1
|
Hiasat DA, Salih MB, Abu Jaber AH, Abubaker OF, Qandeel YA, Saleem BA, Aburumman SI, Al-Sayyed ARH, Hussein TI, Hyassat D. The prevalence of diabetes distress among patients with type 2 diabetes in Jordan. J Taibah Univ Med Sci 2023; 18:1237-1243. [PMID: 37250811 PMCID: PMC10213091 DOI: 10.1016/j.jtumed.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/03/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives Diabetes distress (DD) is a state of emotional distress that evolves from living with chronic disease and the burden of daily adjustments of medications and lifestyle. This study investigated the prevalence of DD in patients with type 2 diabetes mellitus (T2DM) in Jordan and the related sociodemographic and medical factors. Methods We conducted a cross-sectional study in 608 patients with T2DM in Jordan, ranging from ages 15 to 80 years. The participants filled out a questionnaire where they were asked to self-assess their DD using the Diabetes Distress Scale. In all, 32 participants were excluded according to the exclusion criteria, which resulted in 576 people being included in this study. Results The overall prevalence of DD was 53% (25% had moderate distress and 28% had high distress). Emotional distress had the highest prevalence among the DD subscales, with a total prevalence of 58.8%. The data showed a significant association of DD with different factors including age, the presence of diabetic complications, the type of medication used, and medication adherence. Conclusion This study showed a high prevalence of DD (53%). This finding should raise awareness to healthcare providers about the importance of screening for DD as part of the treatment guidelines, especially in patients who are on multiple medication regimens for DM; patients who have previous medical complications related to DM; and those who exhibit poor adherence to medications, which was found to be a risk factor of DD in this study.
Collapse
Affiliation(s)
- Duaa A. Hiasat
- Faculty of Medicine, Al-Balqa' Applied University, Jordan
| | | | | | | | | | | | | | | | | | - Dana Hyassat
- National Center for Diabetes, Endocrinology and Genetics, Jordan
| |
Collapse
|
2
|
Juweid ME, Alselaibi D, Abandeh H, Al-Ibraheem A, Al-Qasem S, Albtoush O, Al-Hawajreh L, Doudeen R, Abujbara M, Hyassat D, Khawaja N, Hadadin H, Hijazein Y, Alduraidi H, Ajlouni K. Degenerative lumbar changes have a statistically significant but small effect on trabecular bone score (TBS)-adjusted fracture risk (FRAX). Medicine (Baltimore) 2023; 102:e36082. [PMID: 38013318 PMCID: PMC10681429 DOI: 10.1097/md.0000000000036082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023] Open
Abstract
Trabecular bone score (TBS) assesses trabecular microarchitecture at the lumbar spine and was shown to improve fracture risk prediction compared to bone mineral density (BMD) alone. We investigated whether lumbar degenerative changes (DC) affect TBS and TBS-adjusted 10-year fracture risk assessment (tool) (FRAX) estimates. All patients who underwent BMD and TBS measurements via dual-energy X-ray absorptiometry at our institution between 1/7/2020 and 1/10/2020 were retrospectively evaluated. We identified all patients who had DC in 1 or 2 vertebrae (out of L1-L4) with a BMD T score > 1 unit higher than the remaining 2 to 3 adjacent vertebrae. TBS and BMD were compared between the vertebrae with and without DC. Change in TBS as well as FRAX estimates for major osteoporotic (MOP) and hip fractures after exclusion of the degenerative vertebrae were also determined. Of the 356 eligible patients, 94 met the inclusion criteria. The mean TBS of vertebrae without DC was not significantly different from that of L1 to L4 (1.31 ± 0.12 vs 1.32 ± 0.12, respectively, P = .11). The FRAX estimates after exclusion of the degenerative vertebrae were statistically significantly higher than for L1 to L4 for both MOP and hip fractures (P = .04 and P = .01, respectively). However, the differences were very small. The mean 10-year MOP FRAX estimate after exclusion of degenerative vertebrae was 7.67% ± 4.50% versus 7.55% ± 4.36% for L1 to L4 and the mean 10-year hip FRAX estimate after exclusion of degenerative vertebrae was 2.06% ± 2.01% versus 2.02% ± 1.98% for L1 to L4. Lumbar DC have a statistically significant but only small effect on TBS-adjusted FRAX making it unnecessary to exclude the degenerative vertebrae when computing TBS.
Collapse
Affiliation(s)
- Malik E. Juweid
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Dana Alselaibi
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Hiba Abandeh
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Akram Al-Ibraheem
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
- King Hussein Cancer Center, Amman, Jordan
| | - Soud Al-Qasem
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Omar Albtoush
- Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Laith Al-Hawajreh
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Rahma Doudeen
- Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Mousa Abujbara
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Dana Hyassat
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Nahla Khawaja
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Hiba Hadadin
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Yazan Hijazein
- Division of Nuclear Medicine/Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | | | - Kamel Ajlouni
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| |
Collapse
|
3
|
Qudah S, Abufaraj M, Farah R, Almazeedi A, Ababneh A, Alnabulsi M, Qatawneh A, Hyassat D, Ajlouni K. The prevalence of overactive bladder and its impact on the quality of life: A cross-sectional study. Arab J Urol 2023; 22:39-47. [PMID: 38205386 PMCID: PMC10776079 DOI: 10.1080/2090598x.2023.2221403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/30/2023] [Indexed: 01/12/2024] Open
Abstract
Objective Overactive bladder (OAB) is a common condition affecting both men and women and has been shown to affect the quality of life. We conducted this study to estimate the prevalence of OAB, and to incorporate symptom severity, symptom bother and health-related quality of life (HRQL) in the assessment of OAB and evaluate associated factors. Methodology A total of 940 participants were categorized into non-OAB and OAB using the Overactive Bladder Symptom Score (OABSS). HRQL and symptom bother were measured using the Overactive Bladder Questionnaire - Short Form (OAB-q SF). Descriptive analyses and multivariable regression analyses were performed. Results The prevalence of OAB among our population was 27.4%. Patients with older age (Odd ratio [OR] = 2.26, 95% confidence interval [CI]: 1.6-3), higher body mass index (BMI) (OR = 2.6, 95% CI: 1.8-3.8), comorbidities (OR = 2.6, 95% CI: 1.9-3.5) and history of recurrent urinary tract infection (UTI) s (OR = 1.9, 95% CI: 1.4-2.6) were significantly associated with increased risk of OAB (p < 0.001). The mean OAB symptom bothers score was 35.7 + 22.9 and increased significantly across OAB severity groups (p < 0.001). The mean HRQL score was 73.3 + 22 and a significant decreased across OAB severity groups (p < 0.001). All OAB symptoms showed significant positive correlation with increased symptom bother (p < 0.001) in addition to significant inverse correlation with HRQL (p < 0.001). Conclusion OAB is a prevalent condition in our population and the associated symptoms negatively affect HRQL. In this study, the detrimental effect is not exclusive to UUI and can be attributed to the other elements in the symptom spectrum of OAB. Screening for OAB should be considered during routine clinical visits using validated and reliable measures for early detection of symptoms and possible modification of risk factors to improve the outcome.
Collapse
Affiliation(s)
- Shrouq Qudah
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, Amman, Jordan
| | - Randa Farah
- Department of Internal Medicine, School of Medicine, Jordan University Hospital, Amman, Jordan
| | | | - Ali Ababneh
- Division of Urology, Department of Special Surgery, Jordan University Hospital, Amman, Jordan
| | - Mazen Alnabulsi
- Division of Urology, Department of Special Surgery, Jordan University Hospital, Amman, Jordan
| | - Ayman Qatawneh
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetic (NCDEG)/The University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetic (NCDEG)/The University of Jordan, Amman, Jordan
| |
Collapse
|
4
|
Hyassat D, Abu Noor N, AlAjlouni Q, Jarrar Y, Qarajeh R, Mahasneh A, Elzoubi Z, Khader Y, Farahid O, El-Khateeb M, Ajlouni K. Control of diabetes, hypertension, and dyslipidemia in Jordan: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:439-445. [PMID: 37008178 PMCID: PMC10060078 DOI: 10.1097/ms9.0000000000000272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/21/2023] [Indexed: 03/31/2023] Open
Abstract
To determine the level of glycemic, blood pressure (BP), and lipids control among patients with type 2 diabetes mellitus (DM) attending the National Center for Diabetes, Endocrinology and Genetics and to determine factors associated with poor control.
Collapse
Affiliation(s)
- Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Nancy Abu Noor
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Qais AlAjlouni
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Yazan Jarrar
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Raed Qarajeh
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Awn Mahasneh
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Zaid Elzoubi
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Yousef Khader
- Jordan University of Science and Technology (JUST), Al Ramtha, Irdid, Jordan
| | - Oraib Farahid
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Mohammed El-Khateeb
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan Amman, Amman
- Corresponding author. Address: National Center for Diabetes, Endocrinology and Genetics, P.O. Box 13165, Amman 11942, Jordan. Tel: +962 6534 7810, fax: + 962 6535 6670. E-mail address: (K. Ajlouni)
| |
Collapse
|
5
|
Hyassat D, El-Khateeb M, Dahbour A, Shunnaq S, Naji D, Bani Ata E, Abujbara M, Khawaja N, Batieha A, Ajlouni K. Post-COVID syndrome among Jordanian health care workers. East Mediterr Health J 2023; 29:247-253. [DOI: 10.26719/emhj.23.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 08/21/2022] [Indexed: 02/17/2023]
|
6
|
Hyassat D, Al-Saeksaek S, Naji D, Mahasneh A, Khader Y, Abujbara M, El-Khateeb M, Ajlouni K. Dyslipidemia among patients with type 2 diabetes in Jordan: Prevalence, pattern, and associated factors. Front Public Health 2022; 10:1002466. [PMID: 36424970 PMCID: PMC9679519 DOI: 10.3389/fpubh.2022.1002466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives To determine the prevalence and patterns of dyslipidemia and its associated risk factors among patients with type 2 diabetes attending the National Center for Diabetes, Endocrinology, and Genetics (NCDEG). Methods A cross-sectional study was conducted at the NCDEG in Amman, Jordan. A total of 971 patients with type 2 diabetes were included during the period September- December 2021. The socio-demographic data were collected through face-to-face interview questionnaire and anthropometric and clinical data were abstracted from medical records. The last three readings of lipid profile and HbA1C were abstracted from the medical records. Results The overall prevalence of dyslipidemia among type 2 diabetic patients was 95.4%. The most common type of dyslipidemia was combined dyslipidemia (37.1%), with high triglycerides and low HDL-c (19.0%) being the most frequent type. Factors associated with hypercholesterolemia were diabetes duration ≤ 10 years, poor compliance to a statin, and HbA1c level (7-8%) (P-values: 0.008, 0.001, 0.021, respectively). Moreover, smoking and poor compliance with statin therapy were associated with high LDL-c level (P-values: 0.046 and 0.001, respectively). The presence of hypertension, high waist circumference, HbA1c level >8%, and diabetes duration ≤ 10 years were all associated with high triglyceride level (P-values: 0.008, 0.016, 0.011, and 0.018, respectively). Hypertension and HbA1c level >8% were associated with low HDL-c level (P-values: 0.010 and 0.011, respectively). Conclusion The combination of high triglyceride and low HDL-c is the commonest lipid abnormality detected in patients with type 2 diabetes. An educational program that emphasizes the importance of adherence to a healthy lifestyle is strongly recommended. Further studies are needed to capture a wide range of factors that might influence dyslipidemia and glycemic control.
Collapse
Affiliation(s)
- Dana Hyassat
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Saba Al-Saeksaek
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Duha Naji
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Awn Mahasneh
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Yousef Khader
- Department of Public Health, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Mousa Abujbara
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Mohammad El-Khateeb
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan,*Correspondence: Kamel Ajlouni
| |
Collapse
|
7
|
Rashed R, Hyassat D, Batieha A, Aldabbas M, Aldarabah F, EL-Khateeb M, Ajlouni K. Prevalence and Correlates of Hypophosphatemia Among Type 2 diabetic patients attending the National Center for Diabetes, Endocrinology and genetics (NCDEG). Ann Med Surg (Lond) 2022; 78:103770. [PMID: 35592823 PMCID: PMC9110974 DOI: 10.1016/j.amsu.2022.103770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/08/2022] [Accepted: 05/08/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives To estimate the prevalence of hypophosphatemia and its associated factors among type 2 diabetic patients attending (NCDEG) in Amman-Jordan, and compare the prevalence of hypophosphatemia between diabetics, nondiabetic subjects. Patients and methods A case-control study was carried out at (NCDEG). A total of 1580 diabetic patients (59.7% females, 40.3% males), mean age (SD) of 55.15 ± 15.3 attended this center from January 1st, 2020 till March 31st, 2020 were included. Our study included 2155 non-diabetic from the national population-based multipurpose study in Jordan in 2017, to compare serum inorganic phosphate between diabetic, nondiabetic. Pregnant, those aged <18 or >80 years, GFR below 30 ml/min or those on hemodialysis were excluded. The data included patient's age, gender, smoking and medication, HbA1c. Statistical analysis were performed using the Package for Social Sciences (SPSS) version 21. Results The overall prevalence of hypophosphatemia in the diabetic patients was significantly higher (10.5% vs. 3.2%, P-value 0.001). Multivariate logistic regression analysis showed that in diabetic: males, current smokers, diabetic patients with HbA1c between 7 and 9% and >9%, those who on thiazide diuretics were 2, 1.9, 1.8, 1.7, and 1.9 times, more likely to have hypophosphatemia than their counterparts (P-values 0.001, 0.001, 0.006, 0.018 and 0.003), respectively, and it was found those on statin were less likely to have hypophosphatemia. Conclusion The prevalence of hypophosphatemia among type 2 diabetic patients is high. Factors independently related to hypophosphatemia in diabetic patients: male gender, smoking, poor glycemic control, taking thiazides and not being on statin. The objectives is to estimate the prevalence of hypophosphatemia and its associated factors among type 2 diabetic patients. Also, to compare the prevalence of hypophosphatemia between diabetics, nondiabetic subjects. The overall prevalence of hypophosphatemia in the diabetic patients was significantly 10.5%. The overall prevalence of hypophosphatemia in the non- diabetic patients was 3.2%. Factors independently related to hypophosphatemia in diabetic patients included: male gender, smoking, poor glycemic control.
Collapse
Affiliation(s)
- Rula Rashed
- The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
| | - Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
| | - Anwar Batieha
- Jordan University of Science and Technology (JUST), Jordan
| | - Mohammad Aldabbas
- The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
| | - Faiq Aldarabah
- The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
| | - Mohammed EL-Khateeb
- The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
- Corresponding author. The National Center for Diabetes, Endocrinology and Genetics, P.O. Box 13165, Amman, 11942, Jordan.
| |
Collapse
|
8
|
Salameh AB, Hyassat D, Suhail A, Makahleh Z, Khader Y, El-Khateeb M, Ajlouni K. The prevalence of hypertension and its progression among patients with type 2 diabetes in Jordan. Ann Med Surg (Lond) 2021; 73:103162. [PMID: 34917355 PMCID: PMC8666513 DOI: 10.1016/j.amsu.2021.103162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022] Open
Abstract
Background Assessing the prevalence and progression of hypertension among diabetics is crucial for designing appropriate strategies for successfully managing hypertension and its life-threatening complications. This study aimed to assess the prevalence of hypertension, its progression, and its determinants among type 2 diabetes mellitus (T2DM) patients in Jordan. Materials and methods A cross-sectional study was conducted among 1382 Jordanian patients with T2DM in the period from January 2019 to January 2020. Blood pressure (BP) was followed and measured every 2–3 months using standardized automated sphygmomanometer during patients’ routine visits for a total of 12 months. Data were obtained from medical records that included sociodemographic variables, anthropometric measurements, HbA1c, lipid profile, presence of T2DM complications and treatment. Results The prevalence of hypertension among T2DM patients at the baseline was 74.6% (95% CI: 72.2%, 76.9%). The one-year incidence of hypertension among T2DM patients who were free of hypertension at the baseline was 26.2% (95% CI: 21.7%, 31.1%). In the multiple logistics regression analysis, patients older than 60 years (OR = 1.3 (95% CI: 1.01, 1.7); p-value 0.045) and those with positive family history of hypertension (OR = 4.2 (95% CI: 1.2, 8.2); p-value 0.026) were more likely to have uncontrolled hypertension. Patients who were using insulin only were less likely (OR = 0.5 (95% CI: 0.2, 0.9); p-value 0.026) to have uncontrolled hypertension compared to those who were on oral hypoglycemic agents only. Conclusion The prevalence of hypertension among Jordanian patients with T2DM is alarmingly high. Healthcare providers should be committed to policies or preventive strategies targeting the modifiable risk factors associated with hypertension. Three quarters of patients with type 2 diabetes have hypertension. Patients older than 60 years are more likely to have uncontrolled blood pressure than younger patients. Family history of hypertension is significantly associated with uncontrolled blood pressure.
Collapse
Affiliation(s)
- Ahlam Bani Salameh
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan, Amman, Jordan
| | - Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan, Amman, Jordan
| | - Ahmad Suhail
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan, Amman, Jordan
| | - Zaina Makahleh
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan, Amman, Jordan
| | - Yousef Khader
- Jordan University of Science and Technology (JUST), Jordan
| | - Mohammed El-Khateeb
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics, University of Jordan, Amman, Jordan
| |
Collapse
|
9
|
Allehdan S, Basha A, Hyassat D, Nabhan M, Qasrawi H, Tayyem R. Effectiveness of carbohydrate counting and Dietary Approach to Stop Hypertension dietary intervention on managing Gestational Diabetes Mellitus among pregnant women who used metformin: A randomized controlled clinical trial. Clin Nutr 2021; 41:384-395. [PMID: 34999333 DOI: 10.1016/j.clnu.2021.11.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 10/18/2021] [Accepted: 11/30/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common complication of pregnancy that has significant impacts on both mother and her offspring health. The present study aimed to examine the effect of carbohydrate counting, carbohydrate counting combined with DASH, and control dietary interventions on glycemic control, and maternal and neonatal outcomes. METHODS A total of 75 pregnant women with GDM at 24th - 30th week of gestation were enrolled and randomized to follow one of the three diets: control or carbohydrate counting, or carbohydrate counting combined with Dietary Approach to Stop Hypertension (DASH). Only 70 of them completed the study until delivery. Fasting blood samples were taken at baseline and the end of the study to measure fasting blood glucose (FBG), fasting insulin, glycated hemoglobin (HbA1c), and fructosamine. Homeostatic model assessment-insulin resistance (HOMA-IR) score was calculated using HOMA2 calculator program. The participants recorded at least four blood glucose readings per day. Maternal and neonatal outcomes were collected from medical records. Dietary intake was assessed by three-day food records at the baseline and the end of the study. RESULTS Adherence to the three dietary interventions, resulted in decreased FBG levels significantly among all the participants (P < 0.05). Consumption of the carbohydrate counting combined with the DASH diet showed significant reduction in serum insulin levels and HOMA-IR score compared to carbohydrate counting group and control group. Means of fructosamine and HbA1c did not differ significantly among the three intervention diet groups. Overall mean of 1-h postprandial glucose (1 h PG) level was significantly lower in the carbohydrate counting combined with DASH group compared with that in the carbohydrate counting group and the control group (P < 0.001). The number of women who were required to commence insulin therapy after dietary intervention was significantly lower in carbohydrate counting group and carbohydrate counting combined with DASH group (P = 0.026). There were no significant differences in other maternal and neonatal outcomes among the three dietary intervention groups. CONCLUSIONS The carbohydrate counting and the carbohydrate counting combined with DASH dietary interventions resulted in beneficial effects on FBG and 1 h PG compared with the control diet. The three dietary interventions produced similar maternal and neonatal outcomes in women with GDM. TRIAL REGISTRATION This trial was registered on ClinicalTrials.gov under the identification code: NCT03244579. https://clinicaltrials.gov/ct2/show/NCT03244579.
Collapse
Affiliation(s)
- Sabika Allehdan
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan; Department of Biology, College of Science, University of Bahrain. Zallaq, Sakhir Campus 32038, Bahrain.
| | - Asma Basha
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Jordan, Amman, Jordan.
| | - Dana Hyassat
- The National Centre for Diabetes Endocrinology and Genetics, Amman, Jordan.
| | - Mohammed Nabhan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Jordan, Amman, Jordan.
| | - Husam Qasrawi
- Department of Obstetrics and Gynaecology, Al-Bashir Hospital Amman, Jordan.
| | - Reema Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman 11942, Jordan; Department of Human Nutrition, College of Health Sciences, Qatar University, Doha 2713, Qatar.
| |
Collapse
|
10
|
Al-Qerem W, Jarab AS, Badinjki M, Hyassat D, Qarqaz R. Exploring variables associated with medication non-adherence in patients with type 2 diabetes mellitus. PLoS One 2021; 16:e0256666. [PMID: 34424940 PMCID: PMC8382191 DOI: 10.1371/journal.pone.0256666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/11/2021] [Indexed: 12/15/2022] Open
Abstract
Objective This study aims to assess medication adherence and explore its predictors in outpatients with type 2 diabetes. Method This cross-sectional study collected socio-demographics, disease-related information, and different biomedical variables for type 2 diabetes patients attending a Jordanian Diabetes center. The four-item medication adherence scale (4-IMAS) and the beliefs about medications questionnaire (BMQ) which includes necessity and concerns were used. Stepwise backward quartile regression models were conducted to evaluate variables associated with the Necessity and Concerns scores. Stepwise ordinal regression was conducted to evaluate variables associated with adherence. Results 287 diabetic patients participated in the study. Almost half of the participants (46.5%) reported moderate adherence and 12.2% reported low adherence. Significant predictors of the adherence were necessity score (OR = 14.86, p <0.01), concern score (OR = 0.36, p <0.05), and frequency of medication administration (OR = 0.88, p- <0.01). Education was a significant predictor of Necessity and Concerns scores (β = 0.48, -0.2, respectively). Conclusion Simplifying the medication regimen, emphasizing medication necessity and overcoming medication concerns should be targeted in future diabetes intervention programs to improve medication adherence and hence glycemic control among diabetic patients.
Collapse
Affiliation(s)
- Walid Al-Qerem
- Department of pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
- * E-mail:
| | - Anan S. Jarab
- Faculty of Pharmacy, Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Badinjki
- Department of pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Dana Hyassat
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Raghda Qarqaz
- Department of pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| |
Collapse
|
11
|
Hammad AM, Al-Qerem W, Alassi A, Hyassat D. Effect of Type 2 Diabetes Mellitus and Diabetic Medication on Pulmonary Function. CRMR 2021. [DOI: 10.2174/1573398x17666210121141412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Type 2 diabetes mellitus (T2DM) is a chronic condition with an impairing
effect on multiple organs. Numerous respiratory disorders have been observed in patients with
T2DM. However, the effect of T2DM on pulmonary function is inconclusive.
Aims:
In this study, we investigated the effect of T2DM on respiratory function and the correlation
of glycemic control, diabetes duration and insulin intake.
Methods:
1500 patients were recruited for this study; 560 having T2DM for at least a year were included
in the final data, in addition to 540 healthy volunteers. Forced expiratory volume in one second
(FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), as
well as FEV1/FVC ratio values were measured.
Results:
A two-sample t-test showed that z-scores produced by Al-Qerem et al.’s equations for
FEV1, FVC, and FEF 25-75% were significantly lower for the T2DM group than the control group
(p < 0.01). FEV1/FVC ratio in the T2DM group was significantly higher (p < 0.01). Multiple linear
regression analysis found that glycemic control represented by HbA1c as well as disease duration
were negatively associated with the pulmonary function (p < 0.01). However, insulin intake was
found to have no significant correlation with pulmonary function.
Conclusion:
T2DM was linked to reduced pulmonary function and was consistent with a restrictive
ventilation pattern. HbA1c, as well as disease duration, were found to be independent risk factors
for reduced pulmonary function.
Collapse
Affiliation(s)
- Alaa M. Hammad
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Walid Al-Qerem
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ameen Alassi
- Department of Pharmacy, College of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Dana Hyassat
- National Center for Diabetes, Endocrinology and Genetics, Jordan University, Amman, Jordan
| |
Collapse
|
12
|
Safiah M, Hyassat D, Khader Y, Farahid O, Batieha A, El-Khateeb M, Ajlouni K. Effect of Metformin on Anthropometric Measurements and Hormonal and Biochemical Profile in Patients with Prediabetes. J Diabetes Res 2021; 2021:8275303. [PMID: 34950736 PMCID: PMC8692055 DOI: 10.1155/2021/8275303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Metformin is the most widely preferred first-line oral antidiabetic agent that results in clear benefits in blood sugar regulation and diabetes-related complications. This study is aimed at assessing the effect of metformin on anthropometric, hormonal, and biochemical parameters in patients with prediabetes or insulin resistance. METHODS A prepoststudy was conducted among 52 patients with prediabetes or insulin resistance who met the inclusion criteria. Weight, body mass index (BMI), and waist circumference were measured before and 12 months after metformin treatment. Serum concentrations of sex steroids, gonadotropins, and lipids were also assessed. Homeostasis model assessment (HOMA) index and quantitative sensitivity check (QUICKI) index scores were calculated before metformin treatment and after 12 months of use. RESULTS After 12 months of metformin treatment, female patients had significant reduction in weight, BMI, and waist circumference after adjusting for age. Metformin use for 12 months resulted in significant reduction in mean fasting blood glucose and HbA1c in females only. Total cholesterol decreased significantly among men only and serum HDL-C showed a significant rise among females only. Serum LDL-C and triglycerides did not change significantly in females and males. Our study did now significant changes in ACTH and cortisol levels in both females and males after metformin treatment. Metformin use resulted in significant increase in luteinizing hormone (LH) and progesterone levels in males, while it was associated with significant increase in prolactin, follicular stimulating hormone (FSH), and dehydroepiandrostenedione-sulphate (DHEA-S) levels and significant decrease in total testosterone level in females. CONCLUSION Metformin treatment in females with prediabetes reduces BMI, waist circumference, fasting blood glucose, and HbA1c. The changes in the studied parameters differed significantly according to sex.
Collapse
Affiliation(s)
- Mustafa Safiah
- Department of Endocrinology, The National Center for Diabetes, Endocrinology, and Genetics, The University of Jordan, Amman, Jordan
| | - Dana Hyassat
- Department of Endocrinology, The National Center for Diabetes, Endocrinology, and Genetics, The University of Jordan, Amman, Jordan
| | - Yousef Khader
- Department of Public Health, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Oraib Farahid
- Department of Endocrinology, The National Center for Diabetes, Endocrinology, and Genetics, The University of Jordan, Amman, Jordan
| | - Anwar Batieha
- Department of Public Health, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Mohammed El-Khateeb
- Department of Endocrinology, The National Center for Diabetes, Endocrinology, and Genetics, The University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- Department of Endocrinology, The National Center for Diabetes, Endocrinology, and Genetics, The University of Jordan, Amman, Jordan
| |
Collapse
|
13
|
Shahin L, Hyassat D, Batieha A, Khader Y, El-Khateeb M, Ajlouni K. Insulin Sensitivity Indices in Patients with Polycystic Ovary Syndrome with Different Body Mass Index Categories. Curr Diabetes Rev 2020; 16:483-489. [PMID: 31441729 DOI: 10.2174/1573399815666190823151222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/08/2019] [Accepted: 08/04/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence of insulin resistance among women with polycystic ovary syndrome (PCOS), describe the clinical and biochemical characteristics of women with PCOS, and determine the association between Antimullerian Hormone (AMH) and PCOS. PATIENTS AND METHODS In a clinical case series, 544 women with PCOS were included in this study. Body mass index (BMI), Homeostasis Model Assessment (HOMA), Quantitative Insulin Sensitivity Check Index (QUICKI), and Matsuda index were calculated. Sixty-three women with PCOS and 50 age- and BMI-matched control patients underwent blood sampling for AMH level. RESULTS The most common clinical presentation of PCOS in this study was menstrual irregularity followed by hirsutism and infertility. There was no statistically significant difference in the clinical presentation or hormonal profile in women with PCOS according to different BMI categories. The prevalence of insulin resistance among women with PCOS was 37.7%, 69.3%, and 75.8% using HOMA, QUICKI, and Matsuda index, respectively. Furthermore, the Matsuda index had the highest detection rate of insulin resistance, especially in underweight women with PCOS (94.1%). AMH levels in women with PCOS were significantly higher than that in the control group (P-value = 0.015). CONCLUSION Insulin resistance is prevalent among women with PCOS. The detection rate of insulin resistance varies according to the insulin sensitivity index used. Menstrual irregularity was the most common presentation of PCOS. Women with PCOS have significantly higher levels of AMH levels compared to women in the control group.
Collapse
Affiliation(s)
- Lama Shahin
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Dana Hyassat
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Anwar Batieha
- Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Yousef Khader
- Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Mohammed El-Khateeb
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| |
Collapse
|
14
|
Tabanjeh SF, Hyassat D, Jaddou H, Younes NA, Robert AA, Ajlouni K. The Frequency and Risk Factors of Diabetic Foot Ulcer Recurrence Among Jordanian Patients with Diabetes. Curr Diabetes Rev 2020; 16:910-915. [PMID: 31916518 DOI: 10.2174/1573399816666200109094329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/25/2019] [Accepted: 12/26/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Diabetic foot is a major public health problem and their complications are an imperative cause of morbidity and mortality in diabetes. OBJECTIVE To evaluate the rate of recurrence of foot ulcers post two years of follow-up, including the associated risk factors in the patients attending the diabetic foot clinic at the National Center for Diabetes, Endocrinology, and Genetics (NCDEG), Amman, Jordan. METHODS A historical cohort design was adopted for the patients who presented for the first time to the diabetic foot clinic at the NCDEG. Every patient who came to the clinic was reviewed by using his or her medical files with respect to diabetic foot-related complaints. Patients were classified under four categories: (1) Recurrent foot ulcers (2) chronic foot ulcer (3) free of recurrence, and (4) no foot ulcers. Among the four groups, group 1 (recurrent foot ulcers, n=76) and group 3 (free of recurrence, n=54) were included for the analysis. RESULTS Among the 141 patients who presented to the diabetic foot clinic during the two-year study period, 76 (53.9%) of them experienced ulcer recurrences, 54 (38.3%) were recurrence-free, and 11 (7.8%) had chronic ulceration. The two-year recurrence rate was 58.5%. The presence of deformity and osteomyelitis were the statistically significant independent risk factors for recurrent foot ulceration. CONCLUSION This study of recurrences was clearly related to the type and complications of the ulcers rather than to the other variables. Recurrent foot ulceration is linked to the presence of osteomyelitis and/or deformities.
Collapse
Affiliation(s)
- Sinan F Tabanjeh
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Dana Hyassat
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| | - Hashem Jaddou
- The Jordan University of Science and Technology (JUST), Jordan
| | - Nidal A Younes
- Department of General Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Asirvatham A Robert
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology, and Genetics, Amman, Jordan
| |
Collapse
|
15
|
El-Khateeb M, Khader Y, Batieha A, Jaddou H, Hyassat D, Khawaja N, Abujbara M, Ajlouni K. Vitamin D deficiency and associated factors in Jordan. SAGE Open Med 2019; 7:2050312119876151. [PMID: 35154754 PMCID: PMC8826271 DOI: 10.1177/2050312119876151] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023] Open
Abstract
Background: In Jordan, many studies reported various rates of vitamin D deficiency and insufficiency among different groups. This study aimed to determine the prevalence of low vitamin D level among Jordanian adults and determine its association with selected variables. Methods: The vitamin D level was assessed in a national representative sample of 4056 subjects aged >17 years. The study involved face-to-face interviews with the subjects and measurement of serum 25(OH)D. Low vitamin D level was defined as 25(OH)D < 30 ng/mL. Deficiency was defined as 25(OH)D < 20 ng/mL, and insufficiency was defined as 25(OH)D level of 20–30 ng/mL. Results: The overall prevalence of low vitamin D status (25(OH)D < 30 ng/mL) was 89.7%, with higher prevalence in males (92.4%) than in females (88.6%). Vitamin D was sufficient in 7.6% of males, insufficient in 38.4% of males, and deficient in 54% of males. Among females, vitamin D was insufficient in 10.1% and deficient in 78.5%. The prevalence of vitamin D deficiency was much higher in females than in males (p = 0.001). The only variables that were significantly associated with low level of vitamin D were gender, age, obesity, and employment. Conclusion: The prevalence of low vitamin D level is extremely high in Jordan. Age, gender, obesity, and unemployment were associated with low levels of vitamin D. Health authorities in Jordan need to increase the level of awareness about vitamin D deficiency and its prevention, particularly among women.
Collapse
Affiliation(s)
- Mohammed El-Khateeb
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Yousef Khader
- Jordan University for Science and Technology, Irbid, Jordan
| | - Anwer Batieha
- Jordan University for Science and Technology, Irbid, Jordan
| | - Hashem Jaddou
- Jordan University for Science and Technology, Irbid, Jordan
| | - Dana Hyassat
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Nahla Khawaja
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Mousa Abujbara
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| |
Collapse
|
16
|
Ajlouni K, Batieha A, Jaddou H, Khader Y, Abdo N, El-Khateeb M, Hyassat D, Al-Louzi D. Time trends in diabetes mellitus in Jordan between 1994 and 2017. Diabet Med 2019; 36:1176-1182. [PMID: 30614070 DOI: 10.1111/dme.13894] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2019] [Indexed: 12/14/2022]
Abstract
AIM The prevalence of diabetes has been increasing over the past few decades. The objective of this study is to assess the time trends in diabetes between 1994 and 2017 in Jordan. METHODS Surveys were conducted in 1994, 2004, 2009 and 2017 by the same investigators using generally similar methods. Fasting blood glucose was measured in all surveys. Variables were obtained using structured questionnaires designed specifically for the surveys. Crude and age-specific diabetes prevalence rates were derived for each sex, together with overall, crude and age-standardized prevalence rates. RESULTS The prevalence of diabetes in men aged ≥ 25 years increased from 14.2% in 1994 to 18.3% in 2004, 26.8% in 2009 and 32.4% in 2017. The corresponding prevalence rates in women were 12.3%, 16.9%, 18.8%, and 18.1%, respectively. The overall age-standardized prevalence rate increased from 13.0% in 1994 to 17.1% in 2004, 22.2% in 2009 and 23.7% in 2017. Known diabetes in the 2017 survey accounted for 82.6% of people with diabetes. A HbA1c of < 59 mmol/mol (7.5%) was observed in 41.4% of participants with known diabetes. CONCLUSION The results showed a high prevalence of diabetes in Jordan among people aged ≥ 25 years. Prevalence increased from 1994 to 2009, but slowed thereafter. The increase was greater in men than in women. Previously diagnosed diabetes accounted for a high percentage of people with diabetes in all surveys and was highest in 2017 survey, suggesting that the national strategy against diabetes has brought some benefits. Efforts should be made to improve glycaemic control in people with diabetes.
Collapse
Affiliation(s)
- K Ajlouni
- National Centre (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), University of Jordan, Amman
| | - A Batieha
- Department of Public Health and Community Medicine, Jordan University of Science and Technology (JUST), Irbid
| | - H Jaddou
- Department of Public Health and Community Medicine, Jordan University of Science and Technology (JUST), Irbid
| | - Y Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology (JUST), Irbid
| | - N Abdo
- Department of Public Health and Community Medicine, Jordan University of Science and Technology (JUST), Irbid
| | - M El-Khateeb
- National Centre (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), University of Jordan, Amman, Jordan
| | - D Hyassat
- National Centre (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), University of Jordan, Amman, Jordan
| | - D Al-Louzi
- Jordan Ministry of Health, Amman, Jordan
| |
Collapse
|
17
|
Alrub AA, Hyassat D, Khader YS, Bani-Mustafa R, Younes N, Ajlouni K. Factors Associated with Health-Related Quality of Life among Jordanian Patients with Diabetic Foot Ulcer. J Diabetes Res 2019; 2019:4706720. [PMID: 30800685 PMCID: PMC6360050 DOI: 10.1155/2019/4706720] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 11/21/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study is aimed at determining factors associated with the quality of life among Jordanian diabetic patients with foot ulcers. METHODS 144 consecutive patients with diabetic foot ulcers aged ≥ 18 years who were attending the diabetic foot clinic at a diabetes-specialized center were included in this study. Health-related quality of life was assessed using two self-administered questionnaires: Diabetic Foot Scale-Short Form (DFS-SF) and Short Form-8 (SF-8). RESULTS Patients with diabetic foot ulcer had low mean DFS-SF score and low mean scores on physical and mental component summary scales (PCS8 and MCS8). Males had significantly higher DFS-SF score indicating better health-related quality of life than females (P value 0.038). A patient with stressful life events had significantly lower health-related quality of life using DFS-SF scale and SF-8 summary scales. Patients with peripheral vascular disease (PVD) and patients with obesity had lower DFS-SF and PCS8 quality of life. CONCLUSION Patients with diabetic foot ulcer had low quality of life. Female gender, obesity, presence of PVD, and stressful life events were the most important factors associated with lower quality of life in patients with diabetic foot ulcer.
Collapse
Affiliation(s)
- Ahmad Abu Alrub
- The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | | | | | - Nidal Younes
- The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| |
Collapse
|
18
|
Hyassat D, Alyan T, Jaddou H, Ajlouni KM. Prevalence and Risk Factors of Osteoporosis Among Jordanian Postmenopausal Women Attending the National Center for Diabetes, Endocrinology and Genetics in Jordan. Biores Open Access 2017; 6:85-93. [PMID: 28736691 PMCID: PMC5515108 DOI: 10.1089/biores.2016.0045] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
To assess the prevalence of osteoporosis and osteopenia among Jordanian postmenopausal women attending the National Center for Diabetes, Endocrinology, and Genetics (NCDEG), and to determine the potential associated risk factors. A cross-sectional study was conducted at (NCDEG) in Amman, Jordan. A total of 1079 Jordanian postmenopausal women aged between 45 and 84 years were included in this study that was conducted during the period between April 2013 and December 2014. All patients underwent bone mineral density measurement through dual-energy X-ray absorptiometry (DEXA) scan. DEXA scan was interpreted in terms of T score as per World Health Organization guidelines. The overall prevalence of osteoporosis and osteopenia was 37.5% and 44.6%, respectively. The maximum prevalence of osteoporosis was observed at the lumbar spine (32.4%) followed by the left femoral neck (14.4%), while the maximum prevalence of osteopenia was observed at the left femoral neck (56.1%) followed by the lumbar spine (41.3%). Patients with longer menopausal duration, normal or overweight body mass index, high parity, physical inactivity, positive family history of osteoporosis, inadequate sun exposure, high daily caffeine intake, low daily calcium intake, and delay in the age of menarche were all positively associated with osteoporosis. On the other hand, women with type 2 diabetes mellitus had lower risk of osteoporosis. There is a high prevalence of osteoporosis and osteopenia among Jordanian postmenopausal women. Necessary steps are needed for more public education and a wider dissemination of information about osteoporosis and its prevention.
Collapse
Affiliation(s)
- Dana Hyassat
- Department of Endocrinology, The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG)/The University of Jordan, Amman, Jordan
| | - Taghreed Alyan
- Department of Endocrinology, The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG)/The University of Jordan, Amman, Jordan
| | - Hashem Jaddou
- Department of Epidemiology and Public Health, The Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Kamel M. Ajlouni
- Department of Endocrinology, The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG)/The University of Jordan, Amman, Jordan
| |
Collapse
|
19
|
Khawaja N, Liswi M, El-Khateeb M, Hyassat D, Bajawi D, Elmohtaseb M, Alkhateeb H, Ajlouni K. Vitamin D Dosing Strategies Among Jordanians With Hypovitaminosis D. J Pharm Pract 2016; 30:172-179. [PMID: 26787629 DOI: 10.1177/0897190015626334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare between weekly and daily cholecalciferol in patients with hypovitaminosis D and to determine the optimal maintenance dose. METHODS Seventy-one volunteers with hypovitaminosis D were randomly assigned to 2 dose regimens: cholecalciferol 50 000 IU weekly for 8 weeks, then 50 000 IU monthly for 2 months (group A) and 7000 IU daily for 8 weeks, then 12 500 IU weekly for 2 months (group B). Cholecalciferol was stopped for 2 months and reintroduced as 50 000 IU bimonthly for group A and 50 000 IU monthly for group B. RESULTS Two months after therapy, the mean serum 25-hydroxyvitamin D (25(OH)D) level increased from 11.4 to 51.2 ng/mL and from 11.7 to 44.9 ng/mL in groups A and B, respectively ( P = .065). The levels of 25(OH)D declined similarly in both groups during maintenance and after holding therapy. After resuming cholecalciferol, 25(OH)D levels increased to 33.8 and 28.8 ng/mL in groups A and B, respectively ( P = .027). There was a negative correlation between serum 25(OH)D levels and body mass index (BMI; P = .040). CONCLUSION Timing and frequency of the dosing (daily vs weekly) have no effect on the rise in serum 25(OH)D levels as long as the accumulative dose of cholecalciferol is similar. Cholecalciferol 50 000 IU bimonthly is required to maintain sufficient 25(OH)D levels.
Collapse
Affiliation(s)
- Nahla Khawaja
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Mohammed Liswi
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Mohammed El-Khateeb
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan.,2 Department of Pathology, Microbiology and Forensic Medicine, The University of Jordan, Amman, Jordan
| | - Dana Hyassat
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Dalila Bajawi
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Mayada Elmohtaseb
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Hussein Alkhateeb
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- 1 The National Center (Institute) for Diabetes, Endocrinology and Genetics (NCDEG), The University of Jordan, Amman, Jordan
| |
Collapse
|
20
|
Hyassat D, Al Shekarchi N, Jaddou H, Liswi M, El-Khateeb M, Ajlouni KM. Are insulin analogues an unavoidable necessity for the treatment of type 2 diabetes in developing countries? The case of Jordan. East Mediterr Health J 2015; 21:729-35. [PMID: 26750163 DOI: 10.26719/2015.21.10.729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 05/13/2015] [Indexed: 11/09/2022]
Abstract
Despite their reported benefits in terms of glycaemic control, insulin analogues are expensive for patients in developing countries. This study in Jordan aimed to compare the effectiveness and adverse events of premixed human insulin (BHI30) versus premixed insulin analogue (BIAsp30) in patients with type 2 diabetes. In a retrospective cohort study from October 2012 to March 2013, outcomes (HbA1c, weight, hypoglycaemia and lipohypertrophy) were compared at baseline and 6 months after treatment in 628 patients. BHI30 produced a significantly greater reduction in HbA1c than did BIAsp30. This difference in HbA1c remained significant after controlling for the effects of age, sex, duration of diabetes, body mass index and hypoglycaemia (β-coefficient was -0.18 in favour of BHI30). Weight gain and mild hypoglycaemia was significantly higher with BHI30 than with BIAsp30. BHI30 achieved better reduction in HbA1c compared with BIAsp30, with less cost, slightly more weight gain and greater reported mild hypoglycaemia.
Collapse
Affiliation(s)
- D Hyassat
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - N Al Shekarchi
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - H Jaddou
- Department of Epidemiology and Public Health, Jordan University of Science and Technology, Amman, Jordan
| | - M Liswi
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - M El-Khateeb
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - K M Ajlouni
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| |
Collapse
|
21
|
Lafi ZM, Irshaid YM, El-Khateeb M, Ajlouni KM, Hyassat D. Association of rs7041 and rs4588 Polymorphisms of the Vitamin D Binding Protein and the rs10741657 Polymorphism of CYP2R1 with Vitamin D Status Among Jordanian Patients. Genet Test Mol Biomarkers 2015; 19:629-36. [PMID: 26383826 DOI: 10.1089/gtmb.2015.0058] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIM Previous studies have shown a high prevalence of vitamin D deficiency among Jordanians despite adequate exposure to sunlight, suggesting the presence of other causes for this deficiency. The aim of this study was to identify the relationship between 25-hydroxyvitamin D [25-(OH) VD] status and the nonsynonymous single-nucleotide polymorphisms (SNPs) (rs7041 and rs4588) of the GC gene, which encodes the vitamin D binding protein, and one SNP (rs10741657) near the CYP2R1 gene. METHODS Blood samples from 381 subjects (74 males and 307 females, 18-60 years of age) were obtained from the "National Center for Diabetes, Endocrinology and Genetics" (Amman, Jordan). The subjects were classified as "apparently healthy" if they did not suffer from chronic diseases and as "unhealthy" if they suffered from certain chronic diseases. Subjects' genotypes for GC; rs7041 and rs4588; CYP2R1; rs10741657 were determined by the polymerase chain reaction-restriction fragment length polymorphism assay method. RESULTS Apparently, healthy subjects had significantly higher 25-(OH) VD levels than unhealthy patients. In apparently healthy subjects, the rs10743657 genotypes containing the variant allele A (AA, GA) were associated with higher 25-(OH) VD levels than the homozygous wild-type genotype (GG). The genotypes containing the variant allele of rs7041 (TT, TG) and rs4588 (AA, AC) were associated with lower 25-(OH) VD levels than the wild-type genotypes (GG and CC, respectively). Haplotype analysis of rs7041 and rs4588 revealed that the haplotypes GC1S and GC1S/S were associated with 25-(OH) VD sufficiency, whereas haplotypes GC1F/S, GC1F/2, GC1S/2, GC2, and GC2/2 were associated with 25-(OH) VD deficiency. In unhealthy patients, only the homozygous genotype of the variant allele of rs7041 (TT) was associated with higher 25-(OH) VD levels, which is the reverse of what had been observed in apparently healthy subjects. CONCLUSIONS The rs70141657G/A of CYP2R1 and rs7041T/G and rs4588C/A of vitamin D binding protein genetic polymorphisms were associated with increased risk of vitamin D deficiency among apparently healthy Jordanians.
Collapse
Affiliation(s)
- Zainab M Lafi
- 1 Department of Pharmacology, Faculty of Medicine, The University of Jordan , Amman, Jordan
| | - Yacoub M Irshaid
- 1 Department of Pharmacology, Faculty of Medicine, The University of Jordan , Amman, Jordan
| | | | - Kamel M Ajlouni
- 2 National Center for Diabetes , Endocrinology and Genetics, Amman, Jordan
| | - Dana Hyassat
- 2 National Center for Diabetes , Endocrinology and Genetics, Amman, Jordan
| |
Collapse
|
22
|
Hyassat D, Al Sitri E, Batieha A, EL-Khateeb M, Ajlouni K. Prevalence of Hypomagnesaemia among Obese Type 2 Diabetic Patients Attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG). Int J Endocrinol Metab 2014; 12:e17796. [PMID: 25237327 PMCID: PMC4166041 DOI: 10.5812/ijem.17796] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/05/2014] [Accepted: 05/09/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Some observations suggested that magnesium supplementation could be helpful in the treatment of diabetic patients by improving glycemic control and preventing the development of diabetes-related complications. OBJECTIVES To estimate the prevalence of hypomagnesaemia among obese patients with type 2 diabetes attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG) in Amman, Jordan. PATIENTS AND METHODS A cross-sectional study was carried out at the National Center for diabetes, Endocrinology and Genetics (NCDEG) in Amman-Jordan. A total of 1105 patients with type 2 diabetes (51.9% females and 48.1% males) who attended this center between first of October 2011and end of February 2012 were included in the study. The mean age and duration of diabetes were 57.1 years and 5.1 years, respectively and the mean value of HbA1c was 7.9%. Our study also performed a comparison of the prevalence of hypomagnesaemia between our studied sample and 3600 individuals enrolled in the National Vitamin D study completed in Jordan in 2009. The obtained data included patients' age, gender, smoking history, HbA1c level, comorbid history including hypertension, dyslipidemia, and presence of neuropathy and retinopathy. RESULTS Out of 1105 patients with type 2 diabetes, 210 patients (19%) (95% CI, 16.8%-21.4%) were hypomagnesaemic. Female gender, hypertension, statin therapy, HbA1c between 7-7.9% or ≥ 9% and patients with diabetes duration more than five years were independent risk factors for hypomagnesaemia. No association between hypomagnesaemia and age distribution, smoking history, neuropathy and retinopathy was found. In comparison with individuals enrolled in the National Vitamin D study, diabetic patients in this study had a much higher prevalence of hypomagnesaemia (19% vs. 0.7%) with odd's ratio of 32 (95% CI, 21-48.2). CONCLUSIONS As the prevalence of hypomagnesaemia among patients with type 2 diabetes treated at the NCDEG was found to be 19% (95% CI, 16.8%-21.4%), we recommend periodic determination of magnesium level and appropriate magnesium replacement therapy particularly among the above defined groups.
Collapse
Affiliation(s)
- Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
| | - Ebtihaj Al Sitri
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
| | - Anwar Batieha
- Jordan University of Science and Technology (JUST), Amman, Jordan
| | - Mohammed EL-Khateeb
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
- Corresponding author: Kamel Ajlouni, The National Center for Diabetes, Endocrinology and Genetics Center, P.O.Box: 13165, Amman, Jordan. Tel: +96-265347810, Fax: +96-265356670, E-mail:
| |
Collapse
|
23
|
El-Khateeb M, Khader Y, Batieha A, Jaddou H, Hyassat D, Belbisi A, Ajlouni K. Vitamin B 12 Deficiency in Jordan: A Population-Based Study. Ann Nutr Metab 2014; 64:101-5. [DOI: 10.1159/000355440] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 09/02/2013] [Indexed: 11/19/2022]
|
24
|
Batieha A, Khader Y, Jaddou H, Hyassat D, Batieha Z, Khateeb M, Belbisi A, Ajlouni K. Vitamin D status in Jordan: dress style and gender discrepancies. Ann Nutr Metab 2011; 58:10-8. [PMID: 21252499 DOI: 10.1159/000323097] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 11/25/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Vitamin D deficiency is highly prevalent worldwide and has been linked to many diseases. The aims of the present study were to assess the vitamin D status of Jordanians at the national level and to identify groups of the population at high risk for vitamin D deficiency. METHODS Vitamin D status was assessed in a national sample of 5,640 subjects aged ≥7 years. The study involved interviews, laboratory measurements of 25(OH)D and others, and physical measurements. The present report deals, exclusively, with subjects aged >18 years. RESULTS The prevalence of low vitamin D status [25(OH)D <30 ng/ml] was 37.3% in females compared to 5.1% in males. Dress style in females was independently related to low vitamin D status; women wearing 'Hijab' (adjusted OR = 1.7, p = 0.004) or 'Niqab' (adjusted OR = 1.5, p = 0.061) were at a higher risk for low vitamin D status than were western-dressed women. CONCLUSION The high prevalence of low vitamin D status in females in contrast with a low prevalence in males, together with a higher prevalence in women wearing Hijab or Neqab, calls for action to increase the population's awareness and to develop strategies to reduce this risk among women, particularly those wearing dress styles that cover most or all of their skin.
Collapse
Affiliation(s)
- A Batieha
- Jordan University of Science and Technology, Irbid, Jordan
| | | | | | | | | | | | | | | |
Collapse
|