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Alareeki A, Awad SF, Al-Mawali A, Morsi M, Critchley JA, Al-Lawati JA, Abu-Raddad LJ. Impact of mitigating obesity, smoking, and physical inactivity on type 2 diabetes mellitus burden in Oman: insights from mathematical modeling. BMJ Open Diabetes Res Care 2024; 12:e004248. [PMID: 39097298 DOI: 10.1136/bmjdrc-2024-004248] [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: 04/04/2024] [Accepted: 07/05/2024] [Indexed: 08/05/2024] Open
Abstract
INTRODUCTION To estimate the impact of reducing obesity, smoking, and physical inactivity (PIA) prevalence, and of introducing physical activity (PA) as an explicit intervention, on the prevalence, incidence, and mortality of type 2 diabetes mellitus (T2DM) in Oman. RESEARCH DESIGN AND METHODS A deterministic population-level mathematical model was employed to investigate the impact of different scenarios for reducing T2DM risk factors on T2DM epidemiology. The model was stratified by sex, age group, risk factor status, T2DM status, and intervention status and parameterized with nationally representative data. Intervention scenarios were calculated and compared with a baseline (no-intervention) scenario for changes in T2DM prevalence, incidence, and mortality among adult Omanis between 2020 and 2050. RESULTS In the no-intervention scenario, T2DM prevalence increased from 15.2% in 2020 to 23.8% in 2050. Achieving the goals of halting the rise of obesity, reducing smoking by 30%, and reducing PIA by 10% as outlined in the WHO's Global Action Plan for Non-communicable Diseases (implemented between 2020 and 2030 and then maintained between 2031 and 2050) would reduce T2DM prevalence by 32.2%, cumulative incidence by 31.3%, and related deaths by 19.3% by 2050. Halting the rise of or reducing obesity prevalence by 10%-50% would reduce T2DM prevalence by 33.0%-51.3%, cumulative incidence by 31.9%-53.0%, and related deaths by 19.5%-35.6%. Reducing smoking or PIA prevalence by 10%-50% would lead to smaller reductions of less than 5% in T2DM prevalence, cumulative incidence, and related deaths. Introducing PA with varying intensities at a 25% coverage would reduce T2DM prevalence by 4.9%-14.1%, cumulative incidence by 4.8%-13.8%, and related deaths by 3.4%-9.6% by 2050. CONCLUSIONS Intervention-for-prevention efforts targeting obesity reduction and introducing PA could result in major reductions in the T2DM burden. Prioritizing such interventions could alleviate the burden of T2DM in Oman and other countries with similarly high T2DM and obesity burdens.
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Affiliation(s)
- Asalah Alareeki
- Infectious Disease Epidemiology Group, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Susanne F Awad
- Infectious Disease Epidemiology Group, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Adhra Al-Mawali
- Quality Assurance and Planning, German University of Technology in Oman, Athaibah, Muscat, Oman
- Oman Educational Services LLC, Muscat, Oman
| | - Magdi Morsi
- Centre of Studies & Research, Government of Oman Ministry of Health, Muscat, Masqat, Oman
| | - Julia A Critchley
- Population Health Research Institute, Saint George's University, Saint George, UK
| | - Jawad A Al-Lawati
- Directorate General of Primary Health Care, Government of Oman Ministry of Health, Muscat, Masqat, Oman
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
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Zakaria H, Said Y, Aleabova S, Bangayan J, Dandan M, Debs J, Dahlstrom N, Divino D, Hashemi A, Almarzooqi I. Measuring the effectiveness of hybrid diabetes care over 90 days through continuous data monitoring in type 2 diabetic patients. Front Endocrinol (Lausanne) 2024; 15:1355792. [PMID: 38774233 PMCID: PMC11106412 DOI: 10.3389/fendo.2024.1355792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/08/2024] [Indexed: 05/24/2024] Open
Abstract
Background Diabetes Mellitus, a global health challenge, affects 537 million individuals. Traditional management relies on periodic clinic visits, but technological advancements, including remote monitoring, offer transformative changes. Telemedicine enhances access, convenience, adherence, and glycemic control. Challenges include trust-building and limitations in face-to-face interactions. Integrating remote monitoring with in-person healthcare creates a hybrid approach. This study evaluates the impact on Type 2 Diabetes patients over 3 months. Methods A retrospective case-control observational study. Inclusion criteria involved previous Type 2 Diabetes diagnosis and a minimum 3-month GluCare model period with two physical visits. Patients in the case group had in-clinic visits, bi-weekly app engagement, and monthly body weight readings. Control group had in-clinic visits only. Outcomes measured included HbA1c, lipid profile, CV risk, eGFR, urine Albumin/Creatinine Ratio, Uric Acid, and CRP. Results Case group showed significant HbA1c improvements (-2.19%), especially in higher baseline levels. Weight, BMI, LDL, total cholesterol, and CVD risk also improved. Controls showed smaller improvements. Higher digital interactions correlated with better outcomes. Patients with ≥11 interactions showed significant reductions in HbA1c (-2.38%) and weight (-6.00 kg). Conclusion The GluCare.Health hybrid model demonstrates promising outcomes in Type 2 diabetes management. The integration of in-clinic consultations with continuous remote monitoring leads to substantial improvements in glycemic control and clinical parameters. The study highlights the importance of patient engagement in achieving positive outcomes, with higher digital interactions associated with greater reductions in HbA1c and weight. The hybrid approach proves more effective than digital-only interventions, emphasizing the need for comprehensive, end-to-end solutions in diabetes care.
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Affiliation(s)
- Hala Zakaria
- GluCare Integrated Diabetes Center, Dubai, United Arab Emirates
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Al Sahlawi M, AlRukhaimi M, Al-Ghamdi SM, Al Salmi I, Al-Aradi AH, Hamad A, AlSahow A. Peritoneal dialysis in the Arabian Gulf countries: Challenges and opportunities. Perit Dial Int 2024; 44:171-176. [PMID: 37846093 DOI: 10.1177/08968608231204107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
The Gulf Cooperation Council (GCC) is a regional organisation, consisting of six Arab countries that share common objectives and cultural identities, with a total population of 57.3 million. The prevalence of patients requiring dialysis in GCC countries is increasing, with a current mean prevalence of 551 per million population. Despite the several patient-level and healthcare system benefits of peritoneal dialysis (PD) compared to in-centre haemodialysis, the growth in PD utilisation has been limited. This is related to several factors, including deficiencies in modality education for chronic kidney disease patients, nephrology training and governmental policies advocating for this dialysis modality. Establishing a detailed PD registry in GCC countries is an important step towards understanding our patients' characteristics, outcomes, current PD practices and challenges in order to increase the use of PD and to facilitate future initiatives aimed at optimising the management of PD patients in this part of the world. This article reviews common challenges around PD practices and utilisation in GCC countries and provides possible solutions to overcome these challenges. It should be noted that the literature on PD patients, outcomes and treatment practices in GCC countries is limited, and as a result, many of our recommendations and discussion are based on clinical observations, experience and data when available.
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Affiliation(s)
- Muthana Al Sahlawi
- Department of Internal Medicine, College of Medicine, King Faisal University, Al-Hasa, Saudi Arabia
| | | | - Saeed Mg Al-Ghamdi
- Department of Medicine, College of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | | | - Ali H Al-Aradi
- Department of Nephrology, Salmaniya Medical Complex, Manama, Bahrain
| | - Abdullah Hamad
- Division of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Ali AlSahow
- Division of Nephrology, Jahra Hospital, Jahra, Kuwait
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Alawainati MA, Ayoob ZA, AlQari AA, Makhlooq F, Naser HS, Bukamal F. Prevalence and characteristics of obesity in patients with type-2 diabetes mellitus in primary care centers in Bahrain: A cross-sectional study. J Family Community Med 2023; 30:109-115. [PMID: 37303838 PMCID: PMC10252644 DOI: 10.4103/jfcm.jfcm_9_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Obesity is a complex health problem characterized by abnormal and excessive body weight. Globally, the epidemic of obesity is escalating, and today, around one-third of the world's adult population is overweight or obese. Obesity is a risk factor and a predictor of poor outcomes of diabetes. This study aimed to determine the prevalence and characteristics of obesity in adults with type-2 diabetes mellitus. MATERIALS AND METHODS This study was conducted at five primary care centers in Bahrain. Obesity was assessed using body mass index, while glycemic control status was assessed using glycated hemoglobin (HbA1c). Informed consent was obtained from all participants. Means and standard deviation were computed for continuous variables, while categorical variables were presented as frequencies and percentages. Student's t-test and Mann-WhitneyU test, as appropriate, were performed to determine statistical significance between two continuous variables. Chi-square or Fisher's Exact test were used to test for statistical significance for categorical variables. RESULTS A total of 732 participants were included; the mean age was 58.4 ± 11.3 years. Hypertension was the most prevalent comorbidity (63.5%), followed by hyperlipidemia (51.9%). Most participants (59.8%) had HbA1c levels of more than 7%, 20.9% had HbA1c levels between 7% and 8%, and 38.9% had HbA1c levels of more than 8%. Of the cohort, 47.5% were obese and 35.0% were overweight. Obesity was significantly higher in Bahraini patients and females (P < 0.001). Lower obesity rates were observed among patients who exercised regularly (P < 0.001) and patients who followed diet control measures (P = 0.039). In addition, we found higher obesity rates were found in patients with uncontrolled diabetes (P = 0.004), hypertension (P = 0.032), and hyperlipidemia (P = 0.048). CONCLUSION Obesity is prevalent among type-2 diabetic patients and is associated with poor glycemic outcomes. Thus, more efforts should be taken by physicians to address obesity in diabetic patients as it negatively impacts their glycemic control.
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Affiliation(s)
| | - Zahra A. Ayoob
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Aala A. AlQari
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Fatema Makhlooq
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Huda S. Naser
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Fajer Bukamal
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
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Mamdouh H, Hussain HY, Ibrahim GM, Alawadi F, Hassanein M, Zarooni AA, Suwaidi HA, Hassan A, Alsheikh-Ali A, Alnakhi WK. Prevalence and associated risk factors of overweight and obesity among adult population in Dubai: a population-based cross-sectional survey in Dubai, the United Arab Emirates. BMJ Open 2023; 13:e062053. [PMID: 36693685 PMCID: PMC9884894 DOI: 10.1136/bmjopen-2022-062053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To study the prevalence of overweight and obesity and determine the associated risk factors among adults in Dubai. DESIGN AND SETTING A cross-sectional survey with a multistage, stratified random sampling design was conducted in the Emirate of Dubai in 2019. PARTICIPANTS The study included 2142 adults aged 18+ years in the Emirate of Dubai. RESULTS The overall prevalence of obesity, which was defined as body mass index (BMI) ≥30 kg/m2, was 17.8%. The highest obesity rates were reported among women (21.6%) and the United Arab Emirates (UAE)-nationals (39.6%). Moreover, 39.8% of the population was overweight (BMI ≥25-29.9 kg/m2). Multivariate logistic regression showed associations between obesity and age, sex, nationality, hypertension and occupation. Obesity increases with age, with the highest risk at age group 50-59 years (OR 4.30; 95% CI 1.57 to 11.78) compared with the reference group (18-24 years). Females had a higher risk of obesity than males (OR 1.62; 95% CI 1.10 to 2.38). Compared with those in the reference group (Western and others), UAE nationals, other Arabs and Asians were more likely to be obese ((OR 2.08; 95% CI 1.18 to 3.67), (OR 3.61; 95% CI 2.41 to 5.44) and (OR 1.98; 95% CI 1.12 to 3.50), respectively). Clerical and service workers (OR 4.50; 95% CI 2.54 to 8.00) and elementary and unskilled occupation categories (OR 2.57; 95% CI 1.56 to 4.25) had higher risks of obesity than the reference group (professionals), p<0.01). Hypertensive individuals had a higher risk of obesity than normotensive individuals (OR=3.96; p<0.01). CONCLUSIONS Obesity and overweight are highly prevalent among adults in Dubai and are remarkably associated with sociodemographic and behavioural risk factors. Comprehensive strategic initiatives are urgently needed to control obesity in the high-risk populations in the Emirate of Dubai.
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Affiliation(s)
- Heba Mamdouh
- Department of Data Analysis, Dubai Health Authority, Dubai, UAE
- Department of Family Health, Alexandria University, Alexandria, Egypt
| | - Hamid Y Hussain
- Department of Data Analysis, Dubai Health Authority, Dubai, UAE
| | - Gamal M Ibrahim
- Department of Data Analysis, Dubai Health Authority, Dubai, UAE
- Departemnet of statistics, High Institute for Management Sciences, Belqas, Egypt
| | - Fatheya Alawadi
- Department of Diabetes and Endocrinology, Dubai Health Authority, Dubai, UAE
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Mohamed Hassanein
- Department of Diabetes and Endocrinology, Dubai Health Authority, Dubai, UAE
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Amer Al Zarooni
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Hanan Al Suwaidi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Amar Hassan
- HBMCDM, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Alawi Alsheikh-Ali
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
- Dubai Health Authority, Dubai, UAE
| | - Wafa Khamis Alnakhi
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
- Department of Data Analysis Research and Studies, Dubai Health Authority, Dubai, UAE
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Alsaeed D, Guess N, Al Ozairi E. Remission of type 2 diabetes: Perspectives of dietitians in Kuwait. PLoS One 2022; 17:e0276679. [PMID: 36301897 PMCID: PMC9612548 DOI: 10.1371/journal.pone.0276679] [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: 11/22/2021] [Accepted: 10/11/2022] [Indexed: 11/18/2022] Open
Abstract
Although many dietary and lifestyle interventions have been proposed, the concept of total dietary replacement (TDR) to achieve remission of type 2 diabetes in the Gulf region is new. With the high levels of obesity and type 2 diabetes in the region, offering TDR to patients for weight loss and remission of type 2 diabetes would assist in achieving health outcomes. The aim of the current study was to explore and understand remission of type 2 diabetes and TDR from the perspectives of dietitians to identify challenges and recommend solutions for implementation in Kuwait. A qualitative approach utilizing focus groups was chosen to explore the topic. Purposive sampling was used to gain experiences from a diverse sample across primary, secondary, and tertiary specialized diabetes centers. Discussions were audio-recorded and transcribed verbatim. Grounded theory using an iterative approach was applied to analyze the data. Three focus groups with a total of 17 participants achieved data saturation. The sample was varied in terms of workplace and years of experience. The three emerging themes were motivation to use the TDR approach, perceived challenges of TDR, and suggestions to improve and adapt approaches for Kuwait. Dietitians reported that remission of type 2 diabetes is a great motivator for patients to undergo TDR, although various factors were identified that may affect uptake including age, level of education, and social and cultural environment. By understanding dietitians' perspectives, it has provided insight on views regarding the implementation of TDR to achieve remission in Kuwait and how best to tailor approaches by focusing on patient support needs and adopting a flexible approach.
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Affiliation(s)
- Dalal Alsaeed
- Clinical Care Research and Trials, Dasman Diabetes Institute, Dasman, Kuwait
- * E-mail:
| | - Nicola Guess
- Nutrition Unit, Dasman Diabetes Institute, Dasman, Kuwait
- Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Ebaa Al Ozairi
- Clinical Care Research and Trials, Dasman Diabetes Institute, Dasman, Kuwait
- Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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Hamdy O, Al Sifri S, Hassanein M, Al Dawish M, Al-Dahash RA, Alawadi F, Jarrah N, Ballout H, Hegazi R, Amin A, Mechanick JI. The Transcultural Diabetes Nutrition Algorithm: A Middle Eastern Version. Front Nutr 2022; 9:899393. [PMID: 35769383 PMCID: PMC9235861 DOI: 10.3389/fnut.2022.899393] [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] [Received: 03/18/2022] [Accepted: 05/04/2022] [Indexed: 12/02/2022] Open
Abstract
Diabetes prevalence is on the rise in the Middle East. In countries of the Gulf region-Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates-prevalence rates are among the highest in the world. Further, Egypt now ranks as one of the top 10 countries in the world for high number of people with diabetes. Medical nutrition therapy is key to optimal management of diabetes. Patient adherence to nutritional guidance depends on advice that is tailored to regional foods and cultural practices. In 2012, international experts created a transcultural Diabetes Nutrition Algorithm (tDNA) for broad applicability. The objective of this current project was to adapt the algorithm and supportive materials to the Middle East region. A Task Force of regional and global experts in the fields of diabetes, obesity, and metabolic disorders met to achieve consensus on Middle East-specific adaptations to the tDNA. Recommendations, position statements, figures, and tables are presented here, representing conclusions of the tDNA-Middle Eastern (tDNA-ME) Task Force. Educational materials can be used to help healthcare professionals optimize nutritional care for patients with type 2 diabetes. The tDNA-ME version provides evidence-based guidance on how to meet patients' nutritional needs while following customs of people living in the Middle Eastern region.
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Affiliation(s)
- Osama Hamdy
- Harvard Medical School, Joslin Diabetes Center, Boston, MA, United States
| | | | | | | | - Raed A. Al-Dahash
- Department of Medicine, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- King Saud bin Abdulaziz for Health Science, Riyadh, Saudi Arabia
| | - Fatheya Alawadi
- Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | - Refaat Hegazi
- Abbott Laboratories, Nutrition Division, Research & Development Department, Columbus, OH, United States
| | - Ahmed Amin
- Abbott Laboratories, Dubai, United Arab Emirates
| | - Jeffrey I. Mechanick
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, New York, NY, United States
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Crawford MA, Wang Y, Marsh DE, Johnson MR, Ogundipe E, Ibrahim A, Rajkumar H, Kowsalya S, Kothapalli KSD, Brenna JT. Neurodevelopment, nutrition and genetics. A contemporary retrospective on neurocognitive health on the occasion of the 100th anniversary of the National Institute of Nutrition, Hyderabad, India. Prostaglandins Leukot Essent Fatty Acids 2022; 180:102427. [PMID: 35413515 PMCID: PMC9152880 DOI: 10.1016/j.plefa.2022.102427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/02/2022] [Accepted: 04/03/2022] [Indexed: 11/28/2022]
Abstract
In celebration of the centenary of the National Institute of Nutrition (NIN), Hyderabad, India (1918-2018), a symposium highlighted the progress in nutrition knowledge made over the century, as well as major gaps in implementation of that knowledge. Brain famine caused by a shortage of nutrients required for perinatal brain development has unfortunately become a global reality, even as protein-calorie famine was largely averted by the development of high yield crops. While malnutrition remains widespread, the neglect of global food policies that support brain development and maintenance are most alarming. Brain disorders now top the list of the global burden of disease, even with obesity rising throughout the world. Neurocognitive health, remarkably, is seldom listed among the non-communicable diseases (NCDs) and is therefore seldom considered as a component of food policy. Most notably, the health of mothers before conception and through pregnancy as mediated by proper nutrition has been neglected by the current focus on early death in non-neurocognitive NCDs, thereby compromising intellectual development of the ensuing generations. Foods with balanced essential fatty acids and ample absorbable micronutrients are plentiful for populations with access to shore-based foods, but deficient only a few kilometres away from the sea. Sustained access to brain supportive foods is a priority for India and throughout the world to enable each child to develop to their intellectual potential, and support a prosperous, just, and peaceful world. Nutrition education and food policy should place the nutritional requirements for the brain on top of the list of priorities.
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Affiliation(s)
- Michael A Crawford
- Institute of Brain Chemistry and Human Nutrition, Chelsea and Westminster Hospital Campus of Imperial College, London, United Kingdom
| | - Yiqun Wang
- Institute of Brain Chemistry and Human Nutrition, Chelsea and Westminster Hospital Campus of Imperial College, London, United Kingdom
| | - David E Marsh
- Institute of Brain Chemistry and Human Nutrition, Chelsea and Westminster Hospital Campus of Imperial College, London, United Kingdom
| | - Mark R Johnson
- Institute of Brain Chemistry and Human Nutrition, Chelsea and Westminster Hospital Campus of Imperial College, London, United Kingdom
| | - Enitan Ogundipe
- Institute of Brain Chemistry and Human Nutrition, Chelsea and Westminster Hospital Campus of Imperial College, London, United Kingdom
| | - Ahamed Ibrahim
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Hemalatha Rajkumar
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - S Kowsalya
- Department of Food Science and Nutrition, Avinashilingam Institute for Home Science and Higher Education for Women (Deemed to be University), Coimbatore, India
| | - Kumar S D Kothapalli
- Dell Pediatric Research Institute, Dell Medical School, The University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX 78723, United States.
| | - J T Brenna
- Dell Pediatric Research Institute, Dell Medical School, The University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX 78723, United States.
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Al-Alawy K, Gaafar R, Moonesar IA, Muhsineh S. The nexus of Sugar-Sweetened Beverages: Insights on demographics, enablers and barriers. PUBLIC HEALTH IN PRACTICE 2021; 2:100189. [PMID: 36101613 PMCID: PMC9461627 DOI: 10.1016/j.puhip.2021.100189] [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: 06/17/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives The study objectives were to a) explore the association between household income and nationality and Sugar-Sweetened Beverage (SSB) enablers and barriers, and b) inform public health policy and health promotion. Study design A Cross-sectional Study in the UAE. Methods Nationally representative population survey was used to capture demographic and SSB behaviour data. Results We recruited 7500 participants into the study and received 1290 responses (17.2% participation rate). We report statistically significant associations between household income, nationality, and enablers and barriers. In some instances, similar enablers and barriers were reported by household income and nationality. Conclusions There are several associations between household income, nationality and SSB enablers, and barriers. These associations should be considered for future public health policy and health promotion decision-making to reduce SSB consumption. In addition, further research is needed to explore how other demographic factors (modifying variables) are associated with SSB enablers and barriers. They are statistically significant associations between household income, nationality and SSB enablers, and barriers; For SSB enablers, participants agreed that SSB is readily available when they go out, and the label and packaging does not suggest SSB is harmful to health. Participants had neutral viewpoints on SSB affordability and availability at home, ease of access through mobile platforms and lack of healthier alternatives suggesting more work is needed to sway participants to disagree or strongly disagree on these aspects; For SSB barriers, participants agreed that they worry about their health if they drink SSB, know about SSB that prevents them from drinking SSB, and were happy with the sugar-free alternatives. There were several areas where participants expressed a neutral viewpoint, e.g. there are no good deals/promotions to buy SSB, SSB is not available when they go out, they do not like the taste of SSB, SSB makes them sick, the label and packaging of SSB tells them it is harmful to their health, and they always have cheaper or free alternatives suggesting more work needed to sway participants to agree or strongly agre; and Household income and nationality can influence SSB enablers and barriers in different ways, and in some instances, presents a nexus.
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Al-Saleh Y, Sabico S, Al-Furqani A, Jayyousi A, Alromaihi D, Ba-Essa E, Alawadi F, Alkaabi J, Hassanein M, Al-Sifri S, Saleh S, Alessa T, Al-Daghri NM. Sulfonylureas in the Current Practice of Type 2 Diabetes Management: Are They All the Same? Consensus from the Gulf Cooperation Council (GCC) Countries Advisory Board on Sulfonylureas. Diabetes Ther 2021; 12:2115-2132. [PMID: 33983614 PMCID: PMC8342668 DOI: 10.1007/s13300-021-01059-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022] Open
Abstract
Since their inception in the commercial market in the mid-twentieth century, sulfonylureas (SUs) have remained a therapeutic option in the management of type 2 diabetes (T2D). Despite their established glucose-lowering effects, there is no consensus among global experts and modern guidelines regarding the priority of SUs in relation to other therapeutic options, given the lack of evidence that SUs are associated with a low risk of macrovascular events and excess mortality. However, findings from recent trials and real-time observations have resolved this contentious issue somewhat, albeit to varying degrees. The present consensus discusses the role of SUs in contemporary diabetes management in the Gulf Cooperation Council (GCC) countries. Regional experts from these countries gathered virtually to formulate a consensus following presentations of topics relevant to SU therapy with an emphasis on gliclazide, including long-term efficacy, cost, end-organ benefits, and side effects, based on up-to-date evidence. The present narrative review reflects the conclusions of this assembly and provides a platform upon which future guidelines for the use of SUs in the GCC can be tailored.
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Affiliation(s)
- Yousef Al-Saleh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 22490, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, 11481, Saudi Arabia.
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, 14611, Saudi Arabia.
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | | | - Amin Jayyousi
- Endocrine and Diabetes Section, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medical College, Doha, Qatar
| | - Dalal Alromaihi
- King Hamad University Hospital, Busaiteen, Bahrain
- Medical University of Bahrain, Busaiteen, Bahrain
- Bahrain Diabetes Society, Manama, Bahrain
| | | | - Fatheya Alawadi
- Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine, and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Mohamed Hassanein
- Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | - Seham Saleh
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Thamer Alessa
- Division of Endocrinology, Diabetes and Metabolism, Jaber Al-Ahmad Hospital, Kuwait City, Kuwait
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
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Inflammatory and endothelial dysfunction indices among Egyptian females with obesity classes I-III. Biosci Rep 2021; 40:226342. [PMID: 32893859 PMCID: PMC7507597 DOI: 10.1042/bsr20192910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 08/05/2020] [Accepted: 08/19/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Obesity is an alarming threat to health in Egypt. More than one in three Egyptians is obese, the highest rate in the world. We aimed to delineate the variability of inflammation and endothelial dysfunction markers among Egyptian females with different obesity classes. Methods: Out of 130 females, 70 were categorized into three obesity groups: Class I, body mass index (BMI) 30–34.9 kg/m2; Class II, BMI 35–39.9 kg/m2 and Class III BMI ≥ 40 kg/m2, besides 60 control subjects. Anthropometric measurements were recorded and serum levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin (IL) 6 (IL-6), IL-12, soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vascular adhesion molecule 1 (sVCAM-1) were assessed among participants. Results: In all three classes of obesity, significant increase (P <0.05) in BMI, waist-hip ratio, fat mass and body fat mass % were noted. CRP and sVCAM-1 levels were increased among the three obesity groups. TNF-α levels were increased in class II and III obesity groups. IL-6 and IL-12 levels were elevated in class I and class III groups. While, ICAM-1 levels were increased in class III obesity group. Conclusion: Based on individuals’ BMI, serum levels of TNF-α, CRP, IL-6, IL-12, sVCAM-1 and sICAM-1 are differentially altered with the progression of obesity. We strongly support the hypothesis that, as the obesity rate is still mounting, a subclinical inflammatory reaction has a role in pathogenesis of obesity and emphasize the elevation of endothelial dysfunction in individuals with obesity.
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Al-Mulla F, Mohammad A, Al Madhoun A, Haddad D, Ali H, Eaaswarkhanth M, John SE, Nizam R, Channanath A, Abu-Farha M, Ahmad R, Abubaker J, Thanaraj TA. ACE2 and FURIN variants are potential predictors of SARS-CoV-2 outcome: A time to implement precision medicine against COVID-19. Heliyon 2021; 7:e06133. [PMID: 33532652 PMCID: PMC7843038 DOI: 10.1016/j.heliyon.2021.e06133] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/23/2020] [Accepted: 01/26/2021] [Indexed: 01/08/2023] Open
Abstract
The severity of the new COVID-19 pandemic caused by the SARS-CoV-2 virus is strikingly variable in different global populations. SARS-CoV-2 uses ACE2 as a cell receptor, TMPRSS2 protease, and FURIN peptidase to invade human cells. Here, we investigated 1,378 whole-exome sequences of individuals from the Middle Eastern populations (Kuwait, Qatar, and Iran) to explore natural variations in the ACE2, TMPRSS2, and FURIN genes. We identified two activating variants (K26R and N720D) in the ACE2 gene that are more common in Europeans than in the Middle Eastern, East Asian, and African populations. We postulate that K26R can activate ACE2 and facilitate binding to S-protein RBD while N720D enhances TMPRSS2 cutting and, ultimately, viral entry. We also detected deleterious variants in FURIN that are frequent in the Middle Eastern but not in the European populations. This study highlights specific genetic variations in the ACE2 and FURIN genes that may explain SARS-CoV-2 clinical disparity. We showed structural evidence of the functionality of these activating variants that increase the SARS-CoV-2 aggressiveness. Finally, our data illustrate a significant correlation between ACE2 variants identified in people from Middle Eastern origins that can be further explored to explain the variation in COVID-19 infection and mortality rates globally.
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Affiliation(s)
- Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Anwar Mohammad
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Ashraf Al Madhoun
- Department of Animal and Imaging Core Facilities, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Dania Haddad
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Hamad Ali
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Health Sciences Center (HSC), Kuwait University, Jabriya, Kuwait
| | | | - Sumi Elsa John
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Rasheeba Nizam
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Arshad Channanath
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Mohamed Abu-Farha
- Department of Special Services Facilities, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Rasheed Ahmad
- Department of Immunology & Microbiology, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - Jehad Abubaker
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute (DDI), Dasman, Kuwait
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Al Awadi F, Hassanein M, Hussain HY, Mohammed H, Ibrahim G, Khater A, Suliman E. Prevalence of Diabetes and Associated Health Risk Factors among Adults in Dubai, United Arab Emirates: Results from Dubai Household Survey 2019. DUBAI DIABETES AND ENDOCRINOLOGY JOURNAL 2020. [DOI: 10.1159/000512428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> The health and social burdens of diabetes mellitus (DM) are steadily increasing worldwide, reflecting the impact of urbanization, industrial transitions, and shifting to nonhealthy, sedentary life patterns’, as well as the high sugar, low-fiber food consumptions. All these factors have contributed to the global increase in the prevalence of DM and metabolic disorders. <b><i>Objectives:</i></b> The objective is to study the prevalence of DM among adult cohorts in Dubai and the extent of behavioral health risk factors associations. <b><i>Methodology:</i></b> A cross-sectional household health survey with multistage, stratified cluster random sample of 9,630 participants including 2,496 households was carried out in Dubai 2019. About 5,371 non-United Arab Emirates (UAE) national, 2,245 UAE-nationals, of different age-groups, gender, education, nationality, smoking, and marital status were included in the survey. The survey questionnaire was adapted from the one used in the World Bank’s Living Standards Measurement Surveys (LSMSs) and the WHO’s World Health Surveys (WHSs). Self-reported diabetes was considered as well as newly diagnosed diabetes based on HbA1C results. About 75 well-trained surveyors, 25 well-trained nurses, and other laboratory technicians conducted the survey. SPSS 21 and Stata 12 software was used for data management. <b><i>Results:</i></b> The data indicate that the prevalence of diabetes among Dubai Emiratis is much higher than Dubai expats (19.3 vs. 12.4% <i>p</i> = 0.000). The association between diabetes and age was evident regardless of nationality. Rates of diabetes were higher in males (15.4%) compared to females (11.8%) (<i>p</i> < 0.001). About 11.2% of those considered overweight have DM, while the prevalence is 21.5% in obese people (<i>p</i> = 0.000). Physical inactivity, smoking, and hypertension (HTN) were strongly associated with higher rates of DM. Regardless of nationality, lower levels of education were statistically significantly associated with the prevalence of DM (<i>p</i> = 0.000), while single marital status was associated with the lowest rate of DM. <b><i>Conclusions:</i></b> Dubai household health survey 2019 indicated that the prevalence of DM among Dubai adults was still high as an overall estimation. Higher rates of diabetes were significantly associated with Emirati nationality, older age-groups, male gender, physical inactivity, high BMI, HTN, smoking<b>,</b> marital status of divorced, separated or divorced as well as low educational level groups.
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Mohammed Khalid Mansoor K, Iqbal S, Nowshad N, Abdelmannan D. Interplay between Vitamin D, Obesity, and Other Metabolic Factors in a Multiethnic Adult Cohort. DUBAI DIABETES AND ENDOCRINOLOGY JOURNAL 2020. [DOI: 10.1159/000511687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Vitamin D deficiency and obesity have been classified as pandemic issues worldwide with high prevalence of both the risk factors in the United Arab Emirates. In recent years, obesity has been associated with vitamin D deficiency, but very few studies have been published about the correlation between them in the UAE population. <b><i>Subjects and Methods:</i></b> This is a cross-sectional study designed to find a correlation between vitamin D deficiency and obesity along with other metabolic factors. Data were collected from electronic medical records of 300 subjects ranging from 15 to 85 years of age of various ethnic origins residing in Dubai. <b><i>Results:</i></b> The study showed a high prevalence of obesity (44.9%) and vitamin D deficiency (40.1) in our study population. There is no evidence of a relation between vitamin D level and the obesity; 40.1% of the subjects were vitamin D deficient, out of which 46.7% were obese. However, a statistically significant relationship was found between cholesterol levels and vitamin D levels. Similarly, a significant relation was found between decreasing Vitamin D levels and increasing age but no relationship was detected with gender. <b><i>Conclusions:</i></b> The present study revealed an alarming prevalence of obesity and vitamin D deficiency. Further steps need to be taken to tackle this growing problem.
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Diet and Food Allergy as Risk Factors for Asthma in the Arabian Gulf Region: Current Evidence and Future Research Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203852. [PMID: 31614710 PMCID: PMC6843839 DOI: 10.3390/ijerph16203852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/30/2019] [Accepted: 10/10/2019] [Indexed: 12/13/2022]
Abstract
Asthma is a chronic respiratory disease which is associated with higher levels of systemic inflammation. The causes of asthma remain poorly understood. Unhealthy diet and food allergy are potential risk factors for developing asthma. The prevalence of asthma in the Arabian Gulf region (AGR), and Kuwait, Saudi Arabia and Qatar in particular, is higher than in other Eastern Mediterranean countries. In the AGR, diets tend to be of low nutritional value due to high levels of total energy, cholesterol, sodium, added sugars and saturated fat, and low levels of fiber, fruit and vegetables. A few studies that include children and adults in the AGR have suggested a potential link between unhealthy diets/specific food allergens and increased risk of asthma, however, the association of food allergy with asthma is still a controversial issue. The aim of this commentary is to consider the evidence from the AGR regarding the effects of diet/food allergy on asthma risk that may be used to make recommendations for future research.
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