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Nassar M, Nassar O, Abosheaishaa H, Elhakim N. Association between type 1 diabetes mellitus and dental caries: A systematic review and meta-analysis. DENTISTRY REVIEW 2024; 4:100088. [DOI: 10.1016/j.dentre.2024.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
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Dubayee MA, Juraibah FA, Alfaraidi H, Alghnam S, Aldahash R, Attia N, Shaikh AA, Habeb A, Jabri AA, Zaben AA, Atawi MA, Mutair AA, Alamri M, Aldibasi O, Alwan IA, Babiker A. Establishing the Saudi pediatric and youth diabetes registry: initial data and challenges. Sudan J Paediatr 2024; 24:10-20. [PMID: 38952627 PMCID: PMC11214787 DOI: 10.24911/sjp.106-106-1715756287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/22/2024] [Indexed: 07/03/2024]
Abstract
The Saudi National Diabetes Registry focuses mainly on adult patients. In 2020, the National Guard Health Authority (NGHA) launched the Saudi Pediatric and Youth Diabetes Registry (SPYDR), for children and adolescents with diabetes. This report is about the first data and the challenges we faced during SPYDR initiation. Patients were identified from the electronic medical records of the Saudi NGHA hospitals using the International Classification of Disease (ICD-10). A trained coordinator verified the diagnosis and entered patients' details into the registry and a random sample was validated by experienced endocrinologists. The data were analyzed according to patients' demography, diabetes subtypes, duration, control, and complications. The challenges faced by the team were identified and addressed. At the time of manuscript submission, 2,344 individuals were enrolled. Their mean age at diagnosis was 9.08 (±4.27) years and 1,136 (48.46%) were females. Of these, 91.3% have type 1 (T1D), and 6.4% have type 2 diabetes (T2D). The mean HbA1c was 10.45% (±2.36) and duration of diabetes was 5.31 (±3.05) years. The main challenges included the COVID-19 pandemic, data validation, and centers' participation. However, within 12 months of initiation enrolled subjects matched the expected number. Despite the challenges, the first step of SPYDR was achieved. The initial data confirmed that T1D is the most common form of childhood diabetes, and the frequency of T2D is comparable to regional and international data. SPYDR provides the infrastructure for data sharing and collaborative research with the enrollment of patients from other Saudi healthcare institutes.
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Affiliation(s)
- Mohammed Al Dubayee
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Fahad Al Juraibah
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Haifa Alfaraidi
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- Population Health, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Raed Aldahash
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Najya Attia
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Adnan Al Shaikh
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Abdelhadi Habeb
- Prince Mohamed Bin Abdulaziz Hospital, National Guard Health Affairs, Madinah, Saudi Arabia
| | | | - Abdullah Al Zaben
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohsen Al Atawi
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Angham Al Mutair
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Muhammed Alamri
- Population Health, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Omar Aldibasi
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Biostatistics Department, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Ibrahim Al Alwan
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Amir Babiker
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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Alhilali MY, Alhilaly YS, Alkalash S. Knowledge and Attitude of School Students About Diabetes Mellitus in the Western Region of Saudi Arabia. Cureus 2023; 15:e47514. [PMID: 38022000 PMCID: PMC10663975 DOI: 10.7759/cureus.47514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a worldwide public health issue. Diabetes has been developing dramatically among young individuals, and childhood onset is now becoming a global epidemic. Data on DM knowledge and attitude among Saudi school pupils in the western region of the country are few. Therefore, this study has been undertaken to assess the level of knowledge and attitude of school students toward DM in the western region of Saudi Arabia. METHODS A cross-sectional study was conducted on a sample of 850 school students in the western region of Saudi Arabia from October to December 2022. The data were collected using an online questionnaire and analyzed using Statistical Product and Service Solutions (SPSS) (version 23.0; IBM SPSS Statistics for Windows, Armonk, NY). RESULTS This study included 850 pupils in total. Females represented most of them (82.1%). The participants' ages ranged from 10 to 18 years, with the majority of them between the ages of 16 and 18. Self-reported diabetes among students was 9.5%, and the most prevalent type was type 1 diabetes. Regarding the physical activity of the participants, 22.6% of them conduct physical exercise for a duration of more than 30 minutes per day, with a significantly higher percentage among non-diabetics, while 34.6% of the diabetics do not exceed 20 minutes of daily exercise, with a P value of 0.017. School students showed a lack of information about symptoms and complications of DM where only diabetics could mention them when compared with non-diabetic students, with P values of <0.001 for each of them. Diabetic students listed DM risk factors, such as genetics, obesity, and smoking, more frequently than non-diabetics; the corresponding P values were 0.004, 0.001, and 0.041. Unfortunately, more than 32% of diabetic students had the misconception that DM is not a controllable disease. According to the majority of diabetic students, soft drinks raise blood sugar levels. The Internet was the main source of information about DM. CONCLUSION The school students' understanding of DM was generally suboptimal. Their understanding of the symptoms, effects, and management of diabetes was low. Most school students in this cohort perceived that DM could not be controlled. Given the high rate of self-reported diabetes in the western region of Saudi Arabia, it is strongly advised to educate children about DM at an early age. Every student at school should adopt a healthy lifestyle that includes a balanced diet and regular exercise, and they should be closely observed by their teachers and parents. Family physicians should regularly check the adherence of diabetic children to their antidiabetic medications and ensure this important point with their caregivers. Psychological assessment and counseling are highly recommended for all diabetic children.
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Affiliation(s)
- Mohamed Y Alhilali
- College of Medicine and Surgery, Umm Al-Qura University, Al-Qunfudah, SAU
| | | | - Safa Alkalash
- College of Community Medicine and Healthcare, Umm Al-Qura University, Al-Qunfudah, SAU
- College of Family Medicine, Menoufia University, Shebin Elkom, EGY
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Altwaijri Y, Kazdin AE, Al-Subaie A, Al-Habeeb A, Hyder S, Bilal L, Naseem MT, De Vol E. Lifetime prevalence and treatment of mental disorders in Saudi youth and adolescents. Sci Rep 2023; 13:6186. [PMID: 37061556 PMCID: PMC10105730 DOI: 10.1038/s41598-023-33005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
Previous global and regional studies indicate that adolescents and young adults (i.e., youth) are affected by various mental disorders with lifelong consequences. However, there are no national estimates of mental disorders prevalent among Saudi youth. Using data from the Saudi National Mental Health Survey (SNMHS), we examined the lifetime prevalence, treatment, and socio-demographic correlates of mental disorders among Saudi youth (aged 15-30). A total of 4004 interviews were conducted using the adapted Composite International Diagnostic Interview (CIDI 3.0). Cross tabulations and logistic regression were used to generate estimates for the SNMHS youth sample (n = 1881). The prevalence of a mental disorder among Saudi youth was 40.10%, where anxiety disorders affected 26.84% of the sample, followed by disruptive behavior disorders (15.44%), mood disorders (9.67%), substance use disorders (4%) and eating disorders (7.06%). Sex, education, parental education, income, marital status, region, and family history of disorders were significant correlates of various classes of mental disorders. Only 14.47% of Saudi youth with any mental disorder received treatment for a lifetime disorder. Age, parental education, and family history of disorders emerged as significant correlates of mental health treatment. Lifetime mental disorders are highly prevalent among Saudi youth. There is an unmet need for culturally sensitive and age-appropriate treatment of lifetime mental disorders among youth in Saudi Arabia.
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Affiliation(s)
- Yasmin Altwaijri
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia.
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Edrak Medical Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Sanaa Hyder
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Health and Meaningful Dialogue (HAMD) Centre, Manchester, UK
| | - Lisa Bilal
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Edward De Vol
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
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Aljuraiban GS, Alfhili MA, Aldhwayan MM, Aljazairy EA, Al-Musharaf S. Metagenomic Shotgun Sequencing Reveals Specific Human Gut Microbiota Associated with Insulin Resistance and Body Fat Distribution in Saudi Women. Biomolecules 2023; 13:biom13040640. [PMID: 37189387 DOI: 10.3390/biom13040640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
(1) Background: Gut microbiota dysbiosis may lead to diseases such as insulin resistance and obesity. We aimed to investigate the relationship between insulin resistance, body fat distribution, and gut microbiota composition. (2) Methods: The present study included 92 Saudi women (18–25 years) with obesity (body mass index (BMI) ≥ 30 kg/m2, n = 44) and with normal weight (BMI 18.50–24.99 kg/m2, n = 48). Body composition indices, biochemical data, and stool samples were collected. The whole-genome shotgun sequencing technique was used to analyze the gut microbiota. Participants were divided into subgroups stratified by the homeostatic model assessment for insulin resistance (HOMA-IR) and other adiposity indices. (3) Results: HOMA-IR was inversely correlated with Actinobacteria (r = −0.31, p = 0.003), fasting blood glucose was inversely correlated with Bifidobacterium kashiwanohense (r = −0.22, p = 0.03), and insulin was inversely correlated with Bifidobacterium adolescentis (r = −0.22, p = 0.04). There were significant differences in α- and β-diversities in those with high HOMA-IR and waist–hip ratio (WHR) compared to low HOMA-IR and WHR (p = 0.02, 0.03, respectively). (4) Conclusions: Our findings highlight the relationship between specific gut microbiota at different taxonomic levels and measures of glycemic control in Saudi Arabian women. Future studies are required to determine the role of the identified strains in the development of insulin resistance.
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Affiliation(s)
- Ghadeer S. Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammad A. Alfhili
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Madhawi M. Aldhwayan
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Esra’a A. Aljazairy
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sara Al-Musharaf
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
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Bjornstad P, Chao LC, Cree-Green M, Dart AB, King M, Looker HC, Magliano DJ, Nadeau KJ, Pinhas-Hamiel O, Shah AS, van Raalte DH, Pavkov ME, Nelson RG. Youth-onset type 2 diabetes mellitus: an urgent challenge. Nat Rev Nephrol 2023; 19:168-184. [PMID: 36316388 PMCID: PMC10182876 DOI: 10.1038/s41581-022-00645-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
The incidence and prevalence of youth-onset type 2 diabetes mellitus (T2DM) and its complications are increasing worldwide. Youth-onset T2DM has been reported in all racial and ethnic groups, but Indigenous peoples and people of colour are disproportionately affected. People with youth-onset T2DM often have a more aggressive clinical course than those with adult-onset T2DM or those with type 1 diabetes mellitus. Moreover, the available treatment options for children and adolescents with T2DM are more limited than for adult patients. Intermediate complications of youth-onset T2DM, such as increased albuminuria, often develop in late childhood or early adulthood, and end-stage complications, including kidney failure, develop in mid-life. The increasing frequency, earlier onset and greater severity of childhood obesity in the past 50 years together with increasingly sedentary lifestyles and an increasing frequency of intrauterine exposure to diabetes are important drivers of the epidemic of youth-onset T2DM. The particularly high risk of the disease in historically disadvantaged populations suggests an important contribution of social and environmental factors, including limited access to high-quality health care, healthy food choices and opportunities for physical activity as well as exposure to stressors including systemic racism and environmental pollutants. Understanding the mechanisms that underlie the development and aggressive clinical course of youth-onset T2DM is key to identifying successful prevention and management strategies.
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Affiliation(s)
| | - Lily C Chao
- Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | | | - Allison B Dart
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
| | - Malcolm King
- University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Helen C Looker
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
| | | | - Orit Pinhas-Hamiel
- Paediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Amy S Shah
- Cincinnati Children's Hospital and The University of Cincinnati, Cincinnati, OH, USA
| | | | - Meda E Pavkov
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert G Nelson
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA.
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Toelsie JR, Morpurgo F, Krishnadath I, Bipat R. Obesity, overweight and hyperglycemia among primary school children in a low-middle income country with a multiethnic population. OBESITY PILLARS (ONLINE) 2023; 5:100053. [PMID: 37990748 PMCID: PMC10661996 DOI: 10.1016/j.obpill.2022.100053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/06/2022] [Accepted: 12/22/2022] [Indexed: 11/23/2023]
Abstract
Objective The number of children with cardiovascular risk factors is increasing steadily. However, limited data are available on the prevalence of overweight, obesity, and hyperglycemia among children in low-middle-income countries with multiethnic populations. Therefore, we assessed these factors in a school-based survey in Suriname, a low-middle-income country. Methods We invited pupils of 5th and 6th grade visiting the primary school to participate in this survey. We used a questionnaire and face to face interviews, and conducted measurements to collect data on biological factors (ethnicity, sex, length, weight, waist circumference, and fasting blood glucose levels), behavior (frequency of physical activity, breakfast, bedtime, screentime), consumption (fruit and vegetables, snack, dairy products) and social factors (parental education, living area). Results Overall, the percentage of children with overweight was 13.9%, obesity 13.3% and for elevated fasting blood glucose level (> 6 mmol/L) 4.5%. In the investigated group of individuals, obesity and overweight were associated with sex (girls showed a lower OR of 0.54 [95%CI: 0.39-0.75] for obesity), ethnicity (Javanese 2.1, 1.5-3.0 for overweight and 5.0, 3.1-8.2 for obesity, Maroon 2.2, 1.2-4.1 and Mixed ethnicity 1.7, 1.1-2.6, for obesity compared to Hindustani), behavior (Skip Breakfast: 1.4, 1.2-1.7, physical activity: 0.8, 0.7-0.9) and maternal education level (high 1.7, 1.0-2.7). Children with elevated fasting blood glucose levels showed an association with obesity (1.8, 1.2-2.7) and waist circumference (1.02, 1.01-1.03). Conclusion The results show that there is a high prevalence for overweight, obesity and elevated fasting blood glucose among children in Suriname. Furthermore, during childhood ethnicity is associated with obesity and overweight. We suggest that the modifiable risk factors such as BMI, WC, behavior, consumption are interesting for early intervention in children in a developing country.
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Affiliation(s)
- Jerry R. Toelsie
- Department of Physiology, Faculty of Medical Science, Anton de Kom University of Suriname, Paramaribo, Suriname
| | | | - Ingrid Krishnadath
- Department of Public Health, Faculty of Medical Science, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Robbert Bipat
- Department of Physiology, Faculty of Medical Science, Anton de Kom University of Suriname, Paramaribo, Suriname
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Al-Dubayee M, Babiker A, Alkewaibeen A, Alkhalifah A, Alanazi T, Nogoud M, Alotaibi A, Alotaibi F, Almetairi F, Alrowaily MA, Masuadi E, Nasr A. Correlation analysis between cytokines' profile, autoimmune antibodies and the duration of type 1 diabetes: A case control study in a specialized children's centre in Riyadh. Int J Immunopathol Pharmacol 2023; 37:3946320231209821. [PMID: 37953627 PMCID: PMC10644762 DOI: 10.1177/03946320231209821] [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: 10/10/2022] [Accepted: 10/06/2023] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the role of cytokines in children with T1D living in Saudi Arabia and their correlation with disease duration and autoimmune antibody markers. METHODS A case-control study was conducted in the endocrine clinic of King Abdullah Specialized Children's Hospital in Riyadh. A total of 274 T1D and healthy control children were enrolled in the study. 5 mL of venous blood samples were collected in the morning after 9 to 12 h of fasting in BD Vacutainer® EDTA tubes and centrifuged at 250g for 15 min at. Plasma was then stored at -20°C for detection of anti-islet, anti-GAD antibodies (Abs), and C-peptide using commercial ELISA kits from Thermo Fisher Scientific. The levels of cytokines were measured using commercial sandwich ELISA kits from Abcam. RESULTS Median differences in cytokine levels (IFN-γ, TNF-α, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-13, IL-18, IL-21, IL-35, and IL-37) were significantly higher in T1D patients compared with healthy controls (p-value < .001). Spearman's Rho correlation indicated that TNFα, IL-1β, IL-4, IL-10, IL-13, and IL-21 correlated significantly with T1D Abs (p-value = .01). HbA1C correlated negatively with IL-35 and IL-37, and positively with IL-18 (p-value = .01). Linear regression analysis showed a significant increase in anti-glutamic acid antibodies (GAD) in patients with >3 years of T1D duration. CONCLUSION Autoantibodies remained positive at high levels in our patients over a 3-year duration of the disease and correlated with specific cytokines. The clear correlations with disease duration and profile of specific cytokines could be targets for future therapeutic interventions.
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Affiliation(s)
- Mohammed Al-Dubayee
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Amir Babiker
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz Alkewaibeen
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Abdulrahman Alkhalifah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Tammam Alanazi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Maysa Nogoud
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Anas Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Faisal Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Firas Almetairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
| | - Mohammed A Alrowaily
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Emad Masuadi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Amre Nasr
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs (MNGHA), King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Almulhim AN, Goyder E, Caton SJ. Assessing the Feasibility and Acceptability of Health Coaching as a New Diabetes Management Approach for the People with Type 2 Diabetes in Saudi Arabia: A Protocol for a Mixed Methods Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15089. [PMID: 36429807 PMCID: PMC9690217 DOI: 10.3390/ijerph192215089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Over recent years, the Middle East, and especially Saudi Arabia, has faced multiple changes, including structural-demographic and economic shifts. This has led to massive changes in the population's lifestyle, including more unhealthy diets and increases in physical inactivity. As a result, accelerating rates of chronic diseases, including type 2 diabetes mellitus (T2DM) are a major public health concern. Current diabetes care in Saudi Arabia focuses on increasing the awareness of patients through various approaches, mainly based on health education, which is found to be suboptimal and ineffective for improving long-term outcomes. This study aims to assess the feasibility and acceptability of using a client-centred approach called health coaching that supports, enables, and engages T2DM patients to take the central role of controlling their own conditions by developing new crucial skills. METHODS A mixed methods randomised controlled feasibility study of health coaching will be used. Participants (n = 30) are adults with T2DM with poorly controlled diabetes (A1C ≥7) who can read and write in Arabic. Eligible participants are randomly allocated to either an intervention or control group for 12 weeks. COM-B model and Behaviour Change Technique Taxonomy version 1 (BCTTv1) guide the intervention curriculum. Predetermined progression criteria will be used to determine whether to proceed to a larger trial or not. Outcomes will be measured at baseline and 3 months. The study's primary aim is to assess the process of eligibility, recruitment, retention and completion rates, acceptability and suitability of intervention and the time to complete each procedure. The preliminary efficacy of health coaching is the secondary outcome that includes different measurements, such as HbA1c, blood pressure, body mass index (BMI), waist circumference, weight, patients' self-efficacy, and diabetes self-management. DISCUSSION This is the first study to explore the feasibility, acceptability, and preliminary efficacy of health coaching that used the Capability, Opportunity, Motivation, Behaviour (COM-B) model and BCTTv1 as guidance to develop the intervention for adults with T2DM in Saudi Arabia. The findings of this study will be used to inform the larger RCT trial if it is shown to be feasible and acceptable.
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Affiliation(s)
- Abdullah N. Almulhim
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK
- Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh 13316, Saudi Arabia
| | - Elizabeth Goyder
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK
| | - Samantha J. Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK
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Cheema S, Abraham A, El-Nahas KG, Abou-Amona R, Al-Hamaq AO, Maisonneuve P, Chaabna K, Lowenfels AB, Mamtani R. Assessment of Overweight, Obesity, Central Obesity, and Type 2 Diabetes among Adolescents in Qatar: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14601. [PMID: 36361482 PMCID: PMC9653877 DOI: 10.3390/ijerph192114601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Qatar has a high obesity and type 2 diabetes mellitus (T2DM) burden. This study aimed to (1) determine the prevalence of overweight, obesity, and T2DM in 13-17-year-old adolescents and (2) evaluate associations with adolescents' lifestyle and breastfeeding history, parental weight, and familial T2DM history. A cross-sectional study (double-stage cluster sampling) was conducted in 2018-2020 using a self-administered parental and adolescent questionnaire. In the results, 23.4% of the adolescents (107/459) were overweight; 19.9% (91/459) were obese; and 37.6% (171/459) had evidence of central obesity. Random blood sugar (RBS) was suggestive of prediabetes (≥140 mg/dL) for 23 (5.0%) adolescents and T2DM (≥200 mg/dL) for none. In multivariable analysis, obesity was significantly associated with no breastfeeding (OR = 3.17, 95% CI: 1.09-9.26) compared to breastfed adolescents for ≥6 months, with first-degree family history of T2DM (OR = 2.27; 95% CI: 1.22-4.27), with maternal obesity (OR = 2.40; 95% CI: 1.01-5.70), and with acanthosis nigricans in adolescents (OR = 19.8; 95% CI: 8.38-46.9). Central obesity was significantly associated with maternal obesity (OR = 2.21; 95% CI: 1.14-4.27) and with acanthosis nigricans (OR = 3.67; 95% CI: 1.88-7.18). Acanthosis nigricans (OR = 4.06; 95% CI: 1.41-11.7) was the only factor associated with elevated RBS. Addressing future disease burden among adults in Qatar will require extensive health and well-being programs, focused on healthy lifestyles and behaviors such as nutritious diets, physical activity, stress management, and self-care.
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Affiliation(s)
- Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
| | | | | | | | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
| | - Albert B. Lowenfels
- Department of Surgery and Department of Family Medicine, New York Medical College, Valhalla, New York, NY 10595, USA
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha P.O. Box 24144, Qatar
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11
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Bakaruddin S, Mohd Noordin Z, Karuppannan M. Affecting children’s knowledge about rational use of medicines using read-along videos of pictorial storybooks. Front Pharmacol 2022; 13:933546. [PMID: 36120329 PMCID: PMC9478889 DOI: 10.3389/fphar.2022.933546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Although efforts have been taken to educate the public about medication from a very young age, there are very limited availability and accessibility of education material for children. The aim of this study is to assess the impact of read-along videos of pictorial storybooks on children’s knowledge about rational use of medicines. This study compared pre and post knowledge scores in a nonrandomized, one-group pre-test-post-test experimental design. Pre-recorded read-along storytelling videos were used as intervention covering two topics on rational use of medicine -medicine storage and antibiotic resistance. The questionnaire and intervention videos were distributed using Google Forms to children aged six and seven in Malaysia via online social media platforms. 521 children completed the study. The mean baseline knowledge score for medication storage was 4.89 (SD = 1.12) pre-test and 5.44 (SD = 0.78) post-test while for antibiotic resistance the mean was 3.616 (SD = 1.340) pre-test and 4.820 (SD = 1.134) post-test. A Wilcoxon signed-rank test showed statistically significant changes on medication storage (Z = −10.21, p < 0.001) and antibiotic resistance (Z = −14.869, p < 0.001) related knowledge among children. Pictorial storybook read-along video interventions were shown to be effective in improving children’s knowledge on rational use of medicine. Education and awareness on the use of antibiotics should be prioritized.
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Affiliation(s)
| | - Zakiah Mohd Noordin
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, Bandar Puncak Alam, Malaysia
| | - Mahmathi Karuppannan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, Bandar Puncak Alam, Malaysia
- *Correspondence: Mahmathi Karuppannan,
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12
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Al-Hazzaa HM, Alrasheedi AA, Alsulaimani RA, Jabri L, Alhowikan AM, Alhussain MH, Bawaked RA, Alqahtani SA. Prevalence of overweight and obesity among saudi children: A comparison of two widely used international standards and the national growth references. Front Endocrinol (Lausanne) 2022; 13:954755. [PMID: 36004353 PMCID: PMC9393362 DOI: 10.3389/fendo.2022.954755] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To compare three body mass index (BMI) classifications that are used to assess the prevalence of overweight and obesity among Saudi children aged 6-13 years: the International Obesity Task Force (IOTF) age and gender cutoffs, the World Health Organization (WHO) growth references for school-aged children, and the Saudi (KSA) national growth references. Methods The sample comprised 2,169 children (52.5% girls) derived from two cross-sectional studies conducted in Riyadh and Jeddah during the 2017 and 2019 school years, respectively. Body weight and height were measured, and BMI was calculated. Results The proportions (%) of the participants who were classified as underweight, overweight, and obese varied according to the reference used: IOTF reference (13.8, 18.4, and 12.7), WHO reference (17.2, 19.1, and 18.9), and KSA reference (7.0, 22.4, and 9.3), respectively, indicating higher values for overweight and obesity prevalence when the WHO references were used. Kappa agreement measures between the three references were found to be high, with the coefficients ranging from 0.936 (between the IOTF and KSA references) to 0.849 (between the IOTF and WHO references). In all three classifications, girls exhibited lower overweight or obesity prevalence than boys. Family income, but not paternal or maternal education, was significantly (p = 0.015) associated with overweight/obesity when using the IOTF standards. In addition, having a small family in the house was significantly (p < 0.05) associated with obesity, irrespective of the classification system. Conclusion Inconsistency was observed when estimating the prevalence of underweight, overweight, and obesity among Saudi children. However, when defining the overall prevalence of overweight plus obesity among Saudi children, the IOTF classification system performed in a similar way to the KSA references (31.1% versus 31.7%) compared to the WHO references (38.0%).
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Affiliation(s)
- Hazzaa M. Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amani A. Alrasheedi
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rayan A. Alsulaimani
- Department of Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Laura Jabri
- American International School of Jeddah, Jeddah, Saudi Arabia
| | | | - Maha H. Alhussain
- Department of Food Science & Nutrition, College of Foods & Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Rowaedh A. Bawaked
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Saleh A. Alqahtani
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, United States
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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13
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Nasrallah M, Tamim H, Mailhac A, AlBuhairan F. Lifestyle habits in Saudi adolescents with diagnosed diabetes: An opportunity for health promotion. PLoS One 2022; 17:e0270807. [PMID: 35925967 PMCID: PMC9352005 DOI: 10.1371/journal.pone.0270807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Aims This study assessed lifestyle and health behavior habits among a representative sample of Saudi adolescents with self-reported diabetes and compared them to non-diabetic peers. Methods This was a nested case-control study, from the Jeeluna cohort, a nationwide, cross-sectional study of 12,575 Saudi boys and girls aged 10–19 years. Non-diabetic adolescents were matched to those with diabetes on a ratio of 4:1 based on age, gender and region. Retained information from the original study included: socio-demographics, lifestyle behaviors, tobacco/substance use, screen use, anthropometric measurements, and laboratory results. Results The prevalence of diabetes was 0.7% (n = 87). Overall, 65% of diabetic participants were males, and 22.4% aged ≤14 years. Overall, both groups had low rates of healthful habits in their diet and physical activity. Both groups had similar rates of tobacco use, and high digital screen time. Adolescents with diabetes had more consistent sleeping pattern, were more likely to be on a diet, thought they spent enough time with their physician and obtained medical information more often from their health clinic. They were also more likely to feel down and to chat more often. Conclusion Adolescents with diabetes remain far from guideline targets but seem predisposed to better lifestyle and have more access to health as compared to their non-diabetic peers.
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Affiliation(s)
- Mona Nasrallah
- Department of Internal Medicine, Division of Endocrinology and Metabolism, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Aurelie Mailhac
- Department of Internal Medicine, Division of Endocrinology and Metabolism, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadia AlBuhairan
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Health Sector Transformation Program, Riyadh, Saudi Arabia
- * E-mail:
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Han C, Song Q, Ren Y, Chen X, Jiang X, Hu D. Global prevalence of prediabetes in children and adolescents: A systematic review and meta-analysis. J Diabetes 2022; 14:434-441. [PMID: 35790502 PMCID: PMC9310043 DOI: 10.1111/1753-0407.13291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/05/2022] [Accepted: 05/31/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Prediabetes is a pivotal risk factor for developing diabetes. This meta-analysis was performed to assess the global prevalence of childhood prediabetes. METHODS A systematic search was conducted for studies of prediabetes prevalence in the general pediatric population from inception until December 2021. Random-effects meta-analysis was used to combine the data. Variations in the prevalence estimates in different subgroups (age group, sex, setting, investigation period, body mass index [BMI] group, family history of diabetes, diagnosis criteria, World Health Organization [WHO] and World Bank [WB] regions) were examined by subgroup meta-analysis. RESULTS A total of 48 studies were included in the meta-analysis. The pooled prevalence was 8.84% (95% CI, 6.74%-10.95%) for prediabetes in childhood. Subgroup meta-analyses showed that the prevalence was higher in males than females (8.98% vs 8.74%, P < .01), in older compared to younger children (7.56% vs. 2.51%, p < 0.01), in urban compared to rural areas (6.78% vs. 2.47, p < 0.01), and higher in children with a family history of diabetes than in those without such a history (7.59% vs. 6.80%, p < 0.01). We observed an upward trend in prediabetes prevalence from 0.93% to 10.66% over past decades (p < 0.01). The pooled prevalence increased from 7.64% to 14.27% with increased BMI (p < 0.01). Pooled prevalence was the lowest for criterion A among different diagnosis criteria (p < 0.01). For WHO and WB regions, the European Region and high-income countries yielded the lowest pooled prevalence (p < 0.01). CONCLUSIONS Elevated prediabetes prevalence in childhood reaches an alarming level. Intensive lifestyle modification is needed to improve the prediabetes epidemic.
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Affiliation(s)
- Chengyi Han
- The First Affiliated Hospital of Henan University of CMZhengzhouHenanChina
- School of Public Health, Shenzhen University Health Science CenterShenzhenGuangdongChina
| | - Qing Song
- The First Affiliated Hospital of Henan University of CMZhengzhouHenanChina
| | - Yongcheng Ren
- The Medical Collage of Huanghuai UniversityZhumadianHenanChina
| | - Xinyu Chen
- School of Public Health, Southwest Medical UniversityChengduSichuanChina
| | - Xuesong Jiang
- The First Affiliated Hospital of Henan University of CMZhengzhouHenanChina
| | - Dongsheng Hu
- School of Public Health, Shenzhen University Health Science CenterShenzhenGuangdongChina
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15
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Esmaeili S, Saeedi Moghaddam S, Namazi N, Bandarian F, Esfahani Z, Peimani M, Shahin S, Nasli-Esfahani E, Akbarzadeh I, Ghanbari A, Rezaei N, Rezaei N, Larijani B, Farzadfar F. Burden of type 1 diabetes mellitus in the North Africa and Middle East Region, 1990-2019; findings from the global burden of disease study. Diabetes Res Clin Pract 2022; 188:109912. [PMID: 35537522 DOI: 10.1016/j.diabres.2022.109912] [Citation(s) in RCA: 2] [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] [Received: 12/09/2021] [Revised: 04/15/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
AIMS We aimed to report the burden of type 1 diabetes mellitus (T1DM) in the North Africa and Middle East region and its 21 countries from 1990 to 2019. METHODS Information related to incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and years lived with disability (YLDs) of T1DM was acquired from the 2019 Global Burden of Disease study. The burden was estimated by sex, age groups, and socio-demographic index (SDI) in 21 countries. RESULTS Over the past 30 years, regional incidence, prevalence, mortality, and DALYs of T1DM increase by 188.7%, 304.8%, 43.7%, and 71.6%, respectively. While the age-standardized incidence and prevalence rates increased by 84% and 91%, the mortality and DALYs rates decreased by 34% and 13%. During these years, the contribution of YLDs to total DALYs increased considerably (from 17% to 42%). The highest increase in the incidence and prevalence rates occurred in high SDI countries. Moreover, the Mortality to Incidence Ratio (MIR) decreased in the region countries. CONCLUSIONS Despite progress made in diabetes care, there is a persistently increasing burden of T1DM in the region countries. This indicates that T1DM is still one of the major health challenges in the region countries, especially in high SDI Arab countries.
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Affiliation(s)
- Shahnaz Esmaeili
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazli Namazi
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bandarian
- Cell therapy and regenerative medicine research center, endocrinology and metabolism, molecular cellular sciences institute, Tehran University of Medical Science, Tehran, Iran
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Peimani
- Metabolomics and genomics research center endocrinology and metabolism molecular- cellular sciences institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvenaz Shahin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Isa Akbarzadeh
- Department of epidemiology and biostatics, school of public health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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16
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Al-Daghri NM, Amer OE, Hameidi A, Alfawaz H, Alharbi M, Khattak MNK, Alnaami AM, Aljohani NJ, Alkhaldi G, Wani K, Sabico S. Effects of a 12-Month Hybrid (In-Person + Virtual) Education Program in the Glycemic Status of Arab Youth. Nutrients 2022; 14:nu14091759. [PMID: 35565727 PMCID: PMC9103307 DOI: 10.3390/nu14091759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/04/2022] Open
Abstract
This 12-month school-based intervention study investigated the effects of hybrid educational lifestyle modifications on glycemic control among Saudi youth with different glycemic statuses. A total of 2600 Arab adolescents aged 12−18 years were recruited from 60 randomly selected schools. Anthropometrics, blood glucose, and HbA1c were measured pre- and post-intervention. Participants were grouped according to baseline HbA1c into normal, prediabetes, and diabetes groups. All participants received lifestyle education at base line and at every 3-month interval to improve diet and exercise behavior. Diabetic and prediabetic participants received a tailored lifestyle intervention. Post-intervention, 643 participants were analyzed as follows: 20 participants from the diabetes group, 39 from prediabetes, and 584 from the normal group. A modest but significant improvement in the glycemic status of diabetic and prediabetic participants was observed, but not in the normal group. In the diabetes group, 11 (55%) participants achieved normal HbA1c levels, 5 had prediabetes levels, and only 4 remained within diabetes HbA1c levels. In the prediabetes group, 34 (87.2%) participants achieved normal HbA1c levels, while 2 (5.1%) participants remained prediabetic and 3 (7.7%) had diabetes HbA1c levels (p < 0.001). This hybrid lifestyle intervention program modestly reduces the risk of T2DM among youth with elevated HbA1c levels. The challenge of sustaining interest in adopting lifestyle changes for a longer duration should be addressed in further studies in this population.
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Affiliation(s)
- Nasser M. Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (A.M.A.); (K.W.); (S.S.)
- Correspondence: ; Tel.: +966-114675939; Fax: +966-114675931
| | - Osama E. Amer
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (A.M.A.); (K.W.); (S.S.)
| | | | - Hanan Alfawaz
- Department of Food Science and Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh 11495, Saudi Arabia;
| | - Mohammed Alharbi
- Diabetes Centres and Units Administration, Ministry of Health, Riyadh 11176, Saudi Arabia;
| | - Malak N. K. Khattak
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (A.M.A.); (K.W.); (S.S.)
| | - Abdullah M. Alnaami
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (A.M.A.); (K.W.); (S.S.)
| | - Naji J. Aljohani
- Obesity Endocrine and Metabolism Center, King Fahad Medical City, Riyadh 11525, Saudi Arabia;
| | - Ghadah Alkhaldi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Kaiser Wani
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (A.M.A.); (K.W.); (S.S.)
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (A.M.A.); (K.W.); (S.S.)
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17
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Alazwari A, Abdollahian M, Tafakori L, Johnstone A, Alshumrani RA, Alhelal MT, Alsaheel AY, Almoosa ES, Alkhaldi AR. Predicting age at onset of type 1 diabetes in children using regression, artificial neural network and Random Forest: A case study in Saudi Arabia. PLoS One 2022; 17:e0264118. [PMID: 35226685 PMCID: PMC8884498 DOI: 10.1371/journal.pone.0264118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/03/2022] [Indexed: 11/18/2022] Open
Abstract
The rising incidence of type 1 diabetes (T1D) among children is an increasing concern globally. A reliable estimate of the age at onset of T1D in children would facilitate intervention plans for medical practitioners to reduce the problems with delayed diagnosis of T1D. This paper has utilised Multiple Linear Regression (MLR), Artificial Neural Network (ANN) and Random Forest (RF) to model and predict the age at onset of T1D in children in Saudi Arabia (S.A.) which is ranked as the 7th for the highest number of T1D and 5th in the world for the incidence rate of T1D. De-identified data between (2010-2020) from three cities in S.A. were used to model and predict the age at onset of T1D. The best subset model selection criteria, coefficient of determination, and diagnostic tests were deployed to select the most significant variables. The efficacy of models for predicting the age at onset was assessed using multi-prediction accuracy measures. The average age at onset of T1D is 6.2 years and the most common age group for onset is (5-9) years. Most of the children in the sample (68%) are from urban areas of S.A., 75% were delivered after a full term pregnancy length and 31% were delivered through a cesarean section. The models of best fit were the MLR and RF models with R2 = (0.85 and 0.95), the root mean square error = (0.25 and 0.15) and mean absolute error = (0.19 and 0.11) respectively for logarithm of age at onset. This study for the first time has utilised MLR, ANN and RF models to predict the age at onset of T1D in children in S.A. These models can effectively aid health care providers to monitor and create intervention strategies to reduce the impact of T1D in children in S.A.
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Affiliation(s)
- Ahood Alazwari
- School of Science, RMIT University, Melbourne, Victoria, Australia
- School of Science, Al-Baha University, Moundq, Saudi Arabia
- * E-mail:
| | - Mali Abdollahian
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Laleh Tafakori
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Alice Johnstone
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Rahma A. Alshumrani
- Pediatric Endocrine Department, Al Aziziyah Maternal and Children Hospital, Jeddah, Saudi Arabia
| | - Manal T. Alhelal
- Pediatric Endocrine Department, Maternal and Children Hospital, Al-Ahsa, Saudi Arabia
| | | | - Eman S. Almoosa
- Pediatric Endocrine Department, Maternal and Children Hospital, Al-Ahsa, Saudi Arabia
| | - Aseel R. Alkhaldi
- Pediatric Endocrine Department, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
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Shilbayeh S. Type 2 diabetes mellitus and its effect on quality of life in adolescents: A retrospective cohort study in Saudi Arabia. Pediatr Endocrinol Diabetes Metab 2022; 28:54-63. [PMID: 35307997 PMCID: PMC10226344 DOI: 10.5114/pedm.2022.113988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/24/2021] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Quality of life (QoL) in adolescent patients suffering from type 2 diabetes mellitus (T2DM) has not been thoroughly explored in Saudi Arabia. Herein, we aimed to measure the health-related quality of life (HRQoL) in adolescent patients suffering from T2DM and explore the correlation between adolescents' self- and parent-reporting of QoL scores, and glycaemic control (HbA1c). MATERIAL AND METHODS A retrospective multi-centre cohort study was conducted at 4 hospitals in Riyadh, Saudi Arabia. The Paediatric Quality of Life Inventory (PedsQLTM) Diabetes Module 3.0 was completed by children and their parents in a confidential and anonyms manner through a phone interview. RESULTS We recruited 49 paediatric patients for this study (mean age: 18.45 years; male: 55%). Both children and parents reported low cumulative mean scores for PedsQL™ (58.65 and 57.38, respectively) as compared to previous international studies. The lowest obtained score was noted for the diabetes symptoms domain (53.4). Comparing the magnitude of discrepancy between the adolescents' and parents' subscale scores revealed a non-significant difference, except for the 'worry' subscale, in which parents reported significantly higher mean scores (76.73 vs. 60.54, p = 0.02). Comparison of mean scores reported by adolescents who met the target HbA1c goal (<7%) and their counterparts revealed a non-significant difference, suggesting an irrelevant impact of this parameter on their perspectives or experiences. CONCLUSIONS The study findings emphasized the need to initiate further intensive awareness programs concerning this disease and its clinical implications in T2DM children to improve treatment adherence and symptoms, and consequently improve the perception of the patient and the family for HRQoL.
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Affiliation(s)
- Sireen Shilbayeh
- Prof. Sireen Shilbayeh Pharmaceutical Practice Princess Nourah bint Abdulrahman University Riyadh, Saudi Arabia e-mail:
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19
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The epidemiology, clinical, biochemical, immunological and radiological features of youth onset type 2 diabetes mellitus in the state of Qatar. Diabetol Int 2021; 13:381-386. [DOI: 10.1007/s13340-021-00548-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/01/2021] [Indexed: 01/16/2023]
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20
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Wang S, Li W, Qiao Y, Wang S, Zhang T, Liu E, Pan L, Leng J. Abnormal glucose in pre-school children and the association with obesity/physical activity: A large population-based study. Diabetes Metab Res Rev 2021; 37:e3442. [PMID: 33496037 DOI: 10.1002/dmrr.3442] [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: 01/16/2020] [Revised: 09/07/2020] [Accepted: 11/13/2020] [Indexed: 11/05/2022]
Abstract
AIM The rise of diabetes mellitus (DM) and impaired fasting glucose (IFG) in children has become a worldwide challenge, but population-based survey targeted on pre-school children is lacking. The aim of the study was to determine the prevalence of DM and IFG in pre-school children and their association with obesity and susceptible behaviours. METHODS A population-based survey was conducted and 21,571 Chinese children aged 5-6 years were recruited from 66 kindergartens in Tianjin, China during the year of 2016-2018. Fasting glucose was measured for all participants. Children with fasting glucose over 7.0 mmol/L was defined as DM, and 5.6-6.9 mmol/L was defined as IFG. RESULTS The prevalence of DM and IFG in the current study among Chinese children aged 5-6 years old was 0.05% and 1.18%, respectively, with significant gender and regional disparities (p < 0.001). The risk of abnormal fasting glucose increased with obesity (OR 1.44, 95% CI 1.00-2.06, p < 0.05), especially with moderate/severe obesity (OR 1.84, 95% CI 1.10-3.10, p < 0.05). Further analyses found that as compared to children who had at least 2 h/day physical activity, physical activity <1 h/day increased the risk of abnormal fasting glucose independently of BMI z-score (OR 1.79, 95% CI 1.10-2.91, p < 0.05). CONCLUSIONS The study was the first population-based large-scale survey of DM and IFG which targeted on pre-school children, and demonstrated that moderate/severe obesity and inadequate physical activity raised the risk of DM and IFG early from pre-school. The findings highlighted the necessity of early detection for abnormal glucose and control of obesity and susceptible behaviours.
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Affiliation(s)
- Shuo Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Yijuan Qiao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Shuting Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Tao Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Enqing Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Lei Pan
- Tianjin Women's and Children's Health Center, Tianjin, China
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Alguwaihes A, Al-Sofiani ME, Alyusuf E, Almutairi A, Ibrahim E, Albunyan SS, Alzahrani S, Hasanto R, Jammah AA. COVID-19 Precautionary Measures and Type 1 Diabetes Patients in Saudi Arabia. Prim Care Diabetes 2021; 15:793-798. [PMID: 34275769 PMCID: PMC8282990 DOI: 10.1016/j.pcd.2021.07.005] [Citation(s) in RCA: 2] [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] [Received: 01/24/2021] [Revised: 06/23/2021] [Accepted: 07/10/2021] [Indexed: 12/23/2022]
Abstract
AIM To minimize the spread of COVID-19, the Kingdom of Saudi Arabia (KSA) enforced a nationwide lockdown. We aimed to explore whether the manner in which Saudi patients with type 1 diabetes (T1D) manage their disease has changed during this unparalleled lockdown. METHODS An online survey exploring the effect of lockdown on T1D outcomes was distributed among T1D patients residing in KSA during lockdown. RESULTS A total of 1010 patients responded to the survey. Around 40% reported communicating with their physicians during lockdown. Age, level of education, residence, previous visits to diabetes education clinics, last HbA1c value, and average monthly income were all significantly associated with communication with the treating physician (p = 0.008, p < 0.001, p < 0.001, p = 0.002, p < 0.001, and p < 0.001, respectively). Age, level of education, and average monthly income were significantly associated with experiencing severe hypoglycemia (p = 0.036, p = 0.03, and p < 0.001, respectively), while average monthly income and level of education were significantly associated with experiencing diabetic ketoacidosis (DKA) (p < 0.001 and p = 0.0039, respectively); during lockdown. Patients who communicated with their physicians reported lower rates of severe hypoglycemia compared to those who did not (25.2% vs 30.7%, respectively). CONCLUSION Age and level of education were significantly associated with communication with the treating physician, and experiencing severe hypoglycemia and DKA; in patients with T1D during the lockdown period in Saudi Arabia. Keeping two-way virtual communication channels between physicians and their T1D patients should be encouraged.
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Affiliation(s)
- Abdullah Alguwaihes
- Division of Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Mohammed E Al-Sofiani
- Division of Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD.
| | - Ebtihal Alyusuf
- Division of Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Aeshah Almutairi
- Health Education, King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Eman Ibrahim
- Health Education, King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Sarah S Albunyan
- Division of Clinical Nutrition, Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Saad Alzahrani
- Obesity, Endocrine, and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia.
| | - Rana Hasanto
- Pathology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Anwar A Jammah
- Division of Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Al Hourani H, Atoum M, Alzoughool F, Al-Shami I. Screening for non-invasive risk factors of type 2 diabetes in overweight and obese schoolchildren. ENDOCRINOL DIAB NUTR 2021; 68:527-533. [PMID: 34872635 DOI: 10.1016/j.endien.2021.11.015] [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: 07/31/2020] [Accepted: 10/21/2020] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The prevalence of type 2 diabetes mellitus (T2DM) is increasing among young people worldwide. The American Diabetes Association has defined the risk factors that are associated with this increased risk for developing T2DM in youths. OBJECTIVE To explore school children at high-risk for T2DM in Jordan. MATERIALS AND METHODS A descriptive cross-sectional study was conducted. The children were 10-14.9 years old. Weight, height, and waist circumference were measured, and the body mass index Z score (BMI) was determined. The waist to height ratio (WHtR) was calculated. Blood pressure was measured and three child́s risk factors were identified. RESULTS Eight hundred and seventy-one schoolchildren were screened; 26.0% were overweight and 19.3% were obese. The most common risk factor among overweight and obese children, accounting for 80.4%, was a positive family history of type 2 diabetes mellitus in first- or second-degree relatives. Children born to mothers with diabetes or gestational diabetes mellitus during the child's gestation represented 17.3%, and around 26.8% were found to have hypertension (stage 1 or 2). In relation to the risk factors, 12.6% presented no risk factors; 54.0% had at least one factor; 29.1% two risk factors and 4.3% had three risk factors. CONCLUSION Risk factors for T2DM are very common. Around 54% had one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Jordanian school children are urgently needed.
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Affiliation(s)
- Huda Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences. The Hashemite University, Zarqa, 13133, Jordan.
| | - Manar Atoum
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Foad Alzoughool
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences. The Hashemite University, Zarqa, 13133, Jordan
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Barakat C, Yousufzai SJ, Booth A, Benova L. Prevalence of and risk factors for diabetes mellitus in the school-attending adolescent population of the United Arab Emirates: a large cross-sectional study. BMJ Open 2021; 11:e046956. [PMID: 34526335 PMCID: PMC8444241 DOI: 10.1136/bmjopen-2020-046956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The prevalence of diabetes has reportedly increased among adolescents in low-income and middle-income countries of the Middle East and may be linked to social, demographic and economic contextual factors. This study aimed: (1) to estimate the prevalence of self-reported diagnosis of diabetes in the adolescent population of the United Arab Emirates (UAE); (2) to assess differences in the prevalence based on gender and (3) to identify other characteristics of those with diabetes including parental marital status, smoking/illegal drug use, quality of life and nationality. DESIGN A secondary data analysis was performed on data from the National Study of Population Health in the UAE, conducted between 2007 and 2009. SETTING Large cross-sectional population-based survey study. PARTICIPANTS Survey was administered to a stratified random sample of 151 public and private schools from the UAE, across 7 emirates. 6365 school-attending adolescents (12-22 years; mean=16 years) participated. OUTCOMES Multivariable logistic regression analysis was used to examine the relationships between diabetes diagnosis and characteristics of participants after adjusting for confounding from other predictors. RESULTS The overall prevalence of self-reported diabetes was 0.9% (95% CI 0.7% to 1.2%) and was higher in males 1.5% (95% CI 1.0% to 2.1%) than females 0.5% (95% CI 0.3% to 0.8%), (p<0.001). Children of parents who were not currently married had more than twice the odds of self-reporting diabetes (p=0.031) compared with those with married parents. Adolescents who reported ever smoking/using illegal drugs had more than three times the odds of diabetes (p<0.001). CONCLUSION We found a positive association between certain characteristics of adolescents and their diabetes status, including male gender, parental marital status and smoking/illegal drug use. The high prevalence of smoking/illegal drug use among those reporting a diagnosis of diabetes suggests the need for behavioural and mental health interventions for adolescents with diabetes, as well as strong parental support and involvement.
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Affiliation(s)
- Caroline Barakat
- Faculty of Health Science, Ontario Tech University, Oshawa, Ontario, Canada
| | | | - Alison Booth
- London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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24
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El-Kebbi IM, Bidikian NH, Hneiny L, Nasrallah MP. Epidemiology of type 2 diabetes in the Middle East and North Africa: Challenges and call for action. World J Diabetes 2021; 12:1401-1425. [PMID: 34630897 PMCID: PMC8472500 DOI: 10.4239/wjd.v12.i9.1401] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/21/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes continues to be a serious and highly prevalent public health problem worldwide. In 2019, the highest prevalence of diabetes in the world at 12.2%, with its associated morbidity and mortality, was found in the Middle East and North Africa region. In addition to a genetic predisposition in its population, evidence suggests that obesity, physical inactivity, urbanization, and poor nutritional habits have contributed to the high prevalence of diabetes and prediabetes in the region. These risk factors have also led to an earlier onset of type 2 diabetes among children and adolescents, negatively affecting the productive years of the youth and their quality of life. Furthermore, efforts to control the rising prevalence of diabetes and its complications have been challenged and complicated by the political instability and armed conflict in some countries of the region and the recent coronavirus disease 2019. Broad strategies, coupled with targeted interventions at the regional, national, and community levels are needed to address and curb the spread of this public health crisis.
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Affiliation(s)
- Imad M El-Kebbi
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Faculty of Medicine, Beirut 11072020, Lebanon
- Department of Internal Medicine, Sheikh Shakhbout Medical City, Abou Dhabi 11001, United Arab Emirates
| | - Nayda H Bidikian
- School of Medicine, American University of Beirut, Faculty of Medicine, Beirut 11072020, Lebanon
| | - Layal Hneiny
- University Libraries, Saab Medical Library, American University of Beirut, Beirut 11072020, Lebanon
| | - Mona Philippe Nasrallah
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Faculty of Medicine, Beirut 11072020, Lebanon
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Akintayo-Usman NO, Okanlawon FA, Usman SO. Prevalence of pre-diabetes and risk factors among secondary school adolescents in Osogbo Local Government Area, Osun State, Nigeria. Afr Health Sci 2021; 21:1301-1309. [PMID: 35222595 PMCID: PMC8843308 DOI: 10.4314/ahs.v21i3.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Pre-diabetes is an emerging public health challenge in sub-Saharan Africa. Objectives To estimate prevalence of pre-diabetes and assess its associated factors among adolescents. The risk factors were divided into individual, interpersonal and community factors, adapting socio-ecological model. Methods This study utilised a cross-sectional descriptive survey. The target population was secondary school adolescents of Osogbo Local Government. Questionnaire was used to interview 405 participants through multi-stage sampling. Prediabetes was measure through fasting blood glucose. Results Findings revealed prevalence rate of 9.4%. Individual factors identified to be significant include age, religion and family history. Further analysis showed adolescents with normal BMI and high BP are likely to develop pre-diabetes when compared to those with underweight and normal BP respectively. Among interpersonal factors, parents' dietary habit was significant. Also, adolescents with employed parents were likely to develop pre-diabetes compared to those with unemployed parents. Lastly, availability of healthy food in school was the only statistically significant community factor. Hence, the more availability of food, fruits and vegetables in schools, the less likelihood of developing prediabetes. Conclusion These findings affirmed that prediabetes is becoming common problem among Nigerian adolescents. There is therefore need for stakeholders to face this challenge before it becomes endemic.
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Affiliation(s)
| | | | - Saheed O Usman
- Department of Chemical Pathology, Nnamdi Azikiwe University Awka, Nigeria
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Latif R, Rafique N. Prevalence and Risk Factors of Prediabetes in Young Saudi Females in a University Setting. Ethiop J Health Sci 2021; 30:929-940. [PMID: 33883838 PMCID: PMC8047230 DOI: 10.4314/ejhs.v30i6.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Studies reporting prediabetes prevalence in young Saudis are almost a decade old. The present study determined prediabetes prevalence and its associated risk factors (body composition, lipid profile, blood pressure and physical activity) in young Saudi females. Methods Three hundred Saudi females (18–20 years old), studying in year 2 and 3 at Imam Abdulrahman Bin Faisal University, were categorized as normoglycemic or prediabetic based on fasting plasma glucose criteria of World Health Organization (WHO) and American Diabetes Association (ADA). Anthropometric measurements, lipid profile, atherogenic indices, and physical activity data were compared. Association between fasting blood glucose and study variables was found by Bivariate analysis (Spearman Correlation for non-parametric variables and Pearson correlation for parametric) followed by Binary Logistic Regression analysis. Results Prevalence of prediabetes by WHO and ADA criteria were 11.3% and 18.7% respectively. Systolic, diastolic and mean arterial pressures, waist circumference, waist-hip and waist-stature-ratios were significantly raised in prediabetics compared to normoglycemic (WHO criteria p-values; 0.03, 0.003, 0.005, 0.01, 0.01, 0.04 respectively; ADA criteria 0.04, 0.001, 0.02, 0.02, 0.03, 0.01 respectively). For each unit increase in systolic, diastolic and mean arterial pressures, and waist circumference, the odds of becoming prediabetic increased by a factor of 1.02, 1.05, 1.04 and 1.03 respectively by WHO criteria: and 1.01, 1.03, 1.02, and 1.02 respectively by ADA criteria Conclusion Substantial numbers of young females in our university are suffering from prediabetes. An increase in systolic, diastolic, and mean arterial pressures and waist circumference are significant risk factors for prediabetes in young females.
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Affiliation(s)
- Rabia Latif
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University
| | - Nazish Rafique
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University
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Gong X, Xiong L, Bi C, Zhang B. Diosmetin ameliorate type 2 diabetic mellitus by up-regulating Corynebacterium glutamicum to regulate IRS/PI3K/AKT-mediated glucose metabolism disorder in KK-Ay mice. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 87:153582. [PMID: 34091150 DOI: 10.1016/j.phymed.2021.153582] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/06/2021] [Accepted: 04/22/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND PURPOSE Diosmetin (Dios), a flavonoid compound with multiple pharmacological activities. However, fewer studies have reported its effects on type 2 diabetic mellitus (T2DM). Here, we address the effect of Dios on glucose metabolism and gut microbiota in KK-Ay diabetic mice. METHOD Wild type C57BL/6 J mice or diabetic KK-Ay mice were treated with vehicle or Dios for one month. The ELISA kit and fluorescence microscope system were respectively employed to the evaluation of serum biochemical indicators and histopathological changes. Liver RNA-Seq and western blot were used to reveal the key signaling pathway. The effects of Dios on gut microbiota was investigated by the 16S rRNA gene sequencing, as well as the relationship between Dios and C. glu on glucose metabolism was explored with the C. glu transplantation. RESULTS Dios treatment significantly decreased blood glucose and increased serum insulin concentrations. RNA-Seq analysis found that the underlying action mechanism of Dios on T2DM was via modulating glucose metabolism, which was proved by up-regulating IRS/PI3K/AKT signaling pathway to promote glycogen synthesis and GLUT4 translocation. Besides, Dios treatment reshaped the unbalanced gut microbiota by suppressing the ratio of Firmicutes/Bacteroidetes and markedly increasing the richness of C. glu. Moreover, treatment with C. glu and Dios together could markedly ameliorate glucose metabolism by up-regulating IRS/PI3K/AKT signaling pathway to promote glycogen synthesis and GLUT4 translocation. CONCLUSIONS Dios treatment remarkably ameliorated glucose metabolism in KK-Ay diabetic mice by the regulation of C. glu via IRS/PI3K/AKT signaling pathway and reshaped the unbalanced gut microbiota. Our study provided evidence for the application of Dios to the treatment of T2DM.
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Affiliation(s)
- Xiaobao Gong
- College of Pharmaceutical Sciences, Southwest University, No.2 Tiansheng Road, Beibei, Chongqing 400716, PR China
| | - Li Xiong
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Caihong Bi
- Service Center for Technology Extension of Linyi Fruit and Tea, Linyi 276000, PR China
| | - Baoshun Zhang
- College of Pharmaceutical Sciences, Southwest University, No.2 Tiansheng Road, Beibei, Chongqing 400716, PR China.
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Al Hourani H, Atoum M, Alzoughool F, Al-Shami I. Screening for non-invasive risk factors of type 2 diabetes in overweight and obese schoolchildren. ENDOCRINOL DIAB NUTR 2021; 68:S2530-0164(21)00074-4. [PMID: 33849819 DOI: 10.1016/j.endinu.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The prevalence of type 2 diabetes mellitus (T2DM) is increasing among young people worldwide. The American Diabetes Association has defined the risk factors that are associated with this increased risk for developing T2DM in youths. OBJECTIVE To explore school children at high-risk for T2DM in Jordan. MATERIALS AND METHODS A descriptive cross-sectional study was conducted. The children were 10-14.9 years old. Weight, height, and waist circumference were measured, and the body mass index Z score (BMI) was determined. The waist to height ratio (WHtR) was calculated. Blood pressure was measured and three child́s risk factors were identified. RESULTS Eight hundred and seventy-one schoolchildren were screened; 26.0% were overweight and 19.3% were obese. The most common risk factor among overweight and obese children, accounting for 80.4%, was a positive family history of type 2 diabetes mellitus in first- or second-degree relatives. Children born to mothers with diabetes or gestational diabetes mellitus during the child's gestation represented 17.3%, and around 26.8% were found to have hypertension (stage 1 or 2). In relation to the risk factors, 12.6% presented no risk factors; 54.0% had at least one factor; 29.1% two risk factors and 4.3% had three risk factors. CONCLUSION Risk factors for T2DM are very common. Around 54% had one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Jordanian school children are urgently needed.
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Affiliation(s)
- Huda Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences. The Hashemite University, Zarqa, 13133, Jordan.
| | - Manar Atoum
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Foad Alzoughool
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences. The Hashemite University, Zarqa, 13133, Jordan
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Khan SQ, Khabeer A, Al-Thobity AM, Benrashed MA, Alyousef NI, AlMaimouni Y. Correlation between diabetes mellitus and number of restored, carious lesions and missing teeth: A retrospective radiographic evaluation. Saudi Dent J 2021; 33:131-136. [PMID: 33679105 PMCID: PMC7910688 DOI: 10.1016/j.sdentj.2019.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/25/2019] [Accepted: 12/29/2019] [Indexed: 11/26/2022] Open
Abstract
Aim This study aimed to evaluate the prevalence of carious, restored, and missing teeth among diabetic and non-diabetic patients who visited dental clinics in Dammam, Saudi Arabia. Method This retrospective study was conducted between April and November 2018. The data collection procedure was conducted in two steps: (1) review of patient records for the demographic variables and (2) screening of digital panoramic radiographs (OPGs). The patients who visited the restorative and prosthetic clinics in the period of 2016–2017 were included in the study. Results A total of 1186 patient records and OPGs were reviewed to extract the data. The average age of the patients in the study sample was 40.96 (±16.29). The sample included 751 (63.3%) female and 435 (36.7%) male patients. Among the patients, 192 (16.2%) had diabetes mellitus and 994 (83.8%) were non-diabetic. The average numbers of fixed partial dentures and missing teeth were significantly high among diabetic patients (P < 0.001). Conversely, the average numbers of carious lesions and restored teeth were higher among the non-diabetic patients. Only the number of restored teeth was found to be significant (P < 0.001). Conclusion The diabetic patients were found to be at high risk of losing teeth compared with the non-diabetic patients. The prevalence of fixed partial dentures was also higher among diabetic patients. The oral health status of dental patients with diabetes needs urgent attention to prevent these patients from having teeth loss, and it can be done by improving their oral health.
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Affiliation(s)
- Soban Qadir Khan
- Lecturer of Biostatistics, College of Dentistry, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia
- Corresponding author.
| | - Abdul Khabeer
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmad M. Al-Thobity
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Yara AlMaimouni
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Ahmed NFH, Alqahtani AS, Albalawi NMR, Alanazi FKM, Alharbi FM, Alsabah BA, Alatawi AM, Alghuraydh AI. Diabetes in Adolescents and Children in Saudi Arabia: A Systematic review. ARCHIVES OF PHARMACY PRACTICE 2021. [DOI: 10.51847/iwjj2omwja] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Arredouani A. Greater and More Focused Measures Are Needed to Tackle Diabetes and Obesity Epidemics in the Nations of the Gulf Cooperation Council. Int J Endocrinol 2021; 2021:6661346. [PMID: 33833799 PMCID: PMC8018843 DOI: 10.1155/2021/6661346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/24/2021] [Accepted: 03/18/2021] [Indexed: 12/30/2022] Open
Abstract
Beyond the suffering of the affected subjects, type 2 diabetes (T2D) and obesity epidemics gripping the Gulf Cooperation Council (GCC) states are expected to seriously jeopardize these nations' economies and development due to productivity losses. Available data show that healthcare budgets in GCC nations are under tremendous pressure because of diabetes- and obesity-linked comorbidities. Furthermore, T2D, once an over-forties disease, risks becoming a whole-adult-life condition because of obesity-associated early-onset T2D and prediabetes. The incidence of T2D is set to worsen unless efficient actions are taken to fight obesity and prevent the conversion of prediabetes to T2D. There is a consensus that the concomitant increase in obesity rates drives T2D rates upward. Fighting obesity at all levels should, therefore, take center stage for the GCC nations. The battle against obesity and T2D is a long-term and complex one. Therefore, only through concerted efforts between several public and private actors, including health, economic, and urbanization agencies, food producers and retailers, schools, families, youth organizations, sports clubs, and voluntary organizations, can this battle be won. The present review tries to assess the current status of diabetes and obesity epidemics in the GCC context and take stock of some of the policies and initiatives that have been, or need to be, implemented to address their growing burden.
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Affiliation(s)
- Abdelilah Arredouani
- Diabetes Research Center; Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
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Al-Sharafi BA, Qais AA, Salem K, Bashaaib MO. Family History, Consanguinity and Other Risk Factors Affecting the Prevalence of Prediabetes and Undiagnosed Diabetes Mellitus in Overweight and Obese Yemeni Adults. Diabetes Metab Syndr Obes 2021; 14:4853-4863. [PMID: 34984017 PMCID: PMC8709553 DOI: 10.2147/dmso.s344440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Overweight and obese adults are at high risk for developing prediabetes and diabetes. The aim of this study was to measure the prevalence of prediabetes (pre-DM) and diabetes (DM) among Yemeni adults who were overweight or obese and had first-degree relatives with DM, consanguinity and other risk factors. PATIENTS AND METHODS This cross-sectional study included 612 adults, all with a BMI≥25 kg/m2. BMI, blood pressure (BP) and waist circumference (WC) were measured in the clinic. Fasting blood glucose (FBG) was collected for all subjects. The patients either had first-degree relatives with diabetes or not, and the subjects answered a questionnaire regarding the consanguinity of their parents, exercise, khat chewing, smoking, and eating vegetables and fruits daily. RESULTS Of the 612 study participants (32% males and 68% females) aged 20-70 years old, 429 (70.1%) had a family history (FM) of DM ± consanguinity of parents, and 183 (29.9%) had no FM of diabetes. Multivariate analysis showed significant risk in those with class III obesity for pre-DM (AOR 3.10 95% CI 1.56-6.18 p value 0.001) and DM (AOR 3.35 95% CI 1.47-7.65 p value 0.004) and those who had siblings with DM had a risk for pre-DM (AOR 1.72 95% CI 1.09-2.71 p value 0.02) and DM (AOR 2.24 95% CI 1.25-4.0 p value 0.007). Khat chewing increased the risk for pre-DM (AOR 1.61 95% CI 1.04-2.48 p value 0.032) and for DM (AOR 2.09 95% CI 1.14-3.82 p value 0.017). Having consanguineous parents plus siblings with DM were associated with a higher risk of DM (p value 0.031). CONCLUSION There is a high prevalence of pre-DM and undiagnosed DM among overweight and obese Yemeni individuals. Class III obesity, having siblings with DM, chewing khat, and having consanguineous parents plus siblings with DM all increased the risk. This group should be screened at an early age for early detection of pre-DM and DM.
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Affiliation(s)
- Butheinah A Al-Sharafi
- Department of Internal Medicine, School of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
- Correspondence: Butheinah A Al-Sharafi Email
| | - Ahmed A Qais
- Department of Internal Medicine, School of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | - Khalil Salem
- Department of Internal Medicine, University of Science and Technology Hospital, Sana’a, Yemen
| | - Muneer O Bashaaib
- Department of Internal Medicine, University of Science and Technology Hospital, Sana’a, Yemen
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Eltaib L, M. Alenzi S. COMPARATIVE EFFICACY OF METFORMIN AND SULFONYLUREA IN MONOTHERAPY OR COMBINATION FOR TYPE 2 DIABETES. ASIAN JOURNAL OF PHARMACEUTICAL RESEARCH AND HEALTH CARE 2020. [DOI: 10.18311/ajprhc/2020/25567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lynch JL, Barrientos-Pérez M, Hafez M, Jalaludin MY, Kovarenko M, Rao PV, Weghuber D. Country-Specific Prevalence and Incidence of Youth-Onset Type 2 Diabetes: A Narrative Literature Review. ANNALS OF NUTRITION AND METABOLISM 2020; 76:289-296. [PMID: 32980841 DOI: 10.1159/000510499] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 07/23/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND With increased awareness of type 2 diabetes (T2D) in children and adolescents, an overview of country-specific differences in epidemiology data is needed to develop a global picture of the disease development. SUMMARY This study examined country-specific prevalence and incidence data of youth-onset T2D published between 2008 and 2019, and searched for national guidelines to expand the understanding of country-specific similarities and differences. Of the 1,190 articles and 17 congress abstracts identified, 58 were included in this review. Our search found the highest reported prevalence rates of youth-onset T2D in China (520 cases/100,000 people) and the USA (212 cases/100,000) and lowest in Denmark (0.6 cases/100,000) and Ireland (1.2 cases/100,000). However, the highest incidence rates were reported in Taiwan (63 cases/100,000) and the UK (33.2 cases/100,000), with the lowest in Fiji (0.43 cases/100,000) and Austria (0.6 cases/100,000). These differences in epidemiology data may be partly explained by variations in the diagnostic criteria used within studies, screening recommendations within national guidelines and race/ethnicity within countries. Key Messages: Our study suggests that published country-specific epidemiology data for youth-onset T2D are varied and scant, and often with reporting inconsistencies. Finding optimal diagnostic criteria and screening strategies for this disease should be of high interest to every country. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Jane L Lynch
- University of Texas Health Science Center San Antonio, San Antonio, Texas, USA,
| | | | - Mona Hafez
- Diabetes and Endocrinology Unit, Department of Paediatrics, Cairo University, Cairo, Egypt
| | | | | | | | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical School, Salzburg, Austria
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Abdullah RI, Allah AA, Mubarak AS, Abdullah RI, Alzhrani SH, Alsufyani MH, Alharthi SJA, Althomali ROH. Prevalence and predictors of using complementary and alternative medicine among diabetic patients in Taif city, Saudi Arabia. J Family Med Prim Care 2020; 9:2092-2098. [PMID: 32670971 PMCID: PMC7346901 DOI: 10.4103/jfmpc.jfmpc_1222_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 12/30/2019] [Accepted: 02/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Saudi Arabia has the second-highest rate of diabetes in the Middle East. Herbal treatment is the most used complementary and alternative therapy among Saudi diabetic patients. Little is known about the use of complementary and alternative medicine among diabetic patients who reside in Taif city. Method: This study evaluated the magnitude and correlates of complementary and alternative medicine (CAM) use among diabetic patients attending diabetic clinics and primary healthcare in two governmental hospitals, namely, Prince Mansour Military Hospital (PMMH) and National Gourd Hospital (NGH) in Taif city. Results: CAM prevalence was 33.7%, of whom 87.3% did not consult a doctor before use and 43.2% had more than one source of information while 62.7% used more than one CAM method. Around 49.2% reported that it is very useful, and 72.9% did not notice any side effect from its use. In addition, 47.5% would recommend CAM to other diabetic patients. All (100%) reported using bitter apple, 66.1% reported using cinnamon, 55.1% used ginger, 35.6% took fenugreek, and 21.2% reported using Garlic as an only CAM. Female gender, family history, diabetic complications, and longer duration of diabetes were associated with the increased use of CAM. Discussion and Conclusion: CAM use by diabetic patients in Taif is prevalent. Health education and the safe use of CAM is much needed. Appropriate efforts from the government to integrate CAM into conventional diabetes treatment should be considered.
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Affiliation(s)
- Rehab I Abdullah
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Ahmad Aman Allah
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Ali S Mubarak
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Rayan I Abdullah
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Sarah H Alzhrani
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Maram H Alsufyani
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Salman J A Alharthi
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Reham O H Althomali
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
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Petry N, Al-Maamary SA, Woodruff BA, Alghannami S, Al-Shammakhi SM, Al-Ghammari IK, Tyler V, Rohner F, Wirth JP. National Prevalence of Micronutrient Deficiencies, Anaemia, Genetic Blood Disorders and Over- and Undernutrition in Omani Women of Reproductive Age and Preschool Children. Sultan Qaboos Univ Med J 2020; 20:e151-e164. [PMID: 32655907 PMCID: PMC7328830 DOI: 10.18295/squmj.2020.20.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/04/2019] [Accepted: 12/05/2019] [Indexed: 01/18/2023] Open
Abstract
A national cross-sectional survey was conducted to estimate the prevalence of anaemia, micronutrient deficiencies, haemoglobin disorders and over- and undernutrition in children and women of reproductive age in Oman. Wasting and stunting were found in 9.3% and 11.4% of children aged 0-59 months, respectively, while 4.2% were overweight or obese. In addition, 23.8% were anaemic and 10.2%, 9.5% and 10.6% had iron, vitamin A and vitamin D deficiencies, respectively. Sickle cell and β-thalassaemia genetic traits were present in 5.3% and 4.2% of children and 4.7% and 2.8% of women, respectively. Overall, 9.1% of Omani women were underweight and 59.2% were overweight or obese. The prevalence of anaemia was 27.8%, while iron, folate, vitamin B12 and vitamin D deficiencies affected 24.8%, 11.6%, 8.9% and 16.2%, respectively. Anaemia among both children and women and the prevalence of overweight and obesity in women are the most concerning nutritional problems in Oman.
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Affiliation(s)
- Nicolai Petry
- Department of Nutrition & Health, GroundWork LLC, Zurich, Switzerland
| | - Salima A Al-Maamary
- Department of Nutrition, Directorate General of Health Affairs, Ministry of Health, Muscat, Oman
| | | | - Samia Alghannami
- Department of Nutrition, Directorate General of Health Affairs, Ministry of Health, Muscat, Oman
| | - Saleh M Al-Shammakhi
- Department of Nutrition, Directorate General of Health Affairs, Ministry of Health, Muscat, Oman
| | - Ibtesam K Al-Ghammari
- Department of Nutrition, Directorate General of Health Affairs, Ministry of Health, Muscat, Oman
| | - Vilma Tyler
- Department of Health & Nutrition, United Nations International Children's Emergency Fund, Amman, Jordan
| | - Fabian Rohner
- Department of Nutrition & Health, GroundWork LLC, Zurich, Switzerland
| | - James P Wirth
- Department of Nutrition & Health, GroundWork LLC, Zurich, Switzerland
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Al-Badr AH, AlJameel AH, Halawany HS, Al-Jazairy YH, Alhadlaq MK, Al-Maflehi NS, Al-Sharif JA, Jacob V, Abraham N. Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh, Kingdom of Saudi Arabia compared to non-diabetic children. Saudi Dent J 2020; 33:276-282. [PMID: 34194191 PMCID: PMC8236546 DOI: 10.1016/j.sdentj.2020.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. Methods The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. Results The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). Conclusion The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of “critical” pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.
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Affiliation(s)
- Abid Hamoud Al-Badr
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Albandary Hassan AlJameel
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hassan Suliman Halawany
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Yousra Hussein Al-Jazairy
- Department of Restorative Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad Khalid Alhadlaq
- Department of Paediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nassr Saleh Al-Maflehi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Vimal Jacob
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nimmi Abraham
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Saeed W, AL-Habori M, Saif-Ali R, Al-Eryani E. Metabolic Syndrome and Prediabetes Among Yemeni School-Aged Children. Diabetes Metab Syndr Obes 2020; 13:2563-2572. [PMID: 32765035 PMCID: PMC7381798 DOI: 10.2147/dmso.s260131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/28/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE In view of the high rate of obesity and physical inactivity as well as the rising incidence of Type 2 DM among children in the neighboring Gulf countries and Middle East region; the aim of this study was, therefore, to determine the prevalence of metabolic syndrome (MetS) and prediabetes in Yemeni school-aged children. PATIENTS AND METHODS In this study, 1402 school children aged 12-13 years old (grade 7) were recruited from public schools in the capital Sana'a during the period April-May 2013. Anthropometric measurements and BP were recorded and BMI was calculated. Fasting venous blood (5 mL) was collected for biochemical analysis including FBG, HbA1c, insulin and lipids profile. Insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were calculated. RESULTS The prevalence of prediabetes (as defined by impaired fasting glucose) and MetS (as classified by the IDF 2007) were 0.86% and 0.5%, respectively. Our results also showed 5.21% and 20.26% of the children to have two or one factor(s) of the MetS criteria fulfilled, respectively, with low HDL-c (17%) being the most prevalent MetS component, followed by metabolic glucose (8%), raised TG (5.3%), DBP (1.4%), and high WC (0.5%). Moreover, the prevalence of overweight and obesity was 4.2% and 2.8%, respectively; and about 1.2% of children had abnormal high insulin levels. Children with impaired fasting glucose (IFG) had increased HOMA-IR (p = 0.016) and SBP (p = 0.042) and decreased HDL-c (p = 0.034) and HOMA-β (p < 0.001); whereas obese children had increased WC (p < 0.001) and TG (p = 0.049). CONCLUSION The main finding of this study is that Yemeni children are at potential risk of obesity, metabolic syndrome and prediabetes despite their low prevalences. These results highlight the need for early identification and close monitoring of children at risk of later Type 2 DM as an important primary care strategy that can effectively prevent or delay the onset of such condition.
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Affiliation(s)
- Walid Saeed
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
| | - Molham AL-Habori
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
- Correspondence: Molham AL-Habori Email
| | - Riyadh Saif-Ali
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
| | - Ekram Al-Eryani
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
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Shao J, Liu Y, Wang H, Luo Y, Chen L. An Integrated Fecal Microbiome and Metabolomics in T2DM Rats Reveal Antidiabetes Effects from Host-Microbial Metabolic Axis of EtOAc Extract from Sophora flavescens. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:1805418. [PMID: 32566075 PMCID: PMC7273480 DOI: 10.1155/2020/1805418] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/24/2020] [Accepted: 04/04/2020] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease. Sophora flavescens (S. flavescens), also named Kushen, is a famous Chinese herbal medicine that has been used to prevent and cure T2DM both in folk medicine and in medical institution. However, its mechanism of action remains unclear. In this study, the pharmacodynamic effects of S. flavescens EtOAc extract (SFE) on high-fat diet and low-dose streptozotocin-induced T2DM rats were examined. Fecal metabolomics analysis and 16S rRNA gene sequencing were applied to determine the influence of T2DM and SFE treatment on gut microbiota and host metabolism. Based on the consistency of the results of metabolic pathways in metabolomics analysis and phylogenetic investigation of communities by reconstruction of unobserved state (PICRUSt) analysis of 16S rRNA gene sequencing, the level of metabolites and the operational taxonomic units of gut bacteria were combined, and Spearman's analysis was implemented. Our data showed that SFE significantly decreased fasted blood glucose levels and improved lipid profile, glycosylated serum protein, glycosylated hemoglobin index, and pancreas damage. Metabolomics and 16S rRNA gene sequencing analysis indicated gut bacteria disorder, disturbed lipid metabolism, carbohydrate metabolism, and especially amino acid metabolism in T2DM and that SFE can regulated these metabolic pathways through the influence on gut bacteria. Spearman's analysis indicated that the amino acid metabolism that included tryptophan, branched chain amino acid, aromatic amino acid, beta-alanine, and glycine, serine and threonine metabolism, lipid metabolism, including lysophosphatidylcholines and lysophosphatidylethanolamines, primary bile acid and linoleic acid metabolism, carbohydrate metabolism, and nucleotide metabolism positively correlated with Faecalibacterium, Flexispira, Phascolarctobacterium, Prevotella, Roseburia, and [Prevotella]. In addition, arginine and proline metabolism, steroid hormone, steroid biosynthesis, and sphingolipid metabolism positively correlated with Lactobacillus, Oscillospira, Parabacteroides, Ruminococcus, and Streptococcus. Taken together, we speculated that SFE may have an effect on T2DM by mediating host-microbial metabolic axis. Exploration of SFE treatment for T2DM by multiomics is expected to provide a reference for clinical treatment.
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Affiliation(s)
- Jing Shao
- 1Key Laboratory of Digital Quality Evaluation of Chinese Materia Medical of State Administration of TCM, China
- 2Engineering & Technology Research Centre for Chinese Materia Medical Quality of Guangdong Province, School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Yi Liu
- 3School of Chinese Medicine, Southern Medical University, Guangzhou 510515, China
| | - Huan Wang
- 1Key Laboratory of Digital Quality Evaluation of Chinese Materia Medical of State Administration of TCM, China
- 2Engineering & Technology Research Centre for Chinese Materia Medical Quality of Guangdong Province, School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Yun Luo
- 1Key Laboratory of Digital Quality Evaluation of Chinese Materia Medical of State Administration of TCM, China
- 2Engineering & Technology Research Centre for Chinese Materia Medical Quality of Guangdong Province, School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Lei Chen
- 1Key Laboratory of Digital Quality Evaluation of Chinese Materia Medical of State Administration of TCM, China
- 2Engineering & Technology Research Centre for Chinese Materia Medical Quality of Guangdong Province, School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
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Robert AA, Al Dawish MA. The Worrying Trend of Diabetes Mellitus in Saudi Arabia: An Urgent Call to Action. Curr Diabetes Rev 2020; 16:204-210. [PMID: 31146665 DOI: 10.2174/1573399815666190531093735] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/23/2019] [Accepted: 05/03/2019] [Indexed: 12/19/2022]
Abstract
From last few years, the pervasiveness of diabetes mellitus (DM), in Saudi Arabia, is growing at a frightening rate. Overall, one-fourth of the adult population is affected by DM, which is further predicted to rise to more than double by the year 2030. The most alarming is possibly the escalation propensity of diabetes, in recent years, where a nearly ten-fold increase has been witnessed over the past thirty years in Saudi Arabia. However, the number of research arbitrations on the prevalence and incidence of DM is woefully inadequate, as compared to developed countries. Apart from this, most of the existing research data carried out in Saudi Arabia is cross-sectional, with small sample sizes, which most often involve only certain parts of the country. Consequently, the present scenario demands more multidimensional and multisectoral research to strengthen the evidence base and to accumulate greater knowledge as a basis for measures and programmes to confront diabetes and its complications. Thus, the present report makes an attempt to depict the current trend of diabetes as well as intends to put forward essential measures for controlling diabetes in Saudi Arabia.
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Affiliation(s)
- Asirvatham A Robert
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohamed A Al Dawish
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Phan DH, Do VV, Khuong LQ, Nguyen HT, Minh HV. Prevalence of Diabetes and Prediabetes among Children Aged 11-14 Years Old in Vietnam. J Diabetes Res 2020; 2020:7573491. [PMID: 32190701 PMCID: PMC7071796 DOI: 10.1155/2020/7573491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/19/2020] [Accepted: 02/18/2020] [Indexed: 01/01/2023] Open
Abstract
AIM Diabetes in children is becoming more prevalent in some countries. However, in most countries, little is known about the epidemiology of this disease. This study is aimed at estimating the prevalence of type 1 and type 2 diabetes and prediabetes among children in Vietnam and examining factors associated with the conditions. METHODS A total of 2880 students aged 11-14 years old were recruited for the survey, using a school-based and nationally representative sampling frame. Capillary blood samples of participants were collected to measure fasting glucose level, using glucose meter OneTouch Verio Pro+. Diabetes and impaired fasting plasma glucose were initially diagnosed based on the cut-off points of the American Diabetes Association criteria. Diabetes status and type of diabetes of participants were confirmed at a hospital. Additionally, anthropometric and blood pressure measurements were conducted following a standardized procedure. Multivariate logistic regression was used to examine the association between outcome and independent variables. RESULTS The overall prevalence of diabetes among the participants was 1.04‰ (three cases), with 2 cases (0.75‰) diagnosed with type 1 diabetes (one known and one newly diagnosed) and 1 case newly diagnosed with type 2 diabetes (0.35‰). The prevalence of impaired fasting glucose was 6.1%. Body mass index, place of residence, and age were found to be significantly associated with the impaired fasting glucose condition in participants. CONCLUSION The prevalence of type 1 and type 2 diabetes in children in Vietnam is lower than that in some other countries reported recently. However, there is a high prevalence in impaired fasting glucose, requiring attention from policymakers to take action to prevent the occurrence of the epidemic of type 2 diabetes in children in the future.
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Affiliation(s)
| | - Vuong V. Do
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Long Q. Khuong
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Hoang V. Minh
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
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Alsunni AA, Albaker WI, Almansour AH, Alenazi AS, Alaftan MS, Badar A. Knowledge, Attitude and Practice Regarding Ramadan Fasting and Related Determinants in Patients with Type 2 Diabetes at a Saudi Diabetes Clinic. Diabetes Metab Syndr Obes 2020; 13:151-159. [PMID: 32021361 PMCID: PMC6982441 DOI: 10.2147/dmso.s241496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 01/09/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE This study was carried out in type 2 diabetes mellitus (T2DM) patients to assess their knowledge, attitude and practice about fasting during Ramadan and to identify the sociodemographic determinants of the knowledge, attitude and practice. METHODS A total of 107 T2DM patients were interviewed at a diabetes clinic in the Eastern Saudi Arabia. A questionnaire containing knowledge, attitude and practice questions about fasting during Ramadan was used to collect data. Data about age, gender, city of residence, nationality, level of education, and history of diabetes in family were also collected. Descriptive and inferential statistics were carried out using IBM-SPSS Version 21. RESULTS The mean total score for knowledge, attitude and practice was 16.5 ±3.72 (out of 27). The individual scores for knowledge, attitude and practice were: 9.67±2.53 (out of 16), 4.10±1.28 (out of 6), and 2.77±1.08 (out of 5), respectively. Gender (OR: 4.08, 95% CI: 1.05,15.79 and p<0.041), education (OR: 0.068, 95% CI: 0.008,0.594, p<0.015) and family history (OR: 5.086, 95% CI: 1.095, 23.630 p<0.038) were identified as independent determinants of the total score. CONCLUSION Gender, Family history of diabetes and Education are determinants of knowledge, attitude and practice regarding fasting during Ramadan in the T2DM patients. A significant knowledge practice gap exists that necessitates further strengthening of the Pre-Ramadan education program for T2DM patients.
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Affiliation(s)
- Ahmed Abdulrahman Alsunni
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
- Correspondence: Ahmed Abdulrahman Alsunni Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia Email
| | - Waleed Ibrahim Albaker
- Department of Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Abdulelah Hassan Almansour
- Department of Family & Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Abdulaziz Saud Alenazi
- Department of Otorhinolaryngology-Head and Neck Surgery, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Mohammed S Alaftan
- Department of Radiology, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Ahmed Badar
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
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Alaqeel AA. Pediatric diabetes in Saudi Arabia: Challenges and potential solutions. A review article. Int J Pediatr Adolesc Med 2019; 6:125-130. [PMID: 31890836 PMCID: PMC6926216 DOI: 10.1016/j.ijpam.2019.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/28/2019] [Indexed: 01/27/2023]
Abstract
Diabetes in children has increased globally, and the World Health Organization ranks Saudi Arabia 7th in prevalence and 5th in incidence of type 1 diabetes (T1D). Type 2 diabetes (T2D) in children and adolescents has been identified in Saudi Arabia but its prevalence is still unknown. Despite advances in diabetes management including new insulins, insulin delivery systems, glucose monitoring and easy access to media for disease awareness, diabetes in children continues to be challenging in many aspects. Problems include delayed diagnosis, suboptimal glycemic control, early and late disease complications, transition from pediatric to adult care and raising of obesity and T2D, poor psychological and school support. This review summarizes the pediatric and adolescent diabetes studies in Saudi Arabia to date and explores the country-specific treatment challenges and potential solutions.
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Al-Musa HM. Early onset type 2 diabetes mellitus in a Saudi child misdiagnosed as type 1 diabetic: A case report. J Family Med Prim Care 2019; 8:313-315. [PMID: 30911531 PMCID: PMC6396608 DOI: 10.4103/jfmpc.jfmpc_426_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: To report a Saudi young patient with early onset type 2 diabetes, who was misdiagnosed for 6 years as type 1 diabetic. Case Report: A Saudi male aged 18-year old presented with uncontrolled diabetes. He was diagnosed 6 years earlier to have type 1 diabetes mellitus. He was kept insulin, but he was not compliant to treatment and his blood glucose kept on fluctuating and not controlled. He came to our diabetes center for management of his uncontrolled diabetes. There was no past history of hospitalization. His father was type 2 diabetic. His body mass index was 46.7 kg/m2. His glycosylated hemoglobin (HbA1c) level was 9.9%. Immune dysfunction was evaluated using serum antibody levels of glutamic acid decarboxylase, which proved to be negative (0.7 U/mL), while serum C-peptide level was not low (2.2 ng/mL). Therefore, the patient was diagnosed as early onset type 2 diabetic, not type 1 diabetic. The patient was advised to start physical exercise through daily walking for at least 1 h. The dietitian planned a strict diet plan for him to follow. Insulin injections and Metformin tablets were started. The patient received detailed health education on nature and management of his condition. After 4 months, his body mass index became 39.4 kg/m2 and his HbA1c became 6%. Insulin was stopped, and he was advised to continue on metformin, the diet, and daily walking. Two months later, his body mass index was 37.7 kg/m2 and his HbA1c became 5.41%. Conclusions: Early onset type 2 diabetes should be suspected among obese children with symptoms of diabetes. Proper health education and patient's compliance to medication, diet, and physical activity are essential for successful management of early onset type 2 diabetes. Moreover, primary care physicians need to be aware that type 2 diabetes is not necessarily adult-onset.
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Affiliation(s)
- Hassan M Al-Musa
- Department of Family and Community Medicine, College of Medicine, King Khalid University, 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: 28] [Impact Index Per Article: 5.6] [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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Haigh K, McDermott R, Sinha A, McLean A. Diagnosis and management of type 2 diabetes in youth in North Queensland and the Northern Territory: A health professional survey. Aust J Rural Health 2019; 27:42-48. [DOI: 10.1111/ajr.12458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Kate Haigh
- Department Diabetes and Endocrinology; Cairns Hospital; Cairns Queensland Australia
| | - Robyn McDermott
- Centre for Chronic Disease Prevention; Australian Institute of Tropical Health and Medicine; James Cook University; Cairns Queensland Australia
| | - Ashim Sinha
- Department Diabetes and Endocrinology; Cairns Hospital; Cairns Queensland Australia
| | - Anna McLean
- Department Diabetes and Endocrinology; Cairns Hospital; Cairns Queensland Australia
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Saraswathi S, Al-Khawaga S, Elkum N, Hussain K. A Systematic Review of Childhood Diabetes Research in the Middle East Region. Front Endocrinol (Lausanne) 2019; 10:805. [PMID: 31824422 PMCID: PMC6882272 DOI: 10.3389/fendo.2019.00805] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 11/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Diabetes mellitus (DM) is a common chronic disorder in children and is caused by absolute or relative insulin deficiency, with or without insulin resistance. There are several different forms of childhood DM. Children can suffer from neonatal diabetes mellitus (NDM), type 1 diabetes (T1DM), type 2 diabetes (T2DM), Maturity Onset Diabetes of the Young (MODY), autoimmune monogenic, mitochondrial, syndromic and as yet unclassified forms of DM. The Middle East has one of the highest incidences of several types of DM in children; however, it is unclear whether pediatric diabetes is an active area of research in the Middle East and if ongoing, which research areas are of priority for DM in children. Objectives: To review the literature on childhood DM related to research in the Middle East, summarize results, identify opportunities for research and make observations and recommendations for collaborative studies in pediatric DM. Methods: We conducted a thorough and systematic literature review by adhering to a list recommended by PRISMA. We retrieved original papers written in English that focus on childhood DM research, using electronic bibliographic databases containing publications from the year 2000 until October 2018. For our final assessment, we retrieved 429 full-text articles and selected 95 articles, based on our inclusion and exclusion criteria. Results: Our literature review suggests that childhood DM research undertaken in the Middle East has focused mainly on reporting retrospective review of case notes, a few prospective case studies, systemic reviews, questionnaire-based studies, and case reports. These reported studies have focused mostly on the incidence/prevalence of different types of DM in childhood. No studies report on the establishment of National Childhood Diabetes Registries. There is a lack of consolidated studies focusing on national epidemiology data of different types of childhood DM (such as NDM, T1DM, T2DM, MODY, and syndromic forms) and no studies reporting on clinical trials in children with DM. Conclusions: Investing in and funding basic and translational childhood diabetes research and encouraging collaborative studies, will bring enormous benefits financially, economically, and socially for the whole of the Middle East region.
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Affiliation(s)
- Saras Saraswathi
- Division of Endocrinology, Department of Pediatrics, Sidra Medicine, Doha, Qatar
| | - Sara Al-Khawaga
- Division of Endocrinology, Department of Pediatrics, Sidra Medicine, Doha, Qatar
- College of Health & Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Education City, Doha, Qatar
| | - Naser Elkum
- Biostatistics Section, Clinical Research Center, Research Services, Sidra Medicine, Doha, Qatar
| | - Khalid Hussain
- Division of Endocrinology, Department of Pediatrics, Sidra Medicine, Doha, Qatar
- *Correspondence: Khalid Hussain
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Almari M, Alsaedi S, Mohammad A, Ziyab AH. Associations of adiposity and parental diabetes with prediabetes among adolescents in Kuwait: A cross-sectional study. Pediatr Diabetes 2018; 19:1362-1369. [PMID: 30255624 DOI: 10.1111/pedi.12780] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/03/2018] [Accepted: 09/17/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Prediabetes, a high-risk state for developing diabetes, has become more prevalent among children and adolescents in recent decades. This study sought to estimate the prevalence of prediabetes and assess its association with adiposity among adolescents in Kuwait. Also, to determine whether maternal and paternal history of diabetes associate with offspring prediabetes in a sex-specific manner. METHODS A cross-sectional study was conducted by enrolling students (n = 1959; aged 14-19 years) attending high schools across Kuwait. Body mass index-for-age z-scores were estimated using the World Health Organization growth reference. Glycated hemoglobin A1c (HbA1c) was measured in capillary blood using point-of-care testing. Prediabetes was defined according to the diagnostic criteria of the American Diabetes Association (ADA; 5.7 ≤ HbA1c% ≤ 6.4) and the International Expert Committee (IEC; 6.0 ≤ HbA1c% ≤ 6.4). Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were estimated using Poisson regression with robust variance estimation. RESULTS According to the ADA criteria, 33.3% (620/1845) of participants had prediabetes; whereas, 8.5% (157/1845) met the IEC definition for prediabetes. Subjects classified as obese had higher prevalence of prediabetes compared to children in the thinness/normal group (aPR = 1.68, 95% CI: 1.44-1.95). Analysis stratified by offspring sex showed that maternal history of diabetes is associated with prediabetes among male offspring (aPR = 1.29, 95% CI: 1.02-1.63). In contrast, paternal history of diabetes showed an association with prediabetes among female offspring (aPR = 1.22, 95% CI: 1.01-1.48). CONCLUSIONS Prediabetes affects a substantial proportion of adolescents in Kuwait and adiposity and parental diabetes being the main associated factors with prediabetes.
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Affiliation(s)
- Mohammad Almari
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait.,Medical Services Directorate, Kuwait National Guard, Safat, Kuwait
| | - Saad Alsaedi
- Medical Services Directorate, Kuwait National Guard, Safat, Kuwait
| | - Anwar Mohammad
- Epidemiology and Public Health Unit, Dasman Diabetes Institute, Safat, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait.,Epidemiology and Public Health Unit, Dasman Diabetes Institute, Safat, Kuwait
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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: 5.7] [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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Prevalence and risk factors of impaired fasting glucose and diabetes among Chinese children and adolescents: a national observational study. Br J Nutr 2018; 120:813-819. [PMID: 30153872 DOI: 10.1017/s0007114518002040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The prevalence of impaired fasting glucose (IFG) and diabetes mellitus (DM) has reportedly increased significantly among Chinese children and adolescents. We aimed to examine the prevalence of IFG and DM, the disparities in sex and region and related risk factors among Chinese children and adolescents. A total of 16 434 Chinese children aged 6-17 years were selected from a national cross-sectional survey, and fasting glucose was measured for all participants. Overall, mean fasting plasma glucose (FPG) concentration was (4·64 (sd 0·51)) mmol/l, and the prevalence of DM and IFG was 0·10 and 1·89 %, respectively. Compared with girls, boys had higher FPG concentration (4·69 v. 4·58 mmol/l, r 0·107, P<0·001) and IFG prevalence (2·67 v. 1·07 %, r φ 0·059, P<0·001). Compared with rural children and adolescents, urban children and adolescent had higher FPG concentration (4·65 v. 4·62 mmol/l, r 0·029, P<0·001) and DM prevalence (0·15 v. 0·05 %, r φ 0·016, P<0·01). In addition, self-reported fried foods intake and overweight/obesity were positively associated with IFG, and the proportion of consuming fried foods more than or equal to once per week and overweight/obesity prevalence in boys and urban children and adolescents were significantly higher than girls and rural children and adolescents, respectively (P<0·05). Although the prevalence of IFG and DM was relatively low in Chinese children and adolescents, sex and region disparities were observed, which may be associated with differences in overweight/obesity prevalence and dietary factors.
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