Prevalence and characteristics of obesity in patients with type-2 diabetes mellitus in primary care centers in Bahrain: A cross-sectional study

GLP-1RA and SGLT2i utilization in people with type 2 diabetes with atherosclerotic cardiovascular disease (ASCVD) or at high risk of ASCVD in the Gulf Region: Results from the PACT-MEA studys

OBJECTIVES

To provide insights into the real-world usage of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) among individuals with type 2 diabetes (T2D) from Bahrain, Kuwait, and Qatar who either had established atherosclerotic cardiovascular disease (eASCVD) or were at high risk of developing ASCVD.

METHODS

This study of 1062 adults diagnosed with T2D from Bahrain, Kuwait, and Qatar is a sub-analysis within the Prevalence and Clinical Management of Atherosclerotic Cardiovascular Diseases in Patients with Type 2 Diabetes across Countries in the Middle East and Africa (PACT-MEA) study, a noninterventional, cross-sectional study. Participants were recruited from 13 primary or secondary care facilities between March and August 2022. Medical records of participants were reviewed to extract relevant data, including demographic characteristics, eASCVD status, ASCVD risk and glucose-lowering treatment. Appropriate descriptive and inferential statistical tests were performed.

RESULTS

Among T2D participants with eASCVD, a significantly higher proportion (41.3%) received SGLT2i compared to GLP-1RA (10.5%, p<0.001). There were notable variations in GLP-1RA/SGLT2i utilization across countries (p<0.001): being lowest in Bahrain (2.3%/18.0%), 26.9%/58.2% in Kuwait and 10.5%/67.1% in Qatar. The use of both medications was significantly higher in individuals with body mass index (BMI) ≥30 kg/m2 (p<0.05).

CONCLUSION

Despite these cardioprotective agents being recommended by guidelines, the study findings suggest a suboptimal use of GLP-1RA and SGLT2i in a real-world setting.

The rat as an animal model in chronic wound research: An update

The increasing global prevalence of chronic wounds underscores the growing importance of developing effective animal models for their study. This review offers a critical evaluation of the strengths and limitations of rat models frequently employed in chronic wound research and proposes potential improvements. It explores these models in the context of key comorbidities, including diabetes, venous and arterial insufficiency, pressure-induced blood flow obstruction, and infections. Additionally, the review examines important wound factors including age, sex, smoking, and the impact of anesthetic and analgesic drugs, acknowledging their substantial effects on research outcomes. A thorough understanding of these variables is crucial for refining animal models and can provide valuable insights for future research endeavors.

Characteristics, glycemic control and outcomes of adults with type-2 diabetes mellitus attending specialized clinics in primary healthcare centers in Bahrain-A cross-sectional study

Introduction

Diabetes mellitus is a global health challenge that requires continuous and multidisciplinary management. Suboptimal diabetes management results in serious complications that impose a huge burden on patients and the healthcare system. This study aimed to assess the characteristics, glycemic control and outcomes of patients with type-2 diabetes attending primary healthcare centers in Bahrain according to the new American Diabetes Association (ADA) guidelines.

Materials and Methods

A cross-sectional study was conducted among adult patients with type-2 diabetes mellitus attending diabetic clinics in Bahrain. A multi-stage sampling technique was adopted. The data collection tool consisted of three parts: baseline and sociodemographic data, the physical measures of the patients and the most recent laboratory results. An A1C of less than 7% was indicative of good glycemic control.

Results

A total of 721 patients with type-2 diabetes mellitus were included with an average age of 58.4 years. Most patients were hypertensive (n = 457, 63.4%), and half of them were hyperlipidemic (n = 373, 51.7%). Around 57% (n = 402) of the patients adopted lifestyle modifications, 14.8% adopted diet control measures and around half performed weekly regular exercises. More than 92% of the cohort were on metformin, 52.0% (n = 375) were on Sulphonylurea medications and 41% (n = 298) were on insulin formulations. While only 40% of the patients had controlled diabetes (n = 283, 39.3%) and hypertension (n = 298, 41.3%), most patients achieved adequate cholesterol and low-density lipoprotein levels (83.2% and 76.6%, respectively). Non-Bahraini (P ≤ 0.001), young (P = 0.027) and obese patients (P = 0.003) had lower glycemic control measures. Adequate cholesterol levels were seen more in patients with a controlled glycemic index (P = 0.015).

Conclusion

Considering the new glycemic targets, glycemic and hypertension control was poor among diabetic patients, especially non-Bahraini, obese and young patients. Urgent interventions by policymakers, physicians and caregivers are needed to improve the outcomes of diabetes.