Diabetes-care practices and related awareness amongst type-2 diabetes patients attending diabetes OPD at a tertiary care hospital in southwestern Saudi Arabia

Knowledge and Competence Regarding the Management of Chronic Kidney Disease among Family Medicine Professionals in the Eastern Province of Saudi Arabia: A Cross-Sectional Study

Diabetes is a significant risk factor for chronic kidney disease (CKD) and a primary cause of global morbidity and mortality, resulting in significant costs to healthcare systems. The management of diabetic CKD in the primary care setting remains an ongoing challenge despite the current best practices in the quality of care. This study evaluated family medicine physicians' knowledge and confidence regarding managing CKD in the Eastern Province of Saudi Arabia. A self-administered online questionnaire was distributed to physicians through various social media sites and email lists. The largest number of participants reported a full confidence in knowing kidney disease stages, blood pressure targets and the importance of urine albumin-creatinine ratio testing. Overall, 71.8% of physicians reported a high confidence level, followed by 23.9% reporting average and 4.2% reporting low confidence. Being younger and working at PHC were identified as significant predictors of increased confidence. Although most of the physicians reported a high confidence in managing CKD patients, the need for improvement was evident. Age and workplace institutions were the greater contributors to physicians' confidence. Continuous education among healthcare practitioners is crucial to updating knowledge and providing optimum quality of care among this group of patients.

The Impact of Diabetes Mellitus Duration and Complications on Health-Related Quality of Life Among Type 2 Diabetic Patients in Khamis Mushit City, Saudi Arabia

BACKGROUND AND OBJECTIVES

 Diabetes mellitus is one of the most significant public health problems in Saudi Arabia. Therefore, this study aims to investigate the impact of disease duration and disease complications on health-related quality of life among type 2 diabetic patients.

MATERIALS AND METHODS

A cross-sectional study was conducted on 380 adult diabetic type 2 patients at a tertiary hospital in the city of Khamis Mushit in Saudi Arabia. The participants were asked to complete a pre-validated health status questionnaire (SF-36) consisting of 36 questions measuring eight domains of health, with each domain providing a score from 0 to 100. Demographic and clinical variables were collected using a diabetes type 2 specification form designed to be used in conjunction with the health status questionnaire. The clinical data included variables such as duration of diabetes, co-morbidities, and treatment modality. Statistical analysis was conducted using SPSS version 22 (IBM Corp., Armonk, NY, USA), with differences tested using various statistical tests. Spearman correlation was done between the score and continuous variables, such as age and BMI. A p-value less than 0.05 was considered statistically significant.

RESULTS

Most of the participants (40%) were recently diagnosed with diabetes mellitus (less than one year ago) and 29.5% of the participants were diagnosed with diabetes mellitus within one to five years. The percentage of those with complications was 39.2%, which was mainly diabetic foot (43.4%) followed by nephropathy (29.5%). 46.8% of the participants were admitted due to conditions related to diabetes mellitus. Dietary modifications were prescribed in 38.4% of the participants, 19.5% used non-insulin medications only, 22.6% were on insulin, and 19.5% were using oral medications and insulin. The relationship between diabetes mellitus complications and quality of life domains revealed no significant difference in most of the domains except physical function and general health, which were lower with complicated diabetes melitus. Similarly, the relation between diabetes mellitus duration and quality of life domains was also not significant in all domains except physical function, which was low with a duration of more than 10 years.

CONCLUSIONS

Understandably, the complications associated with diabetes melitus resulted in low quality of life - in terms of physical function and general health - due to the organ-dysfunction associated with poor glycaemic control. Similarly, disease duration greater than 10 years resulted in impaired physical functioning.

Cascade of diabetes care in Bangladesh, Bhutan and Nepal: identifying gaps in the screening, diagnosis, treatment and control continuum

Diabetes has become a major cause of morbidity and mortality in South Asia. Using the data from the three STEPwise approach to Surveillance (STEPS) surveys conducted in Bangladesh, Bhutan, and Nepal during 2018-2019, this study tried to quantify the gaps in diabetes screening, awareness, treatment, and control in these three South Asian countries. Diabetes care cascade was constructed by decomposing the population with diabetes (diabetes prevalence) in each country into five mutually exclusive and exhaustive categories: (1) unscreened and undiagnosed, (2) screened but undiagnosed, (3) diagnosed but untreated, (4) treated but uncontrolled, (5) treated and controlled. In Bangladesh, Bhutan, and Nepal, among the participants with diabetes, 14.7%, 35.7%, and 4.9% of the participants were treated and controlled, suggesting that 85.3%, 64.3%, and 95.1% of the diabetic population had unmet need for care, respectively. Multivariable logistic regression models were used to explore factors associated with awareness of the diabetes diagnosis. Common influencing factors for awareness of the diabetes diagnosis for Bangladesh and Nepal were living in urban areas [Bangladesh-adjusted odd ratio (AOR):2.1; confidence interval (CI):1.2, 3.6, Nepal-AOR:6.2; CI:1.9, 19.9].

Correlation of serum uric acid with lipid profile in patients with type 2 diabetes mellitus with normal creatinine level: Report from a tertiary care hospital in India

Background

Increased serum uric acid (SUA) level is considered a risk factor for kidney diseases in type 2 diabetes mellitus (T2DM) patients. Deranged lipid profile in T2DM is an overall risk factor for cardiovascular complications.

Aim

This study aimed to find the correlation between SUA and serum lipid profile in T2DM patients who had serum creatinine levels within normal limits.

Materials and Methods

This cross-sectional observational study was conducted in a tertiary care hospital in eastern India. Serum creatinine level was measured first. Then, patients with serum creatinine levels within normal limits were recruited as the final sample. Anthropometric measurements were conducted by an experienced clinician. A 12-h fasting venous blood sample was used to measure serum urea, lipids, sugar, and glycated hemoglobin.

Results

A total of 176 (male = 104 [59.1%], female = 72 [40.9%]) T2DM patients with a median age of 46 (Q1-Q3 = 40-55) years participated in the study. There was no gender difference in fasting blood sugar (FBS) (P = 0.57), SUA (P = 0.42), and high-density lipoprotein-cholesterol (HDL-C) (P = 0.17). Females showed higher total cholesterol (TC) (P < 0.0001), triglyceride (TG) (P = 0.002), low-density lipoprotein-cholesterol (LDL-C) (P = 0.0002), and very-low-density lipoprotein-cholesterol (VLDL-C) (P = 0.01). SUA showed significant positive correlation with TG (rs = 0.65, P < 0.0001) and VLDL-C (rs = 0.63, P < 0.0001) and significant negative correlation with HDL-C (rs = -0.35, P < 0.0001) and FBS (rs = -0.45, P < 0.0001).

Conclusions

A higher level of SUA, an indicator for kidney disease in T2DM patients, may be associated with a higher TG and VLDL-C and lower FBS and HDL-C. Thus, SUA should be monitored along with lipid profile for early detection of the risk of kidney diseases.