Mild cognitive impairment effects on diabetes self-care in Tabuk City, Saudi Arabia

OBJECTIVE

The diabetes epidemic is increasing at an alarming rate in Saudi Arabia. Diabetes and dementia share some pathogeneses, including inflammatory markers, oxidative stress, and insulin resistance. Dementia may substantially influence diabetes self-care activities (DCSAs), thereby initiating a vicious cycle of complications. Therefore, this study aims to assess the effects of mild cognitive impairment (MCI) on DSCA.

PATIENTS AND METHODS

This cross-sectional study was conducted among 206 consecutive patients attending the diabetes center in Tabuk City, Saudi Arabia, during the period from December 2021 to November 2022. A structured questionnaire was administered face-to-face, including sociodemographic data, the Diabetes Self-care Questionnaire, the Mini Cognitive Assessment Tool, and the Hospital Anxiety and Depression Questionnaire. All the participants signed a written informed consent form, and both the Ethical Committees of the University of Tabuk and the Directorate General of Health Affairs, Tabuk, approved the research.

RESULTS

There were 206 patients with diabetes (63.1% women). Dyslipidemia, hypertension, and depression were reported in 59.8%, 55.9%, and 24.3% of patients, respectively, while MCI was reported in 51.5% of patients. MCI was positively correlated with age. MCI also had negative effects on diabetes self-care activities and HbA1c, but these effects were not statistically significant (odds ratio, 0.750, 95% CI, 0.56-1.00, p-value, 0.055, and odds ratio, 1.21, 95% CI, 0.99-1.08, p-value, 0.081, respectively). No significant relationship was found regarding the duration of diabetes, depression, and dyslipidemia (95% CI, 0.95-1.09, 0.32-4.57, and 0.76-8.30, respectively).

CONCLUSIONS

MCI and associated comorbidities were common among patients with diabetes in Tabuk, Saudi Arabia. No association was found between MCI and DSCA, dyslipidemia, hypertension, or duration of diabetes.

Assessment of Barriers and Challenges in Headache Education Among Neurology Residents in Saudi Arabia

Background  Headache problems are among the most common medical conditions. There are major gaps in understanding headaches among healthcare practitioners. This study aimed to determine challenges and barriers to headache training among neurology residents in Saudi Arabia. Methods  A cross-sectional questionnaire-based study was conducted in Saudi Arabia. The target population was all Saudi neurology residents who were currently registered with the Saudi Commission for Health Specialties (SCHS). Statistical analysis was conducted using RStudio (R version 4.1.1). A chi-squared test is used for categorical variables whenever applicable. The statistical differences for continuous variables were assessed using a Wilcoxon rank sum test. Results A total of 227 respondents were included. More than half of the residents were male (56.8%). Large proportions of residents self-rated their knowledge as good for migraines (62.6%) and tension-type headaches (60.4%). The most experienced challenges included difficult diagnosis (30.4%) and treatment difficulties due to comorbidities (19.8%). The most stated barriers to optimal treatment of headache patients were the existence of challenges in collaboration between patient and therapist (24.7%). Most residents rely on the use of the International Classification of Headache Disorders (ICHD) in diagnosing and managing headache patients instead of the Saudi guidelines. The most reported reason for headache referral was suspicion of an underlying serious disease (31.7%). The most recommended non-pharmacological interventions were exercise (15.9%). Conclusion  We found that residents reported the diagnosis of headache as the most challenging barrier. The overuse of analgesics played a role in causing the headache. The most often cited barrier to providing headache patients with the best possible care was difficulties in patient-therapist collaboration. Ongoing headache education and comprehensive academic training are recommended to enhance knowledge during neurology residency training and offer competent care for their patients.