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Mobasher MA, Shabana MA, Germoush MO, Abuzinadah NY, Abd-Elhameed A, Baioumy SA, ElKot MA, Esawy MM. LncRNA LYPLAL1, miR-204-5p, and SIRT1: novel signatures for risk assessment of diabetic macrovascular complications. Sci Rep 2024; 14:24154. [PMID: 39406930 PMCID: PMC11480381 DOI: 10.1038/s41598-024-75543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 10/07/2024] [Indexed: 10/19/2024] Open
Abstract
Long-term, uncontrolled diabetes mellitus can lead to micro- and macrovascular problems. The protective function of lncRNA LYPLAL1 is to reduce endothelium cell inflammation by upregulating sirtuin 1 (SIRT1) and reducing microRNA (miR)-204-5p. This work attempted to examine the lncRNA LYPLAL1/miR-204-5p/SIRT1 molecules as diagnostic biomarkers for diabetic MVC and to assess their clinical correlations. The study enrolled 32 controls, 32 patients with diabetes alone, and 32 patients with diabetic MVC. RT-qPCR, or quantitative real-time PCR, was utilized to determine the expression levels of lncRNA and miR. SIRT1 was measured by ELISA. When comparing cases with MVC to those without MVC, the lncRNA LYPLAL1 and SIRT1 values were significantly lower. Conversely, patients with MVC had significantly higher miR-204-5p levels than those without MVC. The LncRNA LYPLAL1 performed best in terms of detecting MVC. It attained 90.6% specificity and 96.9% sensitivity. A combination of three markers (lncRNA LYPLAL1, miR-204-5p, and SIRT1) yielded the best accuracy at 98.4%. LYPLAL1 expression appeared to be an independent MVC predictor. Adjusted OR for LYPLAL1 expression was 405 (95% CI: 1.4-1200) (p = 0.039). When we compared cases with MVC to those without MVC, the lncRNA LYPLAL1 and SIRT1 values were significantly lower. Patients with MVC had significantly higher miR-204-5p levels than those without MVC. LYPLAL1 LncRNA demonstrated the best performance characteristics. LncRNA LYPLAL1 expression is an independent predictor of MVC.
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Affiliation(s)
- Maysa A Mobasher
- Department of Pathology, Biochemistry Division, College of Medicine, Jouf University, 72388, Sakaka, Saudi Arabia.
| | - Marwa A Shabana
- Clinical Pathology Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Mousa O Germoush
- Biology Department, College of Science, Jouf University, Sakakah, Saudi Arabia
| | - Najlaa Yousef Abuzinadah
- Department of biological science, College of Science, University of Jeddah, 23714, Jeddah, Saudi Arabia
| | - Amir Abd-Elhameed
- Internal Medicine Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Shereen A Baioumy
- Microbiology and Immunology Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Moataz A ElKot
- Cardiology Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Marwa M Esawy
- Clinical Pathology Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
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Moustafa MH, Turkey MS, Mohamedin NS, Darwish AA, Elshal AAM, Yehia MAH, El Safwany MM, Mohamed EI. Eggshell membrane and green seaweed (Ulva lactuca) micronized powders for in vivo diabetic wound healing in albino rats: a comparative study. J Pharm Health Care Sci 2024; 10:43. [PMID: 39044300 PMCID: PMC11265442 DOI: 10.1186/s40780-024-00345-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/08/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Nonhealing diabetic wounds are a serious complication associated with extremely lethargic wound closure and a high risk of infection, leading to amputation or limb loss, as well as substantial health care costs and a poor quality of life for the patient. The effects of either eggshell membrane (ESM) and green seaweed (Ulva lactuca) extracts alone or in combination were evaluated for in vivo skin wound healing in a rat model of induced diabetes. METHODS Micronized powders of waste hen ESM, Ulva lactuca, and their 1:1 mixture were prepared using regular procedures. The mechanical, electrical, and surface morphology characteristics of powders were examined using direct compression, LCR-impedancemetry, and scanning electron microscopy. The effect of ESM, Ulva lactuca, and their mixture as compared to standard Dermazin treatments were evaluated on wounds inflicted on male Wistar Albino rats with induced diabetes. Quantitative wound healing rates at baseline and at 3, 7, 14, and 21 days of treatments among all rat groups were conducted using ANOVA. Qualitative histological analysis of epidermal re-epithelization, keratinocytes, basement membrane, infiltrating lymphocytes, collagen fibrines, and blood vessels at day 21 were performed using Image J processing program. RESULTS Compressive strength measurements of tablets showed a Young's modulus of 44.14 and 27.17 MPa for the ESM and ESM + Ulva lactuca mixture, respectively. Moreover, both samples exhibited relatively low relative permittivity values of 6.62 and 6.95 at 1 MHz, respectively, due to the porous surface morphology of ESM shown by scanning electron microscopy. On day 21, rats treated with ESM had a complete diabetic wound closure, hair regrowth, and a healing rate of 99.49%, compared to 96.79% for Dermazin, 87.05% for Ulva lactuca, 90.23% for the mixture, and only 36.44% for the negative controls. A well-formed basement membrane, well-differentiated epithelial cells, and regular thick keratinocytes lining the surface of the epidermal cells accompanied wound healing in rats treated with ESM, which was significantly better than in control rats. CONCLUSION Ground hen ESM powder, a low-cost effective biomaterial, is better than Ulva lactuca or their mixture for preventing tissue damage and promoting diabetic wound healing, in addition to various biomedical applications.
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Affiliation(s)
- Moustafa H Moustafa
- Medical Biophysics Department, Medical Research Institute, Alexandria University, 165 El-Horreya Avenue, Alexandria, 21561, Egypt
| | - Mohamed S Turkey
- Microbiology and Immunology Department, Faculty of Pharmacy, October 6 University, Sixth of October City, Giza, Egypt
| | - Noha S Mohamedin
- Medical Biophysics Department, Medical Research Institute, Alexandria University, 165 El-Horreya Avenue, Alexandria, 21561, Egypt
| | - Amira A Darwish
- Medical Laboratory Technology Department, Faculty of Applied Health Sciences Technology, Pharos University, Alexandria, Egypt
| | - Amira A M Elshal
- Medical Biophysics Department, Medical Research Institute, Alexandria University, 165 El-Horreya Avenue, Alexandria, 21561, Egypt
| | - Mona A H Yehia
- Histochemistry and Cell Biology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Mohamed M El Safwany
- Radiological Sciences and Medical Imaging Department, Faculty of Applied Health Sciences Technology, Pharos University, Alexandria, Egypt
| | - Ehab I Mohamed
- Medical Biophysics Department, Medical Research Institute, Alexandria University, 165 El-Horreya Avenue, Alexandria, 21561, Egypt.
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Ali YBM, Saed MM, Abdel-Hakem NE, Hussein MAEA, El-Shahat M. Genetic Association of Interleukin 16 Gene Polymorphisms (rs11556218 & rs4778889) with Type 1 Diabetes in Egyptian Children: A Case-Control Study. Immunol Invest 2024; 53:830-842. [PMID: 38771670 DOI: 10.1080/08820139.2024.2349034] [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: 05/23/2024]
Abstract
BACKGROUND Type 1 diabetes (T1D) is a serious chronic autoimmune condition. Even though the underlying reason for the onset of T1D is unknown, due to their effector and regulatory roles in immune responses, cytokines are essential in developing autoimmune disorders. Interleukin (IL)16 is an immunomodulatory cytokine implicated in several inflammatory and autoimmune diseases. OBJECTIVE This study was designed to examine the association of IL16 gene polymorphisms, rs11556218 T > G and rs4778889 T > C, with the risk of T1D in Egyptian children. METHODS Using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay, we analyzed rs11556218 T > G and rs4778889 T > C polymorphisms of the IL16 gene in 100 T1D subjects and 93 controls. RESULTS Rs11556218 T > G polymorphism of the IL16 gene was not associated with the risk of developing T1D. Analysis of IL16 gene rs4778889 T > C showed that the TT genotype had a considerably higher risk of T1D than the TC genotype [OR = 2.195 (1.205-3.999)]. In comparison to patients with the C allele [OR = 0.6914 (0.38-1.2569)], patients with the T allele [OR = 1.45 (0.7956-2.6296)] were notably more likely to have T1D. A significant decrease was found in the frequency of GT (OR = 0.43, p = .03) and TC (OR = 0.32, p = .011) haplotypes of IL16 gene rs11556218 T > G and rs4778889 T > C polymorphisms in T1D patients compared with controls. CONCLUSION IL16 gene rs4778889 T > C polymorphism might be associated with susceptibility to T1D. Egyptians with TT genotypes are more likely to develop T1D. However, GT and TC haplotypes of IL16 gene rs11556218 T > G and rs4778889 T > C polymorphisms highlight their protective role againstT1D disease.
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Affiliation(s)
- Yasser B M Ali
- Molecular Immunology Division, Molecular Biology Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), University of Sadat City, Sadat City, Egypt
| | - Mai M Saed
- Molecular Biochemistry Division, Molecular Biology Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), University of Sadat City, Sadat City, Egypt
| | - Nehal E Abdel-Hakem
- Molecular Immunology Division, Molecular Biology Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), University of Sadat City, Sadat City, Egypt
| | | | - Mohamed El-Shahat
- Molecular Biochemistry Division, Molecular Biology Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), University of Sadat City, Sadat City, Egypt
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Ali Ali MA, Hegazy HS, Abdelkhalek Elsayed MO, Tharwat E, Mansour MN, Hassanein M, Ezzeldin ER, GadElkareem AM, Abd Ellateef EM, Elsayed AA, Elabd IH, Abd Rbu MH, Amer RS, Gabbar AGAE, Mahmoud H, Abdelhameed HM, Abdelkader AME. Aflibercept or ranibizumab for diabetic macular edema. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2024; 13:16-26. [PMID: 38978826 PMCID: PMC11227664 DOI: 10.51329/mehdiophthal1490] [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: 01/25/2024] [Accepted: 04/19/2024] [Indexed: 07/10/2024]
Abstract
Background Vascular endothelial growth factor (VEGF) is the primary substance involved in retinal barrier breach. VEGF overexpression may cause diabetic macular edema (DME). Laser photocoagulation of the macula is the standard treatment for DME; however, recently, intravitreal anti-VEGF injections have surpassed laser treatment. Our aim was to evaluate the efficacy of intravitreal injections of aflibercept or ranibizumab for managing treatment-naive DME. Methods This single-center, retrospective, interventional, comparative study included eyes with visual impairment due to treatment-naive DME that underwent intravitreal injection of either aflibercept 2 mg/0.05 mL or ranibizumab 0.5 mg/0.05 mL at Al-Azhar University Hospitals, Egypt between March 2023 and January 2024. Demographic data and full ophthalmological examination results at baseline and 1, 3, and 6 months post-injection were collected, including the best-corrected distance visual acuity (BCDVA) in logarithm of the minimum angle of resolution (logMAR) notation, slit-lamp biomicroscopy, dilated fundoscopy, and central subfield thickness (CST) measured using spectral-domain optical coherence tomography. Results Overall, the 96 eyes of 96 patients with a median (interquartile range [IQR]) age of 57 (10) (range: 20-74) years and a male-to-female ratio of 1:2.7 were allocated to one of two groups with comparable age, sex, diabetes mellitus duration, and presence of other comorbidities (all P >0.05). There was no statistically significant difference in baseline diabetic retinopathy status or DME type between groups (both P >0.05). In both groups, the median (IQR) BCDVA significantly improved from 0.7 (0.8) logMAR at baseline to 0.4 (0.1) logMAR at 6 months post-injection (both P = 0.001), with no statistically significant difference between groups at all follow-up visits (all P >0.05). The median (IQR) CST significantly decreased in the aflibercept group from 347 (166) µm at baseline to 180 (233) µm at 6 months post-injection, and it decreased in the ranibizumab group from 360 (180) µm at baseline to 190 (224) µm at 6 months post-injection (both P = 0.001), with no statistically significant differences between groups at all follow-up visits (all P >0.05). No serious adverse effects were documented in either group. Conclusions Ranibizumab and aflibercept were equally effective in achieving the desired anatomical and functional results in patients with treatment-naïve DME in short-term follow-up without significant differences in injection counts between both drugs. Larger prospective, randomized, double-blinded trials with longer follow-up periods are needed to confirm our preliminary results.
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Affiliation(s)
| | - Hanan Saied Hegazy
- Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | | | - Ehab Tharwat
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Mona Nabeh Mansour
- Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mohamed Hassanein
- Department of Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | | | | | | | - Ahmed A. Elsayed
- Department of Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Ibrahim Hassan Elabd
- Department of Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Mahmoud H Abd Rbu
- Department of Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Ramy Saleh Amer
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | | | - Hatem Mahmoud
- Department of Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
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Okasha T, Mostafa BM, Ibrahim I, Abdelgawad AA, Lloyd CE, Sartorius N, Elkholy H. Comorbidity of depression and type 2 diabetes in Egypt results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study. Int J Soc Psychiatry 2024; 70:730-738. [PMID: 38366940 DOI: 10.1177/00207640241228431] [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] [Indexed: 02/19/2024]
Abstract
BACKGROUND Diabetes mellitus and depression are serious common diseases, and the number of people with both conditions is rising steadily. Depression in people with diabetes mellitus results in poorer prognosis through different mechanisms. On the other hand, the presence of diabetes in individuals with depression increases functional impairment that is associated with depression. AIMS The study aimed to assess the prevalence and factors associated with depression among adults with type 2 diabetes mellitus attending a diabetes clinic in Cairo, Egypt. METHODS A cross-sectional study was conducted among adult patients with diabetes type 2 attending a diabetes clinic in the endocrinology department in Ain Shams University Teaching Hospital, Cairo, Egypt. Data were collected through face-to-face interviews by trained psychiatrists and from patients' records. RESULTS The prevalence of depression among diabetic patients was 21.8% (95% CI [15.6%, 29.1%]). Depression was more common among younger age groups and those with a higher level of education. There was no significant difference between those with lifetime depression compared to those without depression regarding physical health complications. CONCLUSIONS The prevalence of depression among patients with type 2 diabetes is high. Given the impact of co-morbid diabetes and depression, diabetic patients should be routinely screened for the latter condition.
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Affiliation(s)
- Tarek Okasha
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Bassem Murad Mostafa
- Internal Medicine and Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Islam Ibrahim
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Ahmed Adel Abdelgawad
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Cathy E Lloyd
- Faculty of Wellbeing Education and Language Studies, The Open University, Milton Keynes, UK
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Hussien Elkholy
- Neurology and Psychiatry Department, Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
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Azam MS, Azad MH, Arsalan M, Malik A, Ashraf R, Javed H. Efficacy of Platelet-Rich Plasma in the Treatment of Diabetic Foot Ulcer. Cureus 2024; 16:e60934. [PMID: 38910752 PMCID: PMC11193474 DOI: 10.7759/cureus.60934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Diabetic foot complications leading to limb amputations pose a global health concern. Platelet-rich plasma (PRP) gel has emerged as a promising method for ulcer healing, leveraging the growth factors provided by autologous PRP to enhance tissue healing. Therefore, we aimed to assess the frequency of the success of PRP therapy in the treatment of non-healing diabetic foot ulcers. Methods This quasi-experimental study, conducted in Lahore, Pakistan, from April 2021 to October 2022, enrolled 80 eligible individuals with non-responsive diabetic foot ulcers using a consecutive sampling technique. Inclusion criteria involved patients of both genders, aged 45-75 years, with unhealed diabetic foot ulcers, and exclusion criteria considered factors such as recurrent ulcers at the same site, smoking, and immunosuppressive or anticoagulant drug therapy. Baseline demographic details, ulcer measurements using a scale, and AutoCAD (Autodesk, Inc., San Francisco, California, United States)-assisted quantification of ulcer base were recorded. Autologous PRP injections were administered following strict aseptic protocols, with dressing changes and assessments performed at specified intervals over four weeks. Treatment success, defined as >90% healing after four weeks, was the primary outcome. Data analysis utilized IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), employing post-stratification chi-square and t-tests where appropriate for significant differences. Results The mean age of the patients was 60.40 ± 9.72 years, the mean duration of diabetes was 9.48 ± 2.21 years, and the mean ulcer duration was 11.41 ± 1.63 months. The treatment success rate was 63.7%. Age, gender, and disease duration showed no significant impact on treatment success. However, patients with a normal BMI and shorter ulcer duration exhibited a significantly higher success rate (p <0.001 and p = 0.002, respectively). Conclusions This study reaffirms the efficacy of PRP in treating non-healing diabetic foot ulcers, aligning with previous research. Despite a slightly lower success rate compared to literature reports, PRP remains a promising agent for managing diabetic foot ulcers.
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Affiliation(s)
- Muhammad Saim Azam
- General Surgery, CDA (Capital Development Authority) Hospital, Islamabad, PAK
| | | | - Muhammad Arsalan
- General Surgery, DHQ (District Headquarter) Hospital, Bahawalnagar, PAK
| | - Ahmed Malik
- Renal Transplant, St George's Hospital, London, GBR
| | - Raza Ashraf
- General Surgery, Shifa International Hospital, Islamabad, PAK
| | - Hamza Javed
- Radiology, Ayub Teaching Hospital, Abbottabad, PAK
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Mohamed AH, Abbassi MM, Sabry NA. Knowledge, attitude, and practice of insulin among diabetic patients and pharmacists in Egypt: "cross-sectional observational study". BMC MEDICAL EDUCATION 2024; 24:390. [PMID: 38594659 PMCID: PMC11005131 DOI: 10.1186/s12909-024-05367-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Diabetes recently has been identified as a growing epidemic. Although insulin's vital role in both types of diabetes, it is considered one of the harmful medications if used incorrectly. In Egypt, effective usage of insulin remains a challenge due to insufficient knowledge of insulin and diabetes management, leading to errors in insulin therapy. As pharmacists are experts in pharmacological knowledge, they are uniquely situated to assess adherence to treatment regimens, the effect of drug therapy, or potential alterations in drug therapy to meet patient goals. To provide effective patient education and counseling, community pharmacists in Egypt should be efficiently knowledgeable about diabetes and insulin. OBJECTIVE To identify the knowledge, attitude, and practice of pharmacists and patients about insulin. To identify pharmacists' educational preparedness and confidence in counseling diabetic patients. METHODS A descriptive, cross-sectional study was conducted with two knowledge, attitude, and practice surveys. This study was carried out from September 2016 to February 2023. Face-to-face interviews were conducted with patients, and a paper-based questionnaire was administered to pharmacists. The two questionnaires were adapted from previous studies. RESULTS A total of 492 patients and 465 pharmacists participated in this study. The mean knowledge score of correct answers among patients and pharmacists was 10.67 ± 1.9 and 15 ± 3.6. Most of the patients and pharmacists had a positive attitude regarding insulin's role in improving health and to better control blood glucose. On the negative side, around half of the patients reported that they believe that regular use of insulin leads to addiction, while only 14.5% of the pharmacists believed that insulin could cause addiction. Self-confidence scores for pharmacists differed statistically with sex, years of experience, and pharmacist's direct exposure to diabetic patients. CONCLUSIONS This study uncovers considerable deficiencies in patients' and pharmacists' knowledge about insulin therapy. This study also strongly recommends higher education and a more structured pharmacist training schedule.
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Affiliation(s)
- Alaa H Mohamed
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, P.O. Box: 11562, Cairo, Egypt.
| | - Maggie M Abbassi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, P.O. Box: 11562, Cairo, Egypt
| | - Nirmeen A Sabry
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, P.O. Box: 11562, Cairo, Egypt
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Li X, Shi Y, Wei D, Gong Y, Yan X, Cai S. Knowledge, attitude, and practice toward weight management among diabetic patients in Qidong City, Jiangsu Province. BMC Public Health 2024; 24:922. [PMID: 38553699 PMCID: PMC10979591 DOI: 10.1186/s12889-024-18392-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Weight management is an effective prevention and treatment strategy for diabetes mellitus. This study aimed to assess the knowledge, attitude, and practice (KAP) of diabetic patients towards weight management. METHODS Diabetic patients treated at Qidong City, Jiangsu Province, between January 2023 and June 2023 were included in this cross-sectional study. A self-designed questionnaire was used to collect their demographic characteristics and KAP toward weight management. Structural equation modeling (SEM) was employed to examine the inter-relationships among KAP scores. RESULTS Among a total of 503 valid questionnaires that were collected, 55.07% were filled out by men and 54.67% by those aged < 60 years. The mean scores for knowledge, attitude, and practice were 8.03 ± 3.525 (possible range: 0-13), 31.88 ± 3.524 (possible range: 10-50), and 22.24 ± 3.318 (possible range: 9-45), respectively. Pearson's correlation analysis revealed the knowledge was positively associated with attitude (r = 0.295, P < 0.001) and practice (r = 0.131, P < 0.001), and attitude was positively associated with practice (r = 0.140, P = 0.002). SEM demonstrated positive associations between knowledge and attitude (β = 0.28, P < 0.001), and attitude and practice (β = 0.09, P = 0.019). Moreover, older age was negatively associated with knowledge (β=-0.04, P = 0.001), while higher education (β = 1.220, P < 0.001), increased monthly income (β = 0.779, P < 0.001), diagnosis of fatty liver (β = 1.03, P = 0.002), and screening for excess visceral fat (β = 1.11, P = 0.002) were positively associated with knowledge. CONCLUSION Diabetic patients showed moderate knowledge, neutral attitudes, and inappropriate practices toward weight management. Knowledge was positively associated with attitude and practice. These findings provided valuable directions for healthcare interventions targeting improved KAP status of weight management among diabetic patients.
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Affiliation(s)
- Xiaofeng Li
- Department of Endocrinology, Metabolic Managament Center, Qidong People's Hospital, Qidong Liver Cancer Institute, Affiliated Qidong Hospital of Nantong University, 226200, Qidong, China.
| | - Yu Shi
- Department of Endocrinology, Metabolic Managament Center, Qidong People's Hospital, Qidong Liver Cancer Institute, Affiliated Qidong Hospital of Nantong University, 226200, Qidong, China
| | - Dongqin Wei
- Department of Endocrinology, Metabolic Managament Center, Qidong People's Hospital, Qidong Liver Cancer Institute, Affiliated Qidong Hospital of Nantong University, 226200, Qidong, China
| | - Yan Gong
- Department of Endocrinology, Metabolic Managament Center, Qidong People's Hospital, Qidong Liver Cancer Institute, Affiliated Qidong Hospital of Nantong University, 226200, Qidong, China
| | - Xinyi Yan
- Department of Endocrinology, Metabolic Managament Center, Qidong People's Hospital, Qidong Liver Cancer Institute, Affiliated Qidong Hospital of Nantong University, 226200, Qidong, China
| | - Shengnan Cai
- Department of Endocrinology, Metabolic Managament Center, Qidong People's Hospital, Qidong Liver Cancer Institute, Affiliated Qidong Hospital of Nantong University, 226200, Qidong, China
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Shaban MM, Sharaa HM, Amer FGM, Shaban M. Effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of adult clients with diabetes. BMC Nurs 2024; 23:130. [PMID: 38378505 PMCID: PMC10877800 DOI: 10.1186/s12912-024-01787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND In recent years, there has been growing interest in the use of Digital Based Nursing Intervention to support diabetes management. This study aimed to evaluate the effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of clients with diabetes. METHODS Employing a quasi-experimental design, a sample of 120 adult participants diagnosed with type 2 diabetes, aged more than 18 years with focus on older adults was drawn from outpatient clinics at Cairo University Hospital. The intervention was approved and registered by the ethical committee of the faculty of nursing with IRB number: RHDIRB2019041701. The intervention group (n = 60) received a digital-based nursing intervention, while the control group (n = 60) received standard care. Data were collected using adopted standardized tools including the Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. Demographic characteristics were analyzed, and pre- and post-intervention scores were compared using paired t-tests were statistical methods. RESULTS The digital-based nursing intervention resulted in significant enhancements in participants with diabetes knowledge and self-efficacy levels. Moreover, the intervention group demonstrated marked improvements in various self-care behaviors encompassing diet, exercise, medication adherence, blood glucose testing, and foot care. While the control group also exhibited some progress, the effects were less pronounced. Regression analyses highlighted age as a consistent factor associated with knowledge, self-efficacy, and specific self-care behaviors. CONCLUSION This study underscores the potential of tailored digital nursing interventions to complement traditional care approaches, empowering patients with type 2 diabetes to actively engage in self-management. The findings suggest that digital-based nursing interventions hold promise for enhancing patient knowledge, confidence, and proactive health behaviors. Nevertheless, limitations, including the relatively short intervention duration and a sample from a single clinic, warrant consideration. Future research should address these limitations to bolster the validity and applicability of the study's conclusions.
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Affiliation(s)
- Marwa Mamdouh Shaban
- Lecturer of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt.
| | - Heba Magdy Sharaa
- Professor of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
| | | | - Mostafa Shaban
- Lecturer of Geriatric Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
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Alanzi TM, Alzahrani W, Almoraikhi M, Algannas A, Alghamdi M, Alzahrani L, Abutaleb R, Ba Dughaish R, Alotibi N, Alkhalifah S, Alshehri M, Alzahrani H, Almahdi R, Alanzi N, Farhah N. Adoption of Wearable Insulin Biosensors for Diabetes Management: A Cross-Sectional Study. Cureus 2023; 15:e50782. [PMID: 38239544 PMCID: PMC10795719 DOI: 10.7759/cureus.50782] [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: 12/17/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Wearable insulin biosensors represent a novel approach that combines the benefits of real-time glucose monitoring and automated insulin delivery, potentially revolutionizing how individuals with diabetes manage their condition. STUDY PURPOSE To analyze the behavioral intentions of wearable insulin biosensors among diabetes patients, the factors that drive or hinder their usage, and the implications for diabetes management and healthcare outcomes. METHODS A cross-sectional survey design was adopted in this study. The validated questionnaire included 10 factors (Performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, perceived privacy risk, and personal innovativeness) affecting the acceptance of wearable insulin sensors. A total of 248 diabetic patients who had used wearable sensors participated in the study. RESULTS Performance expectancy was rated the highest (Mean = 3.84 out of 5), followed by effort expectancy (Mean = 3.78 out of 5), and trust (Mean = 3.53 out of 5). Statistically significant differences (p < 0.05) were observed with respect to socio-demographic variables including age and gender on various influencing factors and adoption intentions. PE, EE, and trust were positively associated with adoption intentions. CONCLUSION While wearable insulin sensors are positively perceived with respect to diabetes management, issues like privacy and security may affect their adoption.
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Affiliation(s)
- Turki M Alanzi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Wala Alzahrani
- Department of Clinical Nutrition, College of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
| | | | | | - Mohammed Alghamdi
- Department of Pharmaceutical Services, Dhahran Long Term Care Hospital, Dhahran, SAU
| | | | | | | | - Nada Alotibi
- College of Pharmacy, Shaqra University, Shaqra, SAU
| | - Shayma Alkhalifah
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Mona Alshehri
- College of Medicine, Princess Nourah Bint Abdul Rahman University, Riyadh, SAU
| | | | - Reham Almahdi
- College of Medicine, Al Baha University, Al Baha, SAU
| | - Nouf Alanzi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Jouf University, Jouf, SAU
| | - Nesren Farhah
- Department of Health Informatics, College of Health Sciences, Saudi Electronic University, Riyadh, SAU
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El Miedany Y, El Gaafary M, Gadallah N, Mahran S, Fathi N, Abu Zaid MH, Tabra SAH, Hassan W, Elwakil W. Osteoporosis treatment gap in patients at risk of fracture in Egypt: a multi-center, cross-sectional observational study. Arch Osteoporos 2023; 18:58. [PMID: 37127804 DOI: 10.1007/s11657-023-01252-8] [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: 01/14/2023] [Accepted: 04/19/2023] [Indexed: 05/03/2023]
Abstract
Despite the wide availability of a wide variety of approved osteoporosis medications and DXA scan centers in Egypt, only a minority of patients at high risk of sustaining a fragility fracture receive treatment, even after their first fracture. Such big "treatment gap" leaves the most high-risk individuals unprotected against fragility fractures. This study provides a benchmark to monitor national trends in osteoporosis management and service uptake. PURPOSE To assess the treatment gap among men and postmenopausal women presenting with a fragility fracture, and to analyze the characteristics and fracture risks of the patients presenting with an index fragility fracture. METHODS This was a multi-center, cross-sectional, observational study. Both men and postmenopausal women, admitted with an osteoporotic fracture (whether major osteoporosis or hip fracture), were consecutively recruited for this work. The fracture risk was assessed based on their FRAX calculation prior to the index fracture. All the patients were assessed for their falls and sarcopenia risks. Blood tests for bone profile as well as DXA scan were offered to all the patients. RESULTS Two hundred and thirty-six patients presenting with fragility fractures were included in this work. 70.8% were women and 29.2% were men. Mean age was 70.1 (SD = 9.2) years. Ten-year probability of fracture (without BMD) was high in 65.9% of the postmenopausal women and 40.3% of the men. 82.1% of the postmenopausal women and 100% in men identified to be eligible for osteoporosis therapy did not receive any form of osteoporosis therapy. FRAX score correlated significantly with bone mineral density assessment at both hip and spine. Falls, sarcopenia, and functional disability showed significant relation to the fracture risk. CONCLUSIONS There is a large treatment gap in Egyptian older adults. The recent guidelines for osteoporosis management in Egypt endorsed fracture centric approach to identify people at risk. The gap appears to be related to a low rate of osteoporosis diagnosis and lack of patient education.
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Affiliation(s)
- Yasser El Miedany
- Institute of Medical Sciences, Canterbury Christ Church University, Canterbury, England.
| | - Maha El Gaafary
- Community and Public Health, Ain Shams University, Cairo, Egypt
| | - Naglaa Gadallah
- Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
| | - Safaa Mahran
- Rheumatology and Rehabilitation, Assiut University, Assiut, Egypt
| | - Nihal Fathi
- Rheumatology and Rehabilitation, Assiut University, Assiut, Egypt
| | | | | | - Waleed Hassan
- Rheumatology and Rehabilitation, Benha University, Benha, Egypt
| | - Walaa Elwakil
- Rheumatology, Physcial Medicine and Rehabilitation, Alexandria University, Alexandria, Egypt
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12
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Green Coffee Bean Extract Potentially Ameliorates Liver Injury due to HFD/STZ-Induced Diabetes in Rats. J Food Biochem 2023. [DOI: 10.1155/2023/1500032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The goal of the current study was to examine the therapeutic potential of green coffee bean extract (GCBE) in the treatment of diabetic hepatic damage induced by high-fat diet (HFD) and streptozotocin (STZ) administration. The novelty of this study lies in constructing a newly stabilized in vivo obese diabetic animal model in rats using HFD/STZ for investigating the dose-dependent effect of two commonly used doses of GCBE in hepatoprotection against oxidative stress-induced hepatic damage by measuring many parameters that have not been carried out previously in other studies. GCBE that was used in this study was a hot water extract of green coffee beans with a concentration of 0.1 g ml−1. Male albino rats were given a single dose of STZ (35 mg kg−1), and HFD to induce diabetes mellitus (DM). For 28 days, two separate doses of GCBE 50 mg kg−1 and 100 mg kg−1 were administered orally to diabetic animals. Leptin, liver enzymes, oxidative stress parameters, inflammatory parameters, fasting plasma glucose (FPG), fasting plasma insulin (FPI), and lipid profile levels were examined. Real-time PCR and ELISA were used to quantitatively detect the mRNAs of the genes involved in the insulin signaling pathway, the genes involved in glucose metabolism, and the amounts of proteins. The levels of FPG, lipid profile, liver enzymes, inflammatory markers, and leptin in the HFD/STZ diabetic group revealed a considerable spike, while they considerably decreased after GCBE treatment in a dose-dependent manner. After GCBE treatment, the diabetic group showed a significant rise in the antioxidant markers glutathione, superoxide dismutase, and catalase, as well as a decrease in malondialdehyde and nitric oxide levels. The liver changes caused by HFD/STZ were entirely reversed by GCBE, and most intriguingly, in a dose-dependent manner. We concluded that GCBE can repair the hepatic oxidative damage caused by HFD and STZ by reversing all the previously measured parameters and improving the insulin signaling pathways. GCBE demonstrated strong antifree radical activity and significantly protected cells from oxidative damage caused by HFD/STZ.
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AlWahbi MF, Alharbi SH, Almesned SA, Alfawzan FA, Alsager RT, AlHojailan AA, Alfadhel EA, Al-Harbi FG. An Audit of Factors Impacting the Time to Resolution of the Metabolic Parameters in Diabetic Ketoacidosis Patients. Cureus 2022; 14:e31142. [PMID: 36505109 PMCID: PMC9728988 DOI: 10.7759/cureus.31142] [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: 11/05/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Diabetic ketoacidosis (DKA) is a major complication affecting patients with diabetes. It is often the first presentation of type I diabetes and can also occur due to a lack of compliance with insulin therapy or infection, among other causes. Hospitalizations for DKA have increased globally among patients with type I and type II diabetes, which poses a strain on health systems. AIM To determine the factors impacting the time to resolution of metabolic parameters in DKA patients. METHODS This retrospective study was performed by reviewing the clinical records of hospitalized DKA patients at King Fahad Specialist Hospital, a tertiary-level healthcare center in Buraidah, Al Qassim region, Saudi Arabia. The study included all DKA admissions that met the inclusion criteria between September 2019 and April 2022. RESULTS A total of 129 patients with a diagnosis of DKA from January 2019 to April 2022 were identified. Of these, 67 patients met the inclusion criteria. More females experienced DKA (56.7%), and the study population had an improvement rate of 97%. The mean length of stay (LOS) for patients with DKA was 73.19 hours, and the median time for DKA resolution was 15 hours (mean time 21.38 hours). The omission of insulin was the leading precipitating factor for DKA (43%) followed by infection (12%). A high serum bicarbonate (HCO3) level was identified as an independent predictor for a longer time to resolution. Patients with DKA who have high glucose levels on admission, higher body mass index (BMI), older age, and higher weight stayed in the hospital for extended periods. Conversely, patients with a higher serum potential of Hydrogen (pH) had a shorter LOS. Age was the only clinically independent predictor for a minimum LOS for DKA. Patients with comorbidities had a longer hospital LOS than patients without comorbidities; no such relationship has been reported in other studies. Patients in our study population had a longer time of resolution than observed in other studies, although no clear cause was identified. CONCLUSION This study contributes to our understanding of DKA in hospitalized patients in Saudi Arabia. This is the first study to link patients with DKA who have comorbidities to a longer hospital stay in the kingdom of Saudi Arabia. This study also identified multiple clinical and biochemical parameters related to the variability in LOS and time to resolution of DKA in hospitalized patients.
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Affiliation(s)
- Muath F AlWahbi
- Diabetes and Endocrinology, King Fahad Specialised Hospital, Buraydah, SAU
| | - Sami H Alharbi
- Internal Medicine and Pulmonologist, King Fahad Specialised Hospital, Buraydah, SAU
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