen the quality of a patient's life. Hence, more efforts are needed to improve patient's education especially in rural areas. Aim. Our objective is to explore the association between demographic variables and the knowledge of self-care practices in type 2 diabetes mellitus. Methods. We used observational cross-sectional descriptive study using a validated self-administered questionnaire in both Arabic and English languages as well. A descriptive correlation design analyzed the questionnaire completed by a convenience sample meeting the inclusion criteria. Results. A total of 100 patients met the inclusion criteria for the analysis out of 3251 patients who completed the questionnaire. The study population has low moderate knowledge in diabetes, moderate knowledge in self-care practices, and good knowledge about complications of nephropathy and cardiovascular disease. No significant association between demographic variables. However, better knowledge observed in male (p = 0.028) and self-care practices with female (p = 0.020). Further, educational status is significantly influencing the knowledge of diabetic patients. Conclusion. The study emphasizing irrespective of demographic variable and the importance of patient education to achieve well glycemic control.
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Affiliation(s)
- Wael Ahmed Al Arawi
- Department of Quality Assurance, Tabuk Pharmaceutical Manufacturing Company, Almadina Road, Tabuk, Saudi Arabia
| | - Udai Salamh Al Shaman
- Department of Quality Assurance, Tabuk Pharmaceutical Manufacturing Company, Almadina Road, Tabuk, Saudi Arabia
| | | | | | - Sherif M. H. El-kannishy
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Tabuk, Saudi Arabia
- Department of Toxicology, Emergency Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Alaa Bagalagel
- Department of Pharmacy Practice, Faculty of Pharmacy, Kind Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem Diri
- Department of Pharmacy Practice, Faculty of Pharmacy, Kind Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Aljabri
- Department of Pharmacy Practice, Faculty of Pharmacy, Kind Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Mohsen Hamdan
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
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The Prevalence and Risk Factors of Type 2 Diabetes Mellitus (DMT2) in a Semi-Urban Saudi Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010007. [PMID: 31861311 PMCID: PMC6981763 DOI: 10.3390/ijerph17010007] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/26/2019] [Accepted: 12/03/2019] [Indexed: 12/13/2022]
Abstract
(1) Background: Diabetes mellitus is a common health problem in Saudi Arabia, causing a huge burden for individuals, families, and communities. The objectives of the current study were to determine the prevalence and risk factors of type 2 diabetes mellitus among a semi-urban population of Saudi Arabia. (2) Research methods: The research design was cross-sectional, and the research was conducted in five primary health care centers (PHCC) in Majmaah, Saudi Arabia. The sample size was calculated as 353. A pre-tested questionnaire was used to collect data after obtaining ethical approval. Blood samples were taken to assess glucose levels and other variables. SPSS version 21 was used to analyze data. (3) Results: The prevalence of type 2 diabetes mellitus was 34.6%. The disease was more prevalent among the older respondents compared with the younger age groups (44.6% versus 15.6%). We found that females acquire the disease at a slightly higher rate than males (34.9% versus 34.2%), but this difference is not statistically significant. The sociodemographic risk factors of the disease were as follows: old age (44%), business and private occupation (38.5%), divorced or widowed (56.3%), and low income (42.4%). The health behaviors factors were as follows: overweight or obese status (42.3%), high triglycerides (TG) (43.4%), low high-density lipoprotein (HDL) (37.3%), and high total cholesterol (23.7%). There was a statistically significant difference in these risk factors between patients with and without diabetes. (4) Conclusion: The prevalence of type 2 diabetes mellitus among the semi-urban population of Saudi Arabia is high. The disease is more prevalent among elderly respondents and is associated with obesity, high TG, low HDL, and high total cholesterol.
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Alzeidan R, Shata Z, Hassounah MM, Baghdadi LR, Hersi A, Fayed A, Kashour T, Elmorshedy H. Effectiveness of digital health using the transtheoretical model to prevent or delay type 2 diabetes in impaired glucose tolerance patients: protocol for a randomized control trial. BMC Public Health 2019; 19:1550. [PMID: 31752774 PMCID: PMC6873582 DOI: 10.1186/s12889-019-7921-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/08/2019] [Indexed: 01/22/2023] Open
Abstract
Background There is high prevalence of prediabetes and type 2 diabetes mellitus (T2DM) in Saudi Arabia that is still increasing. Early diagnosis of prediabetes, and immediate, effective intervention is yet unestablished. Conventional health promotion approaches are used to educate prediabetic patients. Behavior modification is very effective in prediabetics to delay T2DM. Thus, the main objective of this study is to examine the effect of the new behavioral model, the Transtheoretical Model short messages (text 4 change) to modify lifestyle to prevent or delay the onset of T2DM, through promotion of a healthy diet and increased physical activity, in impaired glucose tolerance patients. Another objective is to estimate the impact of this model on markers of cardiovascular and metabolic risks as T2DM is one of the modifiable risk factors to prevent cardiovascular diseases. Methods This is a randomized controlled trial. One thousand and sixteen, eligible Saudi adults will be recruited from the Heart Health Promotion study (HHP), which was conducted at the King Saud University from July 2013 to April 2014. These adults were at a higher risk of developing T2DM within 2–3 years. The research team’s database has a contact list and they will recruit individuals over 6–8 weeks. All participants will be randomized at a 1:1 ratio into two groups, receive group education about lifestyle modifications and written information about diet and physical activity. Text 4 change SMS texts will be sent only to the intervention group. All participants will be assessed at baseline, 6, 12, 18, 24, 30, and 36 months for behavioral change using a World Health Organization (WHO) STEPS questionnaire and for glycated hemoglobin, biochemical and anthropometric measurements using standard methods. Discussion This new approach for promoting the importance of behavior modification in prediabetics is expected to delay and/or prevent the development of T2DM in Saudi Arabia, subsequently reducing the risk of cardiovascular morbidity and mortality too. Results from this study will promote an innovative and high-tech way to decrease the burden of cardiovascular diseases in Saudi Arabia. Trial registration International Standard Randomized Control Trial, registration number ISRCTN10857643. Registered 4 June, 2018.
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Affiliation(s)
- Rasmieh Alzeidan
- Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Zeinab Shata
- High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Marwah Mazen Hassounah
- Community Medicine Unit, Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Leena Rashad Baghdadi
- Department of Family and Community Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - Ahmad Hersi
- Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amel Fayed
- High Institute of Public Health, Alexandria University, Alexandria, Egypt.,Princess Nourah Bint Abdulrahman University, College of Medicine, Riyadh, Saudi Arabia
| | - Tarek Kashour
- Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hala Elmorshedy
- High Institute of Public Health, Alexandria University, Alexandria, Egypt.,Princess Nourah Bint Abdulrahman University, College of Medicine, Riyadh, Saudi Arabia
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Alzubaidi HT, Chandir S, Hasan S, McNamara K, Cox R, Krass I. Diabetes and cardiovascular disease risk screening model in community pharmacies in a developing primary healthcare system: a feasibility study. BMJ Open 2019; 9:e031246. [PMID: 31712336 PMCID: PMC6858145 DOI: 10.1136/bmjopen-2019-031246] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aimed to develop an evidence-based community pharmacist-delivered screening model for diabetes and cardiovascular disease (CVD), and assess its feasibility to identify and refer patients with elevated risk. DESIGN A feasibility study. SETTING A purposive sample of 12 community pharmacies in three cities in the United Arab Emirates (UAE). PARTICIPANTS Adults 40 years of age and above who have not been previously diagnosed with either diabetes or CVD. INTERVENTION Pharmacist screening of adults visiting pharmacies involved history, demographics, anthropometric measurements, blood pressure and point-of-care testing including glycated haemoglobin (HbA1c) levels and lipid panel. Participants with a 10-year CVD risk ≥7.5%, HbA1c level ≥5.7% or American Diabetes Association (ADA) risk score ≥5 points were advised to visit their physician. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes were (1) development of UAE pharmacist-delivered screening model, (2) the proportion of screened participants identified as having high CVD risk (atherosclerotic CVD 10-year risk defined as ≥7.5%) and (3) the proportion of participants identified as having elevated blood glucose (high HbA1c level ≥5.7% (38.8 mmol/mol)) or high self-reported diabetes risk (ADA risk score ≥5 points). Secondary outcome is participants' satisfaction with the screening. RESULTS The first UAE pharmacist-delivered screening model was developed and implemented. A total of 115 participants were screened, and 92.3% of the entire screening process was completed during a single visit to pharmacy. The mean duration of the complete screening process was 27 min. At-risk individuals (57.4%) were referred to their physicians for further testing, while 94.5% of participants were at least satisfied with their screening experience. CONCLUSIONS The community pharmacist-delivered screening of diabetes and CVD risk is feasible in the UAE. The model offers a platform to increase screening capacity within primary care and provides an opportunity for early detection and treatment. However, pathways for the integration of the pharmacist-delivered screening service with physicians in primary care are yet to be explored.
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Affiliation(s)
- Hamzah Tareq Alzubaidi
- Pharmacy Practice & Pharmacotherapy, University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
| | - Subhash Chandir
- Center for Global Health Delivery-Dubai, Harvard Medical School, Dubai, United Arab Emirates
| | - Sanah Hasan
- Ajman University of Science and Technology College of Pharmacy and Health Science, Ajman, United Arab Emirates
| | - Kevin McNamara
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Institute for Healthcare Transformation, Deakin University, Geelong, Victoria, Australia
| | - Rachele Cox
- Center for Global Health Delivery-Dubai, Harvard Medical School, Dubai, United Arab Emirates
| | - Ines Krass
- Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
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Epidemiology of Alzheimer's Disease and Dementia in Arab Countries: A Systematic Review. Behav Neurol 2019; 2019:3935943. [PMID: 31772681 PMCID: PMC6854962 DOI: 10.1155/2019/3935943] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 05/25/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022] Open
Abstract
Background/Objectives Contrary to popular belief, the condition of dementia is not an actual discrete disease, but rather a group of symptoms, most notable of which is the disturbance of memory and social ability, often severe enough to impair daily functioning. As a result, it has been a major cause of functional deterioration among varying populations in the world. This study is aimed at reviewing the epidemiology of dementia in Arab countries in terms of its prevalence, distribution, and risk factors. Methods A systematic literature review was conducted using articles published in PubMed, Embase, Scopus, and other local journals between 1990 and 2018. After applying the inclusion and exclusion criteria, a total of 18 studies were concluded to be eligible for the review. Results Prevalence studies demonstrated that dementia is indeed a prevalent condition in Arab countries, ranging between 1.1% and 2.3% among age groups of 50 years and older, as well as between 13.5% and 18.5% among age groups of 80 years and above. However, these results are not different from those of many other countries in the world. Moreover, prevalence was found to vary depending on sociodemographic characteristics. Major risk factors of dementia included hypertension, low income, and low education, while the risk of developing dementia is increased by obesity, diabetes mellitus, and cardiovascular risk factors. Despite the growing evidence regarding the epidemiological distribution and determinants of dementia worldwide, studies from the Arab region remain scarce. Conclusion This systematic review highlights the need for population-based studies to provide necessary information for developing preventive and curative strategies specific to the Arab region.
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26
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Al-Aama J, Mahdi HBA, Salama MA, Bakur K, Alhozali A, Mosli H, Bahijri SM, Bahieldin A, Elango R, Willmitzer L, Edris S. Rapid detection of type II diabetes mellitus in Saudi patients via simultaneous screening of multiple SNPs. BIOTECHNOL BIOTEC EQ 2019. [DOI: 10.1080/13102818.2019.1664321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Jumana Al-Aama
- Princess Al Jawhara Albrahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hadiah B. Al Mahdi
- Princess Al Jawhara Albrahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed A. Salama
- Princess Al Jawhara Albrahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khadija Bakur
- Princess Al Jawhara Albrahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amani Alhozali
- Department of Endocrinology and Metabolism, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hala Mosli
- Department of Endocrinology and Metabolism, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Suhad M. Bahijri
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Bahieldin
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Genetics, Faculty of Agriculture, Ain Shams University, Cairo, Egypt
| | - Ramu Elango
- Princess Al Jawhara Albrahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lothar Willmitzer
- Molecular Physiology, Max-Planck-Institut Für Molekulare Pflanzenphysiologie, Potsdam, Germany
| | - Sherif Edris
- Princess Al Jawhara Albrahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Genetics, Faculty of Agriculture, Ain Shams University, Cairo, Egypt
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27
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Papandreou D, Magriplis E, Abboud M, Taha Z, Karavolia E, Karavolias C, Zampelas A. Consumption of Raw Orange, 100% Fresh Orange Juice, and Nectar- Sweetened Orange Juice-Effects on Blood Glucose and Insulin Levels on Healthy Subjects. Nutrients 2019; 11:nu11092171. [PMID: 31509979 PMCID: PMC6770506 DOI: 10.3390/nu11092171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 12/30/2022] Open
Abstract
Objective: The aim of this study is to investigate the effect of consumption of raw orange (RO), 100% fresh orange juice (FOJ), and nectar-sweetened orange juice (NSOJ) on postprandial glucose and insulin levels in non-diabetic young Emirati women. Research Methods: This is a prospective, three-way, crossover study design. Blood records of thirteen normal weight and seven healthy obese university students were analyzed from Zayed University on three random days with the following three meal samples: 2 ROs, 100% FOJ, and NSOJ. Venous blood was collected at 0, 30, 60, 90, and 120 minutes after the respective meal consumption. Statistical analyses included repeated measures analysis of variance and calculations of the area under the glucose and insulin curves (AUC) for each one of the meal samples. Results: Total fasting glucose and insulin levels did not differ by treatment in the normal versus obese group. All three meals had no significant effects on the plasma glucose levels. However, there was a significant change in plasma insulin concentrations at 120 min compared with that at 0 min for RO: −14 (−27.05, −0.90, P < 0.001); 100% FOJ −13.7 (−28.80, 1.44, P < 0.001); and NSOJ: −9.2 (−28.75, 10.30, P < 0.001). Conclusions: This study shows that whole fresh fruit, 100% fruit juice, and sweetened fruit juice did not have a significant effect on the blood glucose levels in non-diabetic Emirati university students. However, a significant decrease in insulin response and HOMA-IR on all three sample meals was observed.
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Affiliation(s)
| | - Emmanouella Magriplis
- Department of Food Science and Human Nutrition, Agriculture University of Athens, 11855 Athens, Greece.
| | - Myriam Abboud
- Department of Health Sciences, CNHS, Zayed University, Abu Dhabi 144534, UAE.
| | - Zainab Taha
- Department of Health Sciences, CNHS, Zayed University, Abu Dhabi 144534, UAE.
| | - Eleftheria Karavolia
- Faculty of Medicine, University of Groningen, 9712KB Groningen, The Netherlands.
| | | | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agriculture University of Athens, 11855 Athens, Greece.
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Abuelmagd W, Osman BB, Håkonsen H, Jenum AK, Toverud EL. Experiences of Kurdish immigrants with the management of type 2 diabetes: a qualitative study from Norway. Scand J Prim Health Care 2019; 37:345-352. [PMID: 31299877 PMCID: PMC6713117 DOI: 10.1080/02813432.2019.1639911] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: To explore the experiences of immigrant Kurdish patients in Oslo, Norway, related to the management of type 2 diabetes mellitus (T2DM). Design: A qualitative study with focus group interviews. Setting: Participants were recruited at meeting places in Oslo through Kurdish networks. Subjects: Eighteen Kurdish immigrants (9 females and 9 males) living in Oslo, aged 40 to 64 years, diagnosed with T2DM participated in a total of five focus groups. Participants had to be proficient in the Norwegian language to be eligible. Main outcome measures: Immigrant Kurdish patients' experiences with being diagnosed with T2DM, their disease management, and need for medical information. Results: Participants stressed that living with T2DM was emotionally challenging, mainly because they were afraid of possible complications of the disease. They claimed to adhere satisfactorily to their medicines and blood glucose measurements. The majority of participants shared that they had made changes to their diet, even though it was difficult. To the contrary, physical activity received only minimal attention. The participants' main source of information was general practitioners and the majority of them were satisfied with the information that they had received about their disease and its management. Conclusion: Kurdish T2DM patients in the present study from Norway reported that they adhered to the medical treatment, even if they were stressed about living with the disease. However, they were more occupied with changing their diet than to be physically active. Therefore, healthcare personnel should try to be aware of lifestyle challenges among their patients. KEY POINTS Eighteen Kurdish patients in Oslo with Type 2 diabetes claimed to be adherent to medication treatment and blood glucose measurement. The participants shared that they had made changes to their diet, even though it was hard. There was generally little attention given to the need for physical activity in their daily lives. The participants were in need of more information and support in making healthy lifestyle changes.
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Affiliation(s)
- Walaa Abuelmagd
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
- CONTACT Walaa Abuelmagd Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Bavi Botan Osman
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
| | - Helle Håkonsen
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Else-Lydia Toverud
- Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway;
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Alomar MJ, Al-Ansari KR, Hassan NA. Comparison of awareness of diabetes mellitus type II with treatment's outcome in term of direct cost in a hospital in Saudi Arabia. World J Diabetes 2019; 10:463-472. [PMID: 31523382 PMCID: PMC6715573 DOI: 10.4239/wjd.v10.i8.463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/08/2015] [Accepted: 07/20/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Saudi Arabia is among the top 10 countries with the highest prevalence of diabetes. Cost of prevention and the indirect cost must be calculated to increase the awareness of society and to emphasize disease prevention and limit further complications. AIM To understand the importance of awareness and the impact on the expenditure of diabetes mellitus and treatments outcomes. METHODS A prospective descriptive and comparative survey was carried out among patients with diabetes mellitus in Saudi Arabia. RESULTS One hundred and one participants were included in the study of which 40% were female and one third were above the age of 50. The mean of the first HbA1c reading was 6.95, and the median was 7. The mean of the second reading of HbA1c was 7.26, and the median was 7. The mean body mass index was 32.1, and the median was 30.9. The average yearly cost of the medication was 995.14 SR. Comparing participants who think that a healthy low-sugar diet can affect blood sugar with those who do not, showed a statistically significant difference when cost was considered (P value = 0.03). Also, when comparing the group of participants who know when to take their oral hyperglycemic medicine and their yearly direct cost and those who do not know when to take it, by using independent sample T test, showed significant statistical difference (P value = 0.046). CONCLUSION It is essential for the governments to invest in ways to prevent and help in the early detection of such an expensive disease by performing national screening and education programs. Many pharmaco-economic studies can be done to help the decision-maker in our hospitals think about strategies to help the patient to be physically fit by offering gymnasium or places to walk or contract.
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Affiliation(s)
- Muaed Jamal Alomar
- Clinical Pharmacy Department, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Khadeja Rashed Al-Ansari
- Clinical Pharmacy Department, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Najeeb A Hassan
- Clinical Pharmacy Department, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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Mairghani M, Elmusharaf K, Patton D, Burns J, Eltahir O, Jassim G, Moore Z. The prevalence and incidence of diabetic foot ulcers among five countries in the Arab world: a systematic review. J Wound Care 2019; 26:S27-S34. [PMID: 28880754 DOI: 10.12968/jowc.2017.26.sup9.s27] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE There is a rising incidence of diabetes worldwide; however there seems to be a higher incidence and prevalence rates in the Arab world when compared with the global average. 1 Out of the top 10 countries with the highest prevalence rates, six are Arab countries and almost 20.5 million people in that part of the world live with diabetes. Despite this, published scientific research from the 22 Arab countries is limited and seems to be of lower quality when compared with the rest of the developed world. 2 Therefore, our aim was to explore the contribution of the different Arab countries in the world literature, to identify the diabetic foot ulcer (DFU) prevalence and incidence rates and to quality appraise these studies. METHOD A systematic review, following PRISMA guidelines, was undertaken to identify the incidence and prevalence of DFUs in the Arab world. The following databases were searched: PubMed, Embase CINAHL, Web of Science (Scopus), Global Health and EBSCO Results: A total of nine papers were identified. The mean prevalence of DFU in Saudi Arabia was 11.85% (4.7-19%), in Egypt was 4.2% (1-7.4%), in Jordan was 4.65% (4-5.3%), in Bahrain was 5.9% and in Iraq was 2.7%. A single study identified DFU incidence in Saudi Arabia as 1.8% between 2009-2010. CONCLUSION The mean prevalence rates of DFU were highest in Saudi Arabia and Bahrain and lowest in Iraq. Saudi Arabia had the only reported incidence study, thus findings could not be compared to other countries of the Arab world. There were no studies identified during our search reporting prevalence rates of DFU in 17 of the 22 Arab countries. It is clear that further research is required to determine the incidence and prevalance of DFUs in the Arab world and that progress is needed in order to improve the quality of research conducted in those countries.
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Affiliation(s)
- M Mairghani
- PhD Scholar, Royal College of Surgeons in Ireland, Dublin.,Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - K Elmusharaf
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - D Patton
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - J Burns
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - O Eltahir
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - G Jassim
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - Z Moore
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
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Abu-Amara TB, Al Rashed WA, Khandekar R, Qabha HM, Alosaimi FM, Alshuwayrikh AA, Almadi MK, Alfaris A. Knowledge, attitude and practice among non-ophthalmic health care providers regarding eye management of diabetics in private sector of Riyadh, Saudi Arabia. BMC Health Serv Res 2019; 19:375. [PMID: 31196189 PMCID: PMC6567513 DOI: 10.1186/s12913-019-4216-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 06/04/2019] [Indexed: 01/12/2023] Open
Abstract
Background The levels of knowledge, attitude and practice among primary physicians concerning both diabetic retinopathy screening and treatment of sight threatening diabetic retinopathy have been studied by different groups, such as medical students, pharmacists, Primary Health Care staff and opticians. In some studies, the levels were very high, while in others it was noted to be less than desired. Aim This study’s intent is to estimate and improve level of Knowledge (K), Attitude (A) and Practice (P) among non-ophthalmic health care providers regarding eye management of diabetes and barriers that people with diabetes face in Saudi Arabia. Methods This cross-sectional survey targeted medical doctors (except ophthalmologists) working at private sector institutions in Riyadh. They were interviewed using closed-ended questions for knowledge (8), attitude (5), practice (5), and reasons for their current KAP status comprised of 8 questions. The level of Knowledge was assessed as good if its score was (> 50%); positive attitude (> 50%) and excellent practice (> 75%) were estimated and associated to the risk factors. Results Out of the 355 participants that were interviewed, the percentages of good knowledge, positive attitude and excellent practice concerning diabetic retinopathy (DR)were 193 [54.3% (95% CI 49.2–59.5)], 111 [31.3% (95% CI 26.4–36.1)], and 145 [40.8% (95% CI 35.7–46.0) participants, respectively. Gender, place of work and type of doctor were not significantly associated with the level of KAP. Salient reasons for low KAP status included a busy schedule (54.6%), less resources (75.2%), inadequate periodic training in eye care (69%), and absence of retinal evaluation training (49.6%). Conclusions Improving KAP level is urgently needed. Addressing underlying causes of low KAP could enhance eye care of people with diabetes. Additionally, training for primary health care providers for early detection of DR and timely management of sight threatening diabetic retinopathy (STDR) is necessary.
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Affiliation(s)
- Talal Bassam Abu-Amara
- Department of Ophthalmology, Imam Mohammad Bin Saud Islamic University, collage of medicine, Riyadh, Saudi Arabia.
| | - Waleed Abdulaziz Al Rashed
- Department of Ophthalmology, Imam Mohammad Bin Saud Islamic University, collage of medicine, Riyadh, Saudi Arabia
| | - Rajiv Khandekar
- Department of Ophthalmology, Imam Mohammad Bin Saud Islamic University, collage of medicine, Riyadh, Saudi Arabia
| | - Hamad Mohammed Qabha
- Department of Ophthalmology, Imam Mohammad Bin Saud Islamic University, collage of medicine, Riyadh, Saudi Arabia
| | - Faris Mohammad Alosaimi
- Department of Ophthalmology, Imam Mohammad Bin Saud Islamic University, collage of medicine, Riyadh, Saudi Arabia
| | | | - Mansour Khalid Almadi
- Department of Ophthalmology, Imam Mohammad Bin Saud Islamic University, collage of medicine, Riyadh, Saudi Arabia
| | - Alanoud Alfaris
- Department of Ophthalmology, Imam Mohammad Bin Saud Islamic University, collage of medicine, Riyadh, Saudi Arabia
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Abstract
Background: Type 2 Diabetes Mellitus (T2DM) is becoming increasingly prevalent and is considered to be a major public health threat worldwide. Behavioral and sociodemographic factors associated with T2DM vary within different societies. Objective: The aim of this study is to determine the various behavioral and sociodemographic factors associated with T2DM in the Arab society in Israel. Methods: A cross-sectional study was conducted based on data from 1,894 residents over the age of 21 belonging to the Arab population in Israel. The data collected from the subjects were subjected to statistical analyses using the SPSS program. Findings: Of the total sample population, 13.7% were found to be affected with T2DM. The prevalence of T2DM increased sharply in the successive age groups of both men and women. The prevalence of T2DM was found to increase progressively particularly in women with an increase in BMI (~20%, 37% and 44% respectively), while, in men it increased sharply (from 25% to ~50%) until a BMI of 29.9; it then decreased drastically (to ~24%) for a BMI of ≥30. About 85% of the men affected with T2DM were physically inactive, while 97% of the affected women were physically inactive. Almost half of the participants with diabetes have a family history of the disease in both genders. In the multivariate analysis, it was found that age, obesity, physical inactivity and family history of the disease were the significant factors associated with the prevalence of diabetes. Conclusions: It could be concluded that age, obesity, family history and physical inactivity were the significant factors associated with the prevalence of T2DM within the Arab society in Israel.
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Meo SA, Sheikh SA, Sattar K, Akram A, Hassan A, Meo AS, Usmani AM, Qalbani E, Ullah A. Prevalence of Type 2 Diabetes Mellitus Among Men in the Middle East: A Retrospective Study. Am J Mens Health 2019; 13:1557988319848577. [PMID: 31055980 PMCID: PMC6505246 DOI: 10.1177/1557988319848577] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 12/15/2022] Open
Abstract
The rising prevalence of diabetes mellitus (DM) is a serious global health concern. The world is experiencing type 2 diabetes epidemics and prevalence differs by gender, regions, and level of socioeconomic development. Type 2 diabetes mellitus (T2DM) in men increased at a faster rate and numbers are continuing to rise in some regions of the world. This study aimed to estimate the prevalence of T2DM among men in the Middle East countries. Seventy-four research articles were identified through search engines including Web of Science, Medline, PubMed, EMBASE, Scopus, and Ovid databases by using keywords "epidemiology," "prevalence," "diabetes mellitus," and individual names of the Middle East states. Finally, 17 studies were included for the assessment of prevalence of T2DM among men in the Middle East. In the Middle East, high prevalence of T2DM among men was identified in Bahrain (33.60%), Saudi Arabia (29.10%), United Arab Emirates (UAE; 25.83%), and Kuwait (25.40%), whereas low prevalence was reported in Iran (9.90%) and Yemen (9.80%). The random pooled prevalence in the Gulf Cooperation Council (GCC) states was (24.0%) compared to non-GCC states (16.0%), and in both GCC and non-GCC countries combined, it was 19%. The prevalence was significantly associated with the gross domestic product of these states ( p = .0005). Despite different socioeconomic and cultural settings in the Middle East, the rising T2DM prevalence among men was identified in Bahrain, Saudi Arabia, UAE, and Kuwait. These states must incorporate future diabetes defensive strategies targeting the Middle East population to minimize the burden of DM from the region.
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Affiliation(s)
- Sultan Ayoub Meo
- Department of Physiology, College of
Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed A. Sheikh
- Department of Pharmacology, College of
Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Kamran Sattar
- Department of Medical Education, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ashfaq Akram
- Department of Medical Education, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Asim Hassan
- Endocrinology Department, Armed Forces
Hospital, Alhada, Taif, Saudi Arabia
| | - Anusha Sultan Meo
- Army Medical College, National
University for Health Sciences, Rawalpindi, Pakistan
| | - Adnan Mehmood Usmani
- University Diabetes Centre, College of
Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Anhar Ullah
- Department of Cardiac Sciences, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
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Alwin Robert A, Al Dawish MA. Microvascular complications among patients with diabetes: An emerging health problem in Saudi Arabia. Diab Vasc Dis Res 2019; 16:227-235. [PMID: 30599757 DOI: 10.1177/1479164118820714] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Diabetes mellitus, besides disrupting the carbohydrate metabolism process, also induces vascular disease and impacts nearly all the types and sizes of blood vessels. In fact, vascular complications cause majority of the morbidity, hospitalizations and mortality of patients with diabetes mellitus. Retinopathy, nephropathy and neuropathy (microvascular complications) impact hundreds of millions of diabetics and normally target those having long-term or uncontrolled forms of the disease; however, these disorders can also exist at the time of diagnosis or in those yet to be diagnosed. The Kingdom of Saudi Arabia is the biggest country in the Middle East that occupies around four-fifths of the Arabian Peninsula supporting a population of more than 33.3 million people. The prevalence of diabetes mellitus is increasing at an alarming rate in Saudi Arabia. Over 25% of the adult population is suffering and that figure is projected to more than double by 2030. In fact, diabetes mellitus has approximately registered a 10-fold upsurge in the past three decades in Saudi Arabia. However, the prevalence and risk factors of microvascular complications in diabetes mellitus patients have not yet been clearly documented in Saudi Arabia. Hence, in this review, we aim to provide an overview of the microvascular complications among patients with diabetes in Saudi Arabia, utilizing data from the currently available published literature. This is an attempt to facilitate the government and healthcare systems aware of the enormous worth of prevention, early detection and appropriate management of such microvascular complications.
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Affiliation(s)
- Asirvatham Alwin Robert
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohamed Abdulaziz Al Dawish
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Prevalence of metabolic syndrome and its components among type 2 diabetic mellitus Syrian patients according to NCEP-ATP III and IDF diagnostic criteria. ANTHROPOLOGICAL REVIEW 2019. [DOI: 10.2478/anre-2019-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The metabolic syndrome (MetS) is an important group of components responsible of high incidence of cardio-vascular disease (CVD) and stroke among the type 2 diabetic mellitus (DM) patients. Studies on the prevalence of the MetS and its components among DM patients are limited in developing countries and such studies never been done in Syria before. The objectives of current study were two-folds: (a) to investigate the prevalence of MetS in a group of DM Syrian patients as defined by NCEP-ATP Ш and IDF diagnostic criteria, and (b) to identify the individual MetS associated risk factors components in the studied group. A cross-sectional study carried out at one of the diabetic clinics of the health ministry in Damascus, Syria between 2016–2017. A random sample of 424 patients (209 males, 215 females) DM patients aged 40–79 years were participated in this study. Anthropometric indices, blood pressure (BP), fasting blood sugar (FBS), total cholesterol, high density lipoprotein cholesterol (HDL-C), triglycerides (TG) were determined. The overall prevalence of the MetS was 67% and 69.3% according to the NCEP-ATP Ш and IDF criteria, respectively. The prevalence was higher in females and increased with age. According to NCEP/ATP III criteria and for the overall group, high TG was the most prevalent component of the MetS. However, when an IDF criterion was applied, central obesity was the commonest component in the overall group. According to both diagnostic criteria, hypertension was significantly higher in males while central obesity was dominated in females (p<0.05, p<0.001, respectively). In conclusion, the results revealed high prevalence of the MetS in DM Syrian patients using both diagnostic criteria but slightly higher with IDF criteria. Especial care, health awareness, life style modifications, and proper medications should be directed towards controlling the risk factors components of this syndrome.
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Musambil M, Siddiqui K. Genetics and genomics studies in type 2 diabetes: A brief review of the current scenario in the Arab region. Diabetes Metab Syndr 2019; 13:1629-1632. [PMID: 31336532 DOI: 10.1016/j.dsx.2019.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/12/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Type 2 diabetes (T2D) is a polygenic and multi-factorial complex disease, the challenge to find genetic markers that could explain the risk of development of this disease still remains unresolved. The Arab region is one among the populations with a high prevalence of T2D and a large number of studies have been carried out in exploring the genetic factors associated with T2D risk. AIM To summarize the recent developments in the Arab world based on the recent studies that had looked into genetic factors associated with the development of T2D in the Arab populations. METHODS A systematic literature search was conducted to identify studies published between 2015 and 2018 reporting genetic factors or polymorphisms associated with the risk of T2D in the Arab world. The online databases PubMed and Web of Science were used to perform the literature search. CONCLUSION The present study has evaluated 14 studies published during the year 2015-2018. Studies from Egypt, Iraq, Jordan, Oman, Qatar, Saudi Arabia, Tunisia, and United Arab Emirates had been explored studying the associations of GIPR, ADIPOQ, FTO, (GRCh38.p12), MLXIP, AKNAD1, KCNJ11 CDKAL1, CDKN2A/2B, TCF7L2, ACE, SNAP25, ELMO1, VDR, KCTD8, GABRA4 and PRKD1 genes with T2D development.
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Affiliation(s)
- Mohthash Musambil
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Khalid Siddiqui
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Al Busaidi N, Shanmugam P, Manoharan D. Diabetes in the Middle East: Government Health Care Policies and Strategies that Address the Growing Diabetes Prevalence in the Middle East. Curr Diab Rep 2019; 19:8. [PMID: 30715611 DOI: 10.1007/s11892-019-1125-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Diabetes is a primary public health concern and a challenge for health decision makers in this century. Though the number of people with diabetes is increasing all over the globe, the very high prevalence of diabetes in many Middle East countries has made this region one of the global diabetes hot spots. Due to rapid socioeconomic growth, lifestyle changes and increasing obesity prevalence, the number of people with diabetes is expected to double by 2045 in this region. This high prevalence of diabetes imposes a substantial socioeconomic impact on the individual and governments in this region. The governments in the Middle East have devised many policies, programs, and strategies to address the growing prevalence of diabetes. In this article, we aim to review such policies, programs, and the magnitude of diabetes in this part of the world. RECENT FINDINGS Faced with a challenge on a high scale, most governments in the Middle East are making progress in responding to diabetes. Diabetes is a chronic and costly disease; however, it can be prevented. The alarm of the rising tide of diabetes has not yet been successfully translated into action in the Middle East. The governments in the region need to devise more intense, broader policies and preventive measure programs based on local sociocultural practices to effectively combat the situation. Further improvements of the primary health care system and cross-governmental approaches are needed in the region to keep the growing epidemic of diabetes under control.
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Affiliation(s)
- Noor Al Busaidi
- National Diabetes and Endocrine Centre, Royal Hospital, Muscat, Sultanate of Oman.
| | - Prakash Shanmugam
- National Diabetes and Endocrine Centre, Royal Hospital, Muscat, Sultanate of Oman
| | - Deepa Manoharan
- National Diabetes and Endocrine Centre, Royal Hospital, Muscat, Sultanate of Oman
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Al-Alawi K, Al Mandhari A, Johansson H. Care providers' perceptions towards challenges and opportunities for service improvement at diabetes management clinics in public primary health care in Muscat, Oman: a qualitative study. BMC Health Serv Res 2019; 19:18. [PMID: 30621675 PMCID: PMC6325807 DOI: 10.1186/s12913-019-3866-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 01/02/2019] [Indexed: 11/27/2022] Open
Abstract
Background The literature has described several challenges related to the quality of diabetes management clinics in public primary health care centres in Oman. These clinics continue to face challenges due to the continuous growth of individuals diagnosed with type 2 diabetes. We sought to explore the challenges faced in these clinics and discuss opportunities for improvement in Oman. Methods This qualitative study was designed to include non-participant observations of diabetic patients and care providers during service provision at diabetes management clinics, as well as semi-structured interviews with care providers, at five purposively selected public primary health care centres. Care providers included physicians, nurses, dieticians, health educators, pharmacists, an assistant pharmacist, a psychologist, and a medical orderly. The data were analysed using qualitative content analysis. Results The study disclosed three different models of service delivery at diabetes management clinics, which, to varying degrees, face challenges related to health centre infrastructure, technical and pharmaceutical support, and care providers’ interests, knowledge, and skills. Challenges related to the community were also found in terms of cultural beliefs, traditions, health awareness, and public transportation. Conclusion The challenges encountered in diabetes management clinics fall within two contexts: health care centres and community. Although many challenges exist, opportunities for improvement are available. However, improvements in the quality of diabetic clinics in primary health care centres might take time and require extensive involvement, shared responsibilities, and implications from the government, health care centres, and community.
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Affiliation(s)
- Kamila Al-Alawi
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, SE-90185, Umea, Sweden. .,Department of Training and Studies, Royal Hospital, Ministry of Health, Muscat, Oman.
| | - Ahmed Al Mandhari
- Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Helene Johansson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, SE-90185, Umea, Sweden
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Farran B, AlWotayan R, Alkandari H, Al-Abdulrazzaq D, Channanath A, Thanaraj TA. Use of Non-invasive Parameters and Machine-Learning Algorithms for Predicting Future Risk of Type 2 Diabetes: A Retrospective Cohort Study of Health Data From Kuwait. Front Endocrinol (Lausanne) 2019; 10:624. [PMID: 31572303 PMCID: PMC6749017 DOI: 10.3389/fendo.2019.00624] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 08/28/2019] [Indexed: 12/12/2022] Open
Abstract
Objective: In recent decades, the Arab population has experienced an increase in the prevalence of type 2 diabetes (T2DM), particularly within the Gulf Cooperation Council. In this context, early intervention programmes rely on an ability to identify individuals at risk of T2DM. We aimed to build prognostic models for the risk of T2DM in the Arab population using machine-learning algorithms vs. conventional logistic regression (LR) and simple non-invasive clinical markers over three different time scales (3, 5, and 7 years from the baseline). Design: This retrospective cohort study used three models based on LR, k-nearest neighbours (k-NN), and support vector machines (SVM) with five-fold cross-validation. The models included the following baseline non-invasive parameters: age, sex, body mass index (BMI), pre-existing hypertension, family history of hypertension, and T2DM. Setting: This study was based on data from the Kuwait Health Network (KHN), which integrated primary health and hospital laboratory data into a single system. Participants: The study included 1,837 native Kuwaiti Arab individuals (equal proportion of men and women) with mean age as 59.5 ± 11.4 years. Among them, 647 developed T2DM within 7 years of the baseline non-invasive measurements. Analytical methods: The discriminatory power of each model for classifying people at risk of T2DM within 3, 5, or 7 years and the area under the receiver operating characteristic curve (AUC) were determined. Outcome measures: Onset of T2DM at 3, 5, and 7 years. Results: The k-NN machine-learning technique, which yielded AUC values of 0.83, 0.82, and 0.79 for 3-, 5-, and 7-year prediction horizons, respectively, outperformed the most commonly used LR method and other previously reported methods. Comparable results were achieved using the SVM and LR models with corresponding AUC values of (SVM: 0.73, LR: 0.74), (SVM: 0.68, LR: 0.72), and (SVM: 0.71, LR: 0.70) for 3-, 5-, and 7-year prediction horizons, respectively. For all models, the discriminatory power decreased as the prediction horizon increased from 3 to 7 years. Conclusions: Machine-learning techniques represent a useful addition to the commonly reported LR technique. Our prognostic models for the future risk of T2DM could be used to plan and implement early prevention programmes for at risk groups in the Arab population.
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Affiliation(s)
- Bassam Farran
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Rihab AlWotayan
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Primary Health Care, Ministry of Health, Kuwait City, Kuwait
| | - Hessa Alkandari
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Farwaniya Hospital, Al Farwaniyah, Kuwait
| | - Dalia Al-Abdulrazzaq
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Thangavel Alphonse Thanaraj
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- *Correspondence: Thangavel Alphonse Thanaraj
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The Influence of Type 1 Diabetes Mellitus on Dental Caries and Salivary Composition. Int J Dent 2018; 2018:5780916. [PMID: 30369949 PMCID: PMC6189668 DOI: 10.1155/2018/5780916] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/26/2018] [Indexed: 11/29/2022] Open
Abstract
Diabetes mellitus is the most common chronic disease that affects the oral health. The aim of the study is to evaluate the dental caries, salivary flow rate, buffer capacity, and Lactobacilli in saliva in children with type 1 diabetes mellitus compared to the control group. Methods. The sample consisted of 160 children of 10 to 15 years divided into two groups: 80 children with type 1 diabetes mellitus and 80 children as a control group. Dental caries was assessed using the DMFT index for permanent dentition. Stimulated saliva was collected among all children. Salivary flow rate and buffer capacity were measured, and the colonies of Lactobacillus in saliva were determined. The observed children have answered a number of questions related to their dental visits and parents' education. The data obtained from each group were compared statistically using the chi-square test and Mann–Whitney U-test. The significant level was set at p < 0.05. Results. DMFT in children with type 1 diabetes was significantly higher than that in the control group (p < 0.001). Diabetic children have a low level of stimulated salivary flow rate compared to control children (0.86 ± 0.16 and 1.10 ± 0.14). The buffer capacity showed statistically significant differences between children with type 1 diabetes and control group (p < 0.001). Also, children with type 1 diabetes had a higher count and a higher risk of Lactobacillus compared to the control group (p < 0.05 and p < 0.001). Conclusion. The findings we obtained showed that type 1 diabetes mellitus has an important part in children's oral health. It appears that children with type 1 diabetes are exposed to a higher risk for caries and oral health than nondiabetic children.
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Alkandari A, Longenecker JC, Barengo NC, Alkhatib A, Weiderpass E, Al-Wotayan R, Al Duwairi Q, Tuomilehto J. The prevalence of pre-diabetes and diabetes in the Kuwaiti adult population in 2014. Diabetes Res Clin Pract 2018; 144:213-223. [PMID: 30179683 DOI: 10.1016/j.diabres.2018.08.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Kuwait ranks among the top 20 countries worldwide in diabetes prevalence. This study's objectives were to assess the prevalence of pre-diabetes and diabetes in Kuwaiti adults. METHODS Kuwaiti citizens aged 18-69 years (n = 3915) were studied using the WHO's STEPwise survey methodology, including its Instrument for Chronic Disease Risk Factor Surveillance. Participants' demographics, medical history, physical measurements and blood biochemistry were assessed. A subset of 2561 individuals completed all three survey steps, including fasting plasma glucose (FPG) and HbA1c assays. The study assessed the prevalence of pre-diabetes (FPG 6.1-6.9 mmol/L or HbA1c level 5.7-6.4%) and diabetes (self-reported history of diabetes with prescription of diabetes medications or FPG ≥ 7 mmol/L or HbA1c level ≥6.5%). RESULTS The prevalence of pre-diabetes was 19.4% [95% CI: 17.9-21.0%] (By sex: Men, 19.3%; Women, 19.5%; p = 0.92; By age (years): 18-29 y, 13.9%; 30-44 y, 22.6%; 45-59 y, 25.8%; 60-69 y, 16.4%; p < 0.001). The prevalence of diabetes was 18.8% [17.3-20.4%] (By sex: Men, 20.4%; Women, 17.4%; p = 0.055; By age: 18-29 y, 6.6%; 30-44 y, 14.0%; 45-59 y, 36.7%; 60-69 y, 62.8%; p < 0.001), of whom 41.5% were previously undiagnosed. Diabetes prevalence was 27.4% among those with body mass index (BMI) ≥ 30 kg/m2, 29% among those with elevated waist-hip ratio and 36% among those with hypertension. Diabetes was positively associated with BMI, waist-hip ratio and blood pressure level. Pre-diabetes was positively associated with BMI and waist-hip ratio, but not blood pressure level. CONCLUSIONS Almost 40% of Kuwaiti citizens had pre-diabetes or diabetes. Urgent public health action is needed to decrease diabetes prevalence and thus avoid associated morbidity and mortality.
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Affiliation(s)
| | | | - Noël C Barengo
- Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, USA
| | | | - Elisabete Weiderpass
- Dasman Diabetes Institute, Kuwait City, Kuwait; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
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Saeed RS, Bakir YY, Alkhalifah KH, Ali LM. Knowledge and Awareness of Colorectal Cancer among General Public of Kuwait. Asian Pac J Cancer Prev 2018; 19:2455-2460. [PMID: 30255699 PMCID: PMC6249459 DOI: 10.22034/apjcp.2018.19.9.2455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common type of cancer and also the fourth most common cause of cancer related death in both men and women worldwide. The CRC is considered to be the second killer in Kuwait after breast cancer.
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Affiliation(s)
- Raed Saeed Saeed
- Department of Radiological Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait.
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Abstract
Diabetes is associated with various complications and reduced quality of life. Of the many complications, some are life-threatening. Among these, foot complications remain an important concern. The major foot complications include foot ulceration, cellulitis, abscess, wet gangrene, dry gangrene, and necrotizing fasciitis, with different pathophysiological concepts behind each of them. Gangrene occurs due to reduced blood supply in the body tissues that leads to necrosis. This condition may arise because of an injury, infection, or other health conditions, majorly diabetes. Gangrene is classified as dry, wet, and gas gangrene. In case of wet and gas gangrene, surgical amputation is usually performed to prevent the spread of infection to other tissues. In dry gangrene, due to the presence of clear demarcation, autoamputation is preferred in certain parts of the globe. The present review aims to analyze the mode of dry gangrene management in diabetic patients based on previous evidence and plans to highlight various management strategies available for dry gangrene and the advantages/disadvantages of different treatments with special consideration to autoamputation.
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Affiliation(s)
- Abdullah Al Wahbi
- Division of Vascular Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Are the resources adoptive for conducting team-based diabetes management clinics? An explorative study at primary health care centers in Muscat, Oman. Prim Health Care Res Dev 2018; 20:e3. [PMID: 29737963 PMCID: PMC6476396 DOI: 10.1017/s1463423618000282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AimThe aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches. BACKGROUND: The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines. METHOD: A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FindingsThe study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.
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Geographical differences in semen characteristics of 13 892 infertile men. Arab J Urol 2018; 16:3-9. [PMID: 29713531 PMCID: PMC5922224 DOI: 10.1016/j.aju.2017.11.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/11/2017] [Accepted: 11/27/2017] [Indexed: 12/25/2022] Open
Abstract
Objective To assess the relationship between geographical differences and all semen parameters, across 13,892 infertile men of 84 diverse nationalities, recruited at a specialised tertiary hospital that represents the main healthcare provider in Qatar. Male infertility is an important and global public health problem. Despite this, there is a significant scarcity of epidemiological male infertility and semen analysis research in the Middle East and North Africa (MENA) region, as well as geographical comparisons with other parts of the world. Patients and methods Retrospective study of semen findings of 13 892 infertile men assessed at the Male Infertility Unit at Hamad Medical Corporation, in Qatar between January 2012 and August 2015. Based on country of origin, patients were categorised into those from the MENA region (n = 8799) and non-MENA patients (n = 5093). The two groups were compared across demographic features and semen characteristics: age, sperm volume, sperm total motility, sperm progressive motility (PMot), abnormal sperm forms (ABF), and sperm DNA fragmentation (SDF). Results The whole sample's mean (SD) age was 35.7 (0.7) years, sperm concentration was 32.3 (0.25) × 106 sperm/mL, total motility was 45.4 (0.2)%, sperm PMot was 25.1 (0.2)%, and ABF was 79.9 (0.2)%. Overall, 841 patients had azoospermia (6.05%), 3231 had oligospermia (23.3%), 4239 had asthenospermia (30.5%) and 6772 had teratospermia (48.7%). SDF (1050 patients) was abnormal in 333 patients (31.7%). MENA patients were significantly younger than their non-MENA counterparts and had a greater semen volume. Non-MENA patients had significantly higher sperm counts, total motility and PMot, and lower ABF. SDF showed no statistical difference between the two groups. MENA patients had significantly higher prevalence of oligospermia, asthenospermia, and teratospermia; and lower prevalence of normal sperm concentration, normal motility, and normal morphology. Throughout the 4 years of the study, MENA patients constantly had significantly lower sperm counts; generally lower sperm total motility percentage and generally lower quality sperm morphology. We compared patients by age (≤40 and >40 years): in the patients aged ≤40 years, the same results as for the overall study were reproduced; in the >40-years group, the same results were reproduced with the exception of morphology, which was not significantly different between the MENA and non-MENA patients. Conclusion Semen quality is generally lower in male infertility patients from the MENA region compared to non-MENA regions.
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Radwan H, Ballout RA, Hasan H, Lessan N, Karavetian M, Rizk R. The Epidemiology and Economic Burden of Obesity and Related Cardiometabolic Disorders in the United Arab Emirates: A Systematic Review and Qualitative Synthesis. J Obes 2018; 2018:2185942. [PMID: 30652030 PMCID: PMC6311818 DOI: 10.1155/2018/2185942] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 09/30/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs) are considered as a global health problem and considered as a public health priority with the more considerable increasing trend of obesity and cardiometabolic disorders rates in the Middle Eastern countries. This systematic review aims at assessing the prevalence, incidence rates, and trends, as well as the cost of obesity and related cardiometabolic disorders in the United Arab Emirates (UAE). METHODS A highly sensitive strategy was used to retrieve original observational studies, addressing the epidemiology and cost of obesity and related cardiometabolic disorders in the UAE, irrespective of nationality (nationals and expatriates). The search was conducted on April 4, 2017, within numerous electronic databases and the grey literature. Standardized and validated methods were used for data extraction and analysis as well as quality assessment. RESULTS 6789 records were retrieved, of which 36 were deemed eligible. High prevalence rates were reported for obesity, diabetes, hypertension, and metabolic syndrome in all studies. However, the definitions and methods employed by the studies were highly variable. The risk of bias in the epidemiological studies ranged between low and medium. Only one study reported the cost of illness for diabetes. In this study, the estimated cost per patient was $2,015 (adjusted to the year 2015), and it became twofold and sixfold higher in patients with microvascular and macrovascular complications, respectively. CONCLUSIONS Obesity and related cardiometabolic disorders are highly prevalent in the UAE, but quoting a precise prevalence for them is difficult given the methodological heterogeneity of the epidemiological studies addressing them. Nonetheless, we detected a 2-3-fold increase in the prevalence of overweight and obesity in the UAE between 1989 and 2017. It is hopeful that this systematic review will provide an insight into direct future studies, especially longitudinal studies exploring obesity and cardiometabolic risks and their costs.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Rami A. Ballout
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, P.O. Box 27272, Sharjah, UAE
| | - Nader Lessan
- Imperial College London Diabetes Centre, P.O. Box 48338, Abu Dhabi, UAE
| | - Mirey Karavetian
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, P.O. Box 144534, Dubai, UAE
| | - Rana Rizk
- INSPECT-LB, Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Faculty of Public Health, The Lebanese University, Beirut, Lebanon
- Department of Health Services Research, Maastricht University, 6200 MD Maastricht, Netherlands
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Bonger Z, Shiferaw S, Tariku EZ. Adherence to diabetic self-care practices and its associated factors among patients with type 2 diabetes in Addis Ababa, Ethiopia. Patient Prefer Adherence 2018; 12:963-970. [PMID: 29922042 PMCID: PMC5995298 DOI: 10.2147/ppa.s156043] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Self-care practices in diabetes patients are crucial to keep the illness under control and prevent complications. Effective management of diabetes will be a difficult task without adequate understanding of the existing level of practice related to diabetes self-care. This study is, therefore, aimed at assessing the self-care practice and its associated factors among patients with type 2 diabetes in Tikur Anbessa Specialized Hospital, Ethiopia. MATERIALS AND METHODS A health facility-based cross-sectional study was conducted among 419 type 2 diabetes patients from March 29, 2013, to May 16, 2013. The data were collected by face-to-face interview using structured and pretested questionnaire. Binary logistic regression was performed to assess the association between determinant factors and adherence to self-monitoring of blood glucose. Adjusted odds ratios (AOR) with its 95% confidence interval (CI) were estimated to identify factors associated with the outcome variables in the multivariable analysis. RESULT In this study, 318 (75.9%) diabetes patients did not adhere to the recommended diet management, 350 (83.5%) did not adhere to self-monitoring of blood glucose level, while 18 (4.3%) of the respondents did not adhere to the prescribed medications. Diabetic patients who were unemployed were 2.4 times more likely to practice blood glucose monitoring than merchants (AOR [95% CI] =2.4 [1.3-5.9]). Those who attended primary education were 70% less likely to adhere to blood glucose self-monitoring than those educated to a tertiary educational level (AOR [95% CI] =0.3 [0.1-0.9]). Respondents within the age group of 40-49 years were 11 times more likely to adhere to their medication than those aged 60-76 years (AOR [95% CI] =11 [1.03-13.6]). CONCLUSION The study showed that the extent to which individuals adhere to the recommended management of type 2 diabetes is substantially low. Improving awareness of patients and the community at large is imperative especially on medication adherence, glycemic control and diet management.
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Affiliation(s)
- Zeleke Bonger
- TB/HIV Control and Prevention, Ethiopian Public Health Institute, Adama, Ethiopia
| | - Solomon Shiferaw
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Alzubaidi H, Mc Namara K, Versace VL. Predictors of effective therapeutic relationships between pharmacists and patients with type 2 diabetes: Comparison between Arabic-speaking and Caucasian English-speaking patients. Res Social Adm Pharm 2017; 14:1064-1071. [PMID: 29217315 DOI: 10.1016/j.sapharm.2017.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND The benefits of pharmacist-led interventions in achieving desired patient outcomes have been well established. Effective patient-pharmacist relationships are required to provide high-quality pharmacy care. Limited information is available about how Arabic-speaking migrants with diabetes, in Australia, perceive patient-pharmacist relationship and how these perspectives differ from the mainstream society (represented by Caucasian English-speaking people). OBJECTIVE To examine and compare the patient-pharmacist relationship, medication underuse and adherence levels among Arabic-speaking and Caucasian English-speaking patients with type 2 diabetes. METHODS A 98-item survey incorporating several previously-validated measurements was completed by Arabic-speaking migrants (ASMs) and Caucasian English-speaking patients (ESPs) with type 2 diabetes. Participants were recruited from various healthcare settings in the Melbourne metropolitan area and rural Victoria, Australia. This survey-based, cross-sectional study was designed to explore patients' perceptions of the patient-pharmacist relationship. A descriptive analysis of responses was undertaken, and binary logistic regression was used to explore patient-pharmacist relationships. RESULTS A total of 701 participants were recruited; 392 ASMs and 309 ESPs. Of ASMs, 88.3% were non-adherent to their prescribed medication, compared with 45.1% of ESPs. The degree of relationship with community pharmacists differed significantly between ASMs and ESPs. Compared with ASMs, significantly more ESPs reported that they have thought about consulting a pharmacist when they had health problems (P = 0.002). Compared with ESPs, significantly fewer ASMs reported always following pharmacist recommendations (32% versus 61.9% respectively). CONCLUSIONS Arabic-speaking migrants had less-effective relationships with community pharmacists when having their prescriptions filled. Community pharmacists' expertise appeared to be underused. These minimal relationships represent missed opportunities to improve health outcomes.
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Affiliation(s)
- H Alzubaidi
- University of Sharjah, Sharjah Institute for Medical Research and College of Pharmacy, PO Box 2727, Sharjah, United Arab Emirates; Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
| | - K Mc Namara
- Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia; Centre for Population Health Research, Deakin University, Burwood, Victoria 3125, Australia
| | - V L Versace
- Deakin Rural Health, School of Medicine, Deakin University, PO Box 423, Warrnambool, Victoria 3280, Australia
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Alghafri T, Alharthi SM, Al Farsi YM, Bannerman E, Craigie AM, Anderson AS. Perceived barriers to leisure time physical activity in adults with type 2 diabetes attending primary healthcare in Oman: a cross-sectional survey. BMJ Open 2017; 7:e016946. [PMID: 29102987 PMCID: PMC5722082 DOI: 10.1136/bmjopen-2017-016946] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Physical activity is fundamental in diabetes management for good metabolic control. This study aimed to identify barriers to performing leisure time physical activity and explore differences based on gender, age, marital status, employment, education, income and perceived stages of change in physical activity in adults with type 2 diabetes in Oman. DESIGN Cross-sectional study using an Arabic version of the 'Barriers to Being Active' 27-item questionnaire. SETTING Seventeen primary health centres randomly selected in Muscat. PARTICIPANTS Individuals>18 years with type 2 diabetes, attending diabetes clinic for >2 years and with no contraindications to performing physical activity. PRIMARY AND SECONDARY OUTCOME MEASURES Participants were asked to rate how far different factors influenced their physical activity under the following categories: fear of injury, lack of time, social support, energy, willpower, skills, resources, religion and environment. On a scale of 0-9, barriers were considered important if scored ≥5. RESULTS A total of 305 questionnaires were collected. Most (96%) reported at least one barrier to performing leisure time physical activity. Lack of willpower (44.4%), lack of resources (30.5%) and lack of social support (29.2%) were the most frequently reported barriers. Using χ2 test, lack of willpower was significantly different in individuals with low versus high income (54.2%vs40%, P=0.002) and in those reporting inactive versus active stages of change for physical activity (50.7%vs34.7%, P=0.029), lack of resources was significantly different in those with low versus high income (40%vs24.3%, P=0.004) and married versus unmarried (33.8%vs18.5%, P=0.018). Lack of social support was significant in females versus males (35.4%vs20.8%, P=0.005). CONCLUSIONS The findings can inform the design on physical activity intervention studies by testing the impact of strategies which incorporate ways to address reported barriers including approaches that enhance self-efficacy and social support.
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Affiliation(s)
- Thamra Alghafri
- Ministry of Health, Directorate General of Health Services, Muscat, Oman
- Centrefor Public Health Nutrition Research, Ninewells Hospitaland Medical School., University of Dundee, Dundee, United Kingdom
| | - Saud M Alharthi
- Ministry of Health, Directorate General of Health Services, Muscat, Oman
| | - Yahya Mohd Al Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Alkoudh, Oman
| | - Elaine Bannerman
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Angela Mary Craigie
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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Abstract
PURPOSE OF REVIEW Obesity and obesity-related diseases, largely resulting from urbanization and behavioral changes, are now of global importance. Energy restriction, though, is associated with health improvements and increased longevity. We review some important mechanisms related to calorie limitation aimed at controlling of metabolic diseases, particularly diabetes. RECENT FINDINGS Calorie restriction triggers a complex series of intricate events, including activation of cellular stress response elements, improved autophagy, modification of apoptosis, and alteration in hormonal balance. Intermittent fasting is not only more acceptable to patients, but it also prevents some of the adverse effects of chronic calorie restriction, especially malnutrition. There are many somatic and potentially psychologic benefits of fasting or intermittent calorie restriction. However, some behavioral modifications related to abstinence of binge eating following a fasting period are crucial in maintaining the desired favorable outcomes.
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Affiliation(s)
- Saeid Golbidi
- Faculty of Medicine, Department of Pharmacology and Therapeutics, The University of British Columbia, 2176 Health Sciences Mall, Vancouver, V6T 1Z3, Canada
| | - Andreas Daiber
- Center of Cardiology, Cardiology 1, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Bato Korac
- Department of Physiology, Institute for Biological Research "Sinisa Stankovic", University of Belgrade, Belgrade, Serbia
| | - Huige Li
- Department of Pharmacology, Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - M Faadiel Essop
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Ismail Laher
- Faculty of Medicine, Department of Pharmacology and Therapeutics, The University of British Columbia, 2176 Health Sciences Mall, Vancouver, V6T 1Z3, Canada.
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