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Khalil SA, Azar S, Hafidh K, Ayad G, Safwat M. Prevalence and Co-prevalence of Comorbidities Among Patients with Type 2 Diabetes Mellitus in the MENA Region: A Systematic Review. Curr Diabetes Rev 2023:CDR-EPUB-133262. [PMID: 37526192 DOI: 10.2174/1573399820666230731105704] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/25/2023] [Accepted: 07/02/2023] [Indexed: 08/02/2023]
Abstract
AIM The management of type 2 diabetes mellitus is affected by the presence of comorbidities. This meta-analysis aimed to determine how likely it is for individuals with type 2 diabetes in the Middle East and North Africa (MENA) to be living with additional chronic health conditions. METHODS We searched for studies published from January 2010 to December 2020 in PubMed, Ovid MEDLINE®, Cochrane CENTRAL, Scopus, and Web of Science. Studies of adults with type 2 diabetes in the MENA region were included. We performed a random-effects meta-analysis of single proportions to calculate each comorbidity's overall prevalence/co-prevalence. RESULTS Statistically significant co-prevalence was detected at p < 0.01 for angina (pooled proportion: 0.24, 95% CI: 0.06, 0.49), cerebrovascular accident (pooled proportion: 0.16, 95% CI: 0.08, 0.26), coronary artery disease (pooled proportion: 0.25, 95% CI: 0.16, 0.35), coronary heart disease (pooled proportion: 0.05, 95% CI: 0.01, 0.12), peripheral vascular disease (pooled proportion: 0.19, 95% CI: 0.13, 0.26), hypertension (pooled proportion: 0.56, 95% CI: 0.43, 0.69), renal impairment (pooled proportion: 0.19, 95% CI: 0.10, 0.29), in addition to hyperlipidemia and overweight/obesity. CONCLUSION There is evidence of co-prevalence of several comorbidities in patients with type 2 diabetes. This highlights the importance of enhancing communication among healthcare professionals to develop the optimal management plan for each patient.
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Affiliation(s)
- Samir Assaad Khalil
- Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Sami Azar
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Khadija Hafidh
- Department of Diabetes and Endocrinology, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - George Ayad
- Medical Affairs - JAMEL., Medical Advisor - Digital Scientific Engagement., GMSA - Center of Execution, EEMEA., MSD Egypt
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Al Saleh Y, Al Busaidi N, Al Dahi W, Almajnoni M, Mohammed AS, Alshali K, Al-Shamiri M, Al Sifri S, Arafah M, Chan SP, El-Tamimi H, Hafidh K, Hassanein M, Shaaban A, Sultan A, Grassi G. Roadmap for the Management of Type 2 Diabetes and Hypertension in the Middle East: Review of the 2022 EVIDENT Summit. Adv Ther 2023; 40:2965-2984. [PMID: 37233878 PMCID: PMC10271906 DOI: 10.1007/s12325-023-02529-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/20/2023] [Indexed: 05/27/2023]
Abstract
Type 2 diabetes mellitus (T2DM) and hypertension are leading risk factors for death and disability in the Middle East. Both conditions are highly prevalent, underdiagnosed and poorly controlled, highlighting an urgent need for a roadmap to overcome the barriers to optimal glycaemic and blood pressure management in this region. This review provides a summary of the Evidence in Diabetes and Hypertension Summit (EVIDENT) held in September 2022, which discussed current treatment guidelines, unmet clinical needs and strategies to improve treatment outcomes for patients with T2DM and hypertension in the Middle East. Current clinical guidelines recommend strict glycaemic and blood pressure targets, presenting several treatment options to achieve and maintain these targets and prevent complications. However, treatment targets are infrequently met in the Middle East, largely due to high clinical inertia among physicians and low medication adherence among patients. To address these challenges, clinical guidelines now provide individualised therapy recommendations based on drug profiles, patient preferences and management priorities. Efforts to improve the early detection of prediabetes, T2DM screening and intensive, early glucose control will minimise long-term complications. Physicians can use the T2DM Oral Agents Fact Checking programme to help navigate the wide range of treatment options and guide clinical decision-making. Sulfonylurea agents have been used successfully to manage T2DM; a newer agent, gliclazide MR (modified release formulation), has the advantages of a lower incidence of hypoglycaemia with no risk of cardiovascular events, weight neutrality and proven renal benefits. For patients with hypertension, single-pill combinations have been developed to improve efficacy and reduce treatment burden. In conjunction with pragmatic treatment algorithms and personalised therapies, greater investments in disease prevention, public awareness, training of healthcare providers, patient education, government policies and research are needed to improve the quality of care of patients with T2DM and/or hypertension in the Middle East.
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Affiliation(s)
- Yousef Al Saleh
- Dr. Mohammad AlFagih Hospital, Riyadh, Kingdom of Saudi Arabia.
| | - Noor Al Busaidi
- National Diabetes and Endocrine Centre, Royal Hospital, Muscat, Oman
- Oman Diabetes Association, Muscat, Oman
| | | | - Munawar Almajnoni
- Department of Cardiology, My Clinic, Jeddah, Kingdom of Saudi Arabia
- Saudi Society of Echocardiography, Jeddah, Kingdom of Saudi Arabia
| | - Al Saeed Mohammed
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Bahrain Defence Force Royal Medical Services, Riffa, Kingdom of Bahrain
| | - Khalid Alshali
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mostafa Al-Shamiri
- Department of Cardiac Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Saud Al Sifri
- Al Hada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | | | - Siew Pheng Chan
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hassan El-Tamimi
- Mohammed Bin Rashid University of Medicine and Health Science, Dubai, United Arab Emirates
- Department of Cardiology, Mediclinic Parkview Hospital, Dubai, United Arab Emirates
| | - Khadija Hafidh
- Diabetes Unit, Rashid Hospital, Dubai, United Arab Emirates
| | - Mohamed Hassanein
- Department of Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
| | - Ashraf Shaaban
- Diabetes Control Centre, Ghassan Najib Pharaon Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Ali Sultan
- Diabetes Centre, International Medical Centre Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Guido Grassi
- Clinica Medica, University of Milano-Bicocca, Milan, Italy
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3
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Hassanein M, Yousuf S, Ahmedani MY, Albashier A, Shaltout I, Yong A, Hafidh K, Hussein Z, Kallash MA, Aljohani N, Wong HC, Buyukbese MA, Chowdhury T, Fadhila MERZOUKI, Taher SW, Belkhadir J, Malek R, Abdullah NRA, Shaikh S, Alabbood M. Ramadan fasting in people with diabetes and chronic kidney disease (CKD) during the COVID-19 pandemic: The DaR global survey. Diabetes Metab Syndr 2023; 17:102799. [PMID: 37301008 PMCID: PMC10234835 DOI: 10.1016/j.dsx.2023.102799] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND AIMS The DaR Global survey was conducted to observe the impact of the COVID-19 pandemic on the intentions to fast and the outcomes of fasting in people with diabetes and chronic kidney disease (CKD). METHODS Muslim people with diabetes and CKD were surveyed in 13 countries shortly after the end of Ramadan 2020, using a simple Survey Monkey questionnaire. RESULTS This survey recruited 6736 people with diabetes, of which 707 (10.49%) had CKD. There were 118 (16.69%) people with type1 diabetes (T1D), and 589 (83.31%) were with type2 diabetes (T2D). 62 (65.24%) people with T1D and 448 (76.06%) people with T2D had fasted with CKD. Episodes of hypoglycaemia and hyperglycaemia were more frequent among people with T1D compared to T2D, 64.52% and 43.54% vs 25.22% and 22.32% respectively. Visits to the emergency department and hospitalization were more frequent among people with CKD, however no significant difference was found between people with T1D and T2D. CONCLUSION The COVID-19 pandemic had only a minor effect on the intention to fast during Ramadan in people with diabetes and CKD. However, hypoglycaemia and hyperglycaemia were found to be more frequent, as well as emergency visits and hospital admissions among people with diabetic kidney disease. Prospective studies are needed in future to evaluate the risk indicators of hypoglycaemia and hyperglycaemia among fasting people with CKD, especially in the context of different stages of kidney disease.
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Affiliation(s)
- Mohamed Hassanein
- Dubai Hospital, Mohamed Bin Rashed University, United Arab Emirates.
| | - Sanobia Yousuf
- Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan.
| | | | - Alaa Albashier
- Dubai Hospital, Dubai, University of Sharjah UAE, United Arab Emirates.
| | - Inass Shaltout
- Internal Medicine and Diabetes, Faculty of Medicine, Cairo University, Egypt.
| | - Alice Yong
- Endocrine Centre, RIPAS Hospital, Brunei Darussalam.
| | - Khadija Hafidh
- Diabetes Unit, Department of Medicine, Rashid Hospital, Dubai Academic Health Corporation, Saudi Arabia.
| | - Zanariah Hussein
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia.
| | | | - Naji Aljohani
- Obesity, Endocrine and Metabolic Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Hui Chin Wong
- Division of Endocrinology, Department of Internal Medicine, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
| | | | - Tahseen Chowdhury
- Department of Diabetes and Metabolism, The Royal London Hospital, Whitechapel, London, UK.
| | | | | | - Jamal Belkhadir
- Endocrinologist - Diabetologist, Rabat, Morocco, President of Moroccan League for the Fight Against Diabetes, Chair of IDF Mena Region.
| | | | | | - Shehla Shaikh
- Saifee Hospital, Mumbai, Treasurer Maharashtra ESI Executive Committee Member ESI, India.
| | - Majid Alabbood
- Department of Medicine, Alzahra College of Medicine, University of Basrah, Iraq.
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Beshyah AS, Elamouri JS, Almagdub I, Abdulrahman H, Hafidh K, Beshyah SA. Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review. Ibnosina Journal of Medicine and Biomedical Sciences 2023. [DOI: 10.1055/s-0043-1764355] [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: 03/19/2023]
Abstract
Abstract
Introduction Acute medical problems may occur more frequently during Ramadan fasting (RF). We aimed to provide a narrative overview of the global literature on medical emergencies during RF.
Methods This is a nonsystematic review of the international literature from one major medical online database (PubMed, National Institutes of Health, United States). The relevant literature was narrated in a concise thematic account.
Results There is a variable impact in the burden and time distribution of emergency services and hospitalization during RF that may require readjustment of resource allocation. Studies of the risk of accidents and injuries may be increased overall or at specified times, around Iftar time. A classical impact of emergencies has been the risk of worsening peptic ulcer disease. RF impacts diabetic emergencies such as severe hypoglycemia, hyperglycemia, and diabetic ketoacidosis, particularly in type 1 diabetes and poorly controlled patients. Glucocorticoid replacement therapy may represent a challenge to patients and physicians that require education and dose adjustment. Acute neurological conditions of interest include the “first day of Ramadan headache,” epilepsy, and strokes. Several studies evaluated the risk of the acute coronary syndrome and heart failure with inconsistent findings. RF may impact the renal and urological systems through stone disease, renal colic, and acute kidney. The impact on hematological conditions was mostly focused on the safety of anticoagulant therapy during Ramadan.
Conclusion The review addresses the emergency medical encounters of the fasting patient during Ramadan to allow a holistic and ethnically sensitive approach to medical care under circumstances where decisions have to be taken with no delay.
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Affiliation(s)
- Anas S. Beshyah
- Department of Gastroenterology, Wythenshawe Hospital, Manchester, United Kingdom
| | - Jamila S. Elamouri
- Nephrology Unit, Department of Internal Medicine, Tripoli Central Hospital, Tripoli, Libya
| | - Ihab Almagdub
- Department of Medicine, Sheikh Khalifa Medical City, SEHA, Abu Dhabi, United Arab Emirates
| | - Husen Abdulrahman
- Department of Medicine, Sheikh Khalifa Medical City, SEHA, Abu Dhabi, United Arab Emirates
| | - Khadija Hafidh
- Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
| | - Salem A. Beshyah
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
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5
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Alamoudi RM, Aljohani NJ, Alfadhli EM, Alzaman N, Alfadhly AF, Kallash MA, Alshenqete AM, Batais MA, Alharbi M, Ekhzaimy AA, Sheshah E, Ahmedani MY, Buyukbese MA, Shaltout I, Hemaida K, Belkhadir J, Afandi B, Hafidh K, Hussein Z, Elbarbary NS, Hassanein M. Fasting Ramadan in patients with T1DM - Saudi Arabia versus other countries during the COVID-19 pandemic. Diabetes Metab Syndr 2023; 17:102676. [PMID: 36463695 DOI: 10.1016/j.dsx.2022.102676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 06/24/2022] [Revised: 07/28/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS To compare Saudi Arabia with other countries regarding patient attitudes towards fasting Ramadan and complications related to fasting during the COVID-19 pandemic. METHODS Data collected from Saudi Arabia and 12 other mostly Muslim majority countries, via physician administered questionnaire within post Ramadan 2020. RESULTS 1485 Type1 diabetes (T1DM) patients analyzed; 705 (47.5%) from Saudi Arabia vs. 780 (52.5%) from other countries. 1056 (71.1%) fasted Ramadan; 636 (90.2%) of Saudi patients vs. 420 (53.8%) of other countries. Experiencing Ramadan during the COVID-19 pandemic did not affect the Saudi T1DM patients' decision to fast while it significantly influenced their decision in other countries (1.4 vs 9.9%, P < 0.001). More Saudi patients needed to break the fast due to a diabetes related complication compared to other countries (67.4% vs. 46.8%, p=<0.001). The mean number of days fasted in Saudi and other countries was 24 ± 7 and 23 ± 8 days respectively. Hypoglycemic events were more common among Saudi patients during Ramadan compared to other countries 72% and 43.6% (p < 0.001) respectively. There was a significant difference in timing; the largest peak for Saudi Arabia patients was after dawn (35% vs 7%, p < 0.001), while it was pre-sunset for the other countries (23 vs 54%, p = 0.595). Day time-hyperglycemia was also more common among Saudi patients (48.6% vs. 39%, p < 0.001), however it was a less likely cause to break the fast (25.6% vs 38.3%, p < 0.001). CONCLUSION Observing the fast of Ramadan is extremely common among Saudi T1DM patients compared to other Muslim countries and was not affected by the COVID-19 pandemic. However, it was associated with higher frequency of hypoglycemic and hyperglycemic episodes.
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Affiliation(s)
- Reem M Alamoudi
- Department of Medicine, King Abdulaziz Medical City, King Abdullah International Research Centre, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guards Health Affairs, Jeddah, Saudi Arabia.
| | - Naji J Aljohani
- Obesity, Endocrine and Metabolic Center, King Fahad Medical City, King Abdulaziz Bin Saud University for Health Sciences, Riyadh, Saudi Arabia
| | - Eman M Alfadhli
- Department of Medicine, Medical College, Taibah University, AlMadinah, Saudi Arabia
| | - Naweed Alzaman
- Department of Medicine, Medical College, Taibah University, AlMadinah, Saudi Arabia
| | - Abdulaziz F Alfadhly
- Department of Family Medicine, Prince Mansour Military Hospital, Taif City, Saudi Arabia
| | - Majd-Aldeen Kallash
- Obesity, Endocrine and Metabolic Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Mohammed A Batais
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Aishah A Ekhzaimy
- Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Eman Sheshah
- Diabetes Care Center, King Salman Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Muhammad Yakoob Ahmedani
- Department of Medicine, Baqai Institute of Diabetology & Endocrinology, Baqai Medical University, Karachi, Pakistan
| | | | - Inass Shaltout
- Department of Internal Medicine and Diabetes, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Kamel Hemaida
- Glan Clwyd Hospital, Renal and Diabetes, Rhyl, Denbighshire, UK; Alexandria University, Faculty of Medicine, Medical Department, Alexandria, Egypt
| | - Jamal Belkhadir
- Moroccan League for the Fight Against Diabetes, IDF Middle East and North Africa, Morocco
| | | | - Khadija Hafidh
- Diabetes Unit, Rashid Hospital, Dubai Health Authority, Dubai Academic Health Cooperation, United Arab Emirates
| | - Zanariah Hussein
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia
| | | | - Mohamed Hassanein
- Department of Endocrinology and Diabetes, Dubai Hospital, Dubai Academic Health Cooperation, United Arab Emirates
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Al-Rubeaan K, Alsayed M, Ben-Nakhi A, Bayram F, Echtay A, Hadaoui A, Hafidh K, Kennedy K, Kok A, Malek R, Rajadhyaksha V, Arnold SV. Characteristics and Treatment Patterns of Patients with Type 2 Diabetes Mellitus in the Middle East and Africa Cohort of the DISCOVER Study Program: a Prospective Study. Diabetes Ther 2022; 13:1339-1352. [PMID: 35689732 PMCID: PMC9240182 DOI: 10.1007/s13300-022-01272-6] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/11/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Despite the high prevalence of type 2 diabetes (T2D) and suboptimal glycemic control in the Middle East and Africa, comprehensive data on the management of T2D remain scarce. The main aim of this study is to describe the characteristics and treatment of patients with T2D initiating second-line glucose-lowering therapy in these regions. METHODS DISCOVER is a global, 3-year, prospective observational study of patients with T2D enrolled at initiation of second-line glucose-lowering therapy. Baseline characteristics and treatments are presented for patients from 12 countries divided into three regions: Mediterranean, Gulf Cooperation Council, and South Africa. RESULTS Among 3525 patients (52.5% male, mean age 54.3 years), mean time since T2D diagnosis was 6.2 years [across-region range (ARR) 5.8-7.5 years] and mean glycated hemoglobin levels were 8.7% (72.0 mmol/mol) [ARR 8.6-9.0% (68-75 mmol/mol)]. At first line, metformin was prescribed for 88.1% (ARR 85.4-90.3%) of patients and a sulfonylurea for 34.4% (ARR 12.7-45.4%). Sulfonylureas and dipeptidyl peptidase-4 inhibitors were prescribed at second line for 55.5% (ARR 48.6-82.5%) and 49.0% (ARR 3.7-73.8%) of patients, respectively. Main reasons for choice of second-line therapy were efficacy (73.2%; ARR 60.1-77.7%) and tolerability (26.8%; ARR 3.7-31.2%). CONCLUSIONS We demonstrate considerable inter-region variations in the management of T2D, likely affected by multiple factors (health system, physician behavior, and patient compliance), all of which should be addressed to optimize outcomes.
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Affiliation(s)
- Khalid Al-Rubeaan
- Research and Scientific Centre, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Mohamed Alsayed
- International Evidence Delivery Lead, BioPharmaceuticals Medical, AstraZeneca, Ibn Sinha Building, Dubai Healthcare City, Dubai, United Arab Emirates
| | | | - Fahri Bayram
- Faculty of Medicine Endocrinology and Metabolism Department, Erciyes University, Kayseri, Turkey
| | - Akram Echtay
- Lebanese University, Beirut, Lebanon
- Department of Endocrinology, Rafik Hariri University Hospital, Beirut, Lebanon
| | | | | | - Kevin Kennedy
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA
| | - Adri Kok
- University of the Witwatersrand, Netcare Union Hospital, Alberton, South Africa
| | | | | | - Suzanne V Arnold
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA
- University of Missouri-Kansas City, Kansas City, MO, USA
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Hassan-Beck R, Hafidh K, Badi A, Doukman K, Karmo M, Mir R, Beshyah SA. Ramadan Fasting in Health and Disease in 2021: A Narrative Review. Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1757473] [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: 11/06/2022]
Abstract
Abstract
Introduction: The literature on the health aspects of Ramadan fasting (RF) is widely spread in many journals.
Materials and Methods: This is a narrative review of data obtained from the PubMed database (National Library of Medicine, Bethesda, Maryland, United States). We used the search term “Ramadan fasting,” and relevant records were examined. The publications are narrated thematically.
Results: The publications spanned fundamental, clinical, professional, cultural, and advocacy facets. The publications crossed conventional disciplinary lines and geographical locations and appeared in journals with different access systems. The contents are presented under the themes that emerged depending on the retrieved literature. This year basic coverage included changes in physiology and nutrition during Ramadan. However, the clinical issues included a wide range of topics. These included the impact of RF on nonalcoholic fatty liver disease and adjustments needed in endocrine replacement therapy for hypothyroidism and adrenal insufficiency. Coverage also included chronic kidney disease. The impact on maternal health, fetal well-being, and long-term effects of RF exposures were addressed in several studies. Studies in cardiovascular medicine focused on blood pressure and cardiovascular risk factors. Sports medicine and athletes' well-being received somewhat prominent coverage. The impact on renal function, particularly in patients with chronic kidney disease, was investigated by a few authors. Several groups addressed the eyes' structure and function, neurological conditions, especially headache disorders, and hematological and oncological conditions. Finally, the impact of RF on several aspects of mental health and well-being was addressed by various groups.
Conclusions: Health aspects of RF received a sustained academic interest with a broad spectrum in 2021. This narration provides an overview of the year's scholarly health-related literature on various aspects of health and disease. It should help researchers and clinicians catch up quickly with the health concerns during Ramadan.
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Affiliation(s)
- Reem Hassan-Beck
- Clinical Trial Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Khadija Hafidh
- Department of Diabetes and Endocrinology, Rashid Hospital, Dubai, United Arab Emirates
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
| | - Amal Badi
- Department of Obstetrics and Gynecology, Koster Clinic, Dubai, United Arab Emirates
| | - Khaled Doukman
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Abu Dhabi Sports Council, Abu Dhabi, United Arab Emirates
| | - Mazn Karmo
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
| | - Ruqqia Mir
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
- Department of Neurology, Abu Dhabi Stemm Cell Center, Abu Dhabi, United Arab Emirates
| | - Salem A. Beshyah
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
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8
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Hassan-Beck R, Hafidh K, Badi A, Dougman K, Karmo M, Mir R, Beshyah SA. Erratum: Ramadan Fasting in Health and Disease in 2021: A Narrative Review. Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1758814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Reem Hassan-Beck
- Clinical Trial Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Khadija Hafidh
- Department of Diabetes and Endocrinology, Rashid Hospital, Dubai, United Arab Emirates
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
| | - Amal Badi
- Department of Obstetrics and Gynecology, Koster Clinic, Dubai, United Arab Emirates
| | - Khaled Dougman
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Abu Dhabi Sports Council, Abu Dhabi, United Arab Emirates
| | - Mazn Karmo
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
| | - Ruqqia Mir
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
- Department of Neurology, Abu Dhabi Stemm Cell Center, Abu Dhabi, United Arab Emirates
| | - Salem A. Beshyah
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
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9
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Alzubaidi H, Hafidh K, Saidawi W, Othman AM, Khakpour MM, Zoghbor MM, Abu-Gharbieh E, Alzoubi KH, Shaw JE. Behavioral, psychological, and clinical outcomes of Arabic-speaking people with type 2 diabetes during COVID-19 pandemic. Prim Care Diabetes 2022; 16:355-360. [PMID: 35410850 PMCID: PMC8993045 DOI: 10.1016/j.pcd.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/29/2022] [Indexed: 01/21/2023]
Abstract
AIMS Assess self-care activities, health behaviors, self-efficacy, diabetes distress, challenges, and changes in diabetes treatment and clinical parameters among Arabic-speaking people with T2DM during the COVID-19 pandemic. METHODS A cross-sectional study was conducted at a tertiary hospital in the United Arab Emirates. The study instrument collected self-reported data using validated tools about health behaviors, self-efficacy, and diabetes distress, and challenges in accessing and using healthcare services during the pandemic and documented clinical data and treatment before and during the pandemic from medical records. RESULTS 206 patients participated with a mean age of 58.7 years and 15.7 years since diabetes diagnosis. Non-adherence to healthful eating and exercise was reported by 38.3% and 73.7%, respectively. Exercise was the self-care activity that decreased the most (36.8%). Most participants had low diabetes distress (85.9%). There were no significant differences in clinical parameters before and during the pandemic, and diabetes treatment was unchanged for 72.8% of participants. Having two or more challenges with accessing and using diabetes healthcare services was significantly associated with decreased adherence to healthy eating (p = 0.025) and exercise (p = 0.003). CONCLUSIONS Arabic-speaking people with T2DM appeared to maintain relatively similar self-care levels, except exercise, with no deterioration in clinical parameters compared to pre-pandemic.
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Affiliation(s)
- Hamzah Alzubaidi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates; Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Khadija Hafidh
- Rashid Hospital, Dubai Health Authority UAE, Dubai Medical College, United Arab Emirates.
| | - Ward Saidawi
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Amna M Othman
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Mahta M Khakpour
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Malaka M Zoghbor
- Pharmacist, Fakeeh University Hospital, Dubai Silicon Oasis, Dubai, United Arab Emirates.
| | - Eman Abu-Gharbieh
- Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Karem H Alzoubi
- College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates.
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Institute, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Road, PO Box 6492, Melbourne, VIC 3004, Australia.
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10
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Beshyah SA, Hafidh K, Abdulrahman H, Hammami SO. Perceptions of Geriatric Medicine and Care of the Elderly: An Exploratory Survey of Physicians from the Middle East and Africa. Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1748777] [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: 10/17/2022]
Abstract
Abstract
Background The number of older people is growing in the Middle East and Africa (MEA). We aimed to explore the attitudes of MEA's physicians toward the care of the elderly and nursing homes.
Methods We surveyed 137 doctors practicing in the MEA region in 2017 using an online questionnaire that included attitude scales of geriatrics and nursing homes.
Results Most respondents were senior (47.1%) or in middle grades (35.3%), in public facilities (77.4%), and practiced internal medicine and subspecialties. More respondents (86%) agreed with what was perceived as the most exciting and entertaining qualities of most older people in their accounts of their past experiences. Also, 69.0% of respondents disagreed that older people need/demand no more attention or love than younger people. At the same time, 43.6% of respondents were neutral on the question relating to older people's power in business and politics. Positive attitudes, that is, older people's willingness to continue working for as long as possible, and that wisdom with age scored 61.5% was supported by 85.1 and 61.5% of the respondents, respectively.On the other hand, 53.7% of respondents agreed that older people could not adjust and change with changing circumstances, 70.9% disagreed that older people make neighborhoods less favorable. However, only 15.5% disagreed with the statement that older people cannot adjust and change with changing circumstances. Nearly two-thirds thought nursing homes were not well developed (63.0%) in the MEA region. Also, 59.8% said that the expected reimbursement is low, 57.7% were concerned about complicated medical problems, and 57.3% highlighted the deficits in training. There was low satisfaction with providing nursing home care despite agreeing that they may feel professionally satisfied providing nursing home care (49.5%). The respondents were neutral (47.3%) or somewhat agreed (42.9%) about enjoying nursing home care.
Conclusion There is a suboptimal attitude of practicing physicians to geriatrics that needs improvements.
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Affiliation(s)
- Salem A. Beshyah
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
| | - Khadija Hafidh
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
- Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Husen Abdulrahman
- Department of Medicine, Sheikh Khalifa Medical City, SEHA, Abu Dhabi, United Arab Emirates
| | - Sonia Ouali Hammami
- Department of Internal Medicine, Geriatric Unit, CHU F. Bourguiba Monastir, Monastir, Tunisia
- Research Laboratory LR12ES05, Lab-NAFS Nutrition, Functional Food & Health, Faculty of Medicine, University of Monastir, Monastir, Tunisia
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11
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Hassanein M, Afandi B, Yakoob Ahmedani M, Mohammad Alamoudi R, Alawadi F, Bajaj HS, Basit A, Bennakhi A, El Sayed AA, Hamdy O, Hanif W, Jabbar A, Kleinebreil L, Lessan N, Shaltout I, Mohamad Wan Bebakar W, Abdelgadir E, Abdo S, Al Ozairi E, Al Saleh Y, Alarouj M, Ali T, Ali Almadani A, Helmy Assaad-Khalil S, Bashier AMK, Arifi Beshyah S, Buyukbese MA, Ahmad Chowdhury T, Norou Diop S, Samir Elbarbary N, Elhadd TA, Eliana F, Ezzat Faris M, Hafidh K, Hussein Z, Iraqi H, Kaplan W, Khan TS, Khunti K, Maher S, Malek R, Malik RA, Mohamed M, Sayed Kamel Mohamed M, Ahmed Mohamed N, Pathan S, Rashid F, Sahay RK, Taha Salih B, Sandid MA, Shaikh S, Slim I, Tayeb K, Mohd Yusof BN, Binte Zainudin S. Diabetes and Ramadan: Practical guidelines 2021. Diabetes Res Clin Pract 2022; 185:109185. [PMID: 35016991 DOI: 10.1016/j.diabres.2021.109185] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [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: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 12/16/2022]
Abstract
Fasting during Ramadan is one of the five pillars of Islam and is obligatory for all healthy Muslims from the age of puberty. Though individuals with some illness and serious medical conditions, including some people with diabetes, can be exempted from fasting, many will fast anyway. It is of paramount importance that people with diabetes that fast are given the appropriate guidance and receive proper care. The International Diabetes Federation (IDF) and Diabetes and Ramadan (DaR) International Alliance have come together to provide a substantial update to the previous guidelines. This update includes key information on fasting during Ramadan with type 1 diabetes, the management of diabetes in people of elderly ages and pregnant women, the effects of Ramadan on one's mental wellbeing, changes to the risk of macrovascular and microvascular complications, and areas of future research. The IDF-DAR Diabetes and Ramadan Practical Guidelines 2021 seek to improve upon the awareness, knowledge and management of diabetes during Ramadan, and to provide real-world recommendations to health professionals and the people with diabetes who choose to fast.
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Affiliation(s)
| | | | | | | | | | | | - Abdul Basit
- Baqai Institute of Diabetology & Endocrinology, Baqai Medical University, Karachi, Pakistan
| | | | | | - Osama Hamdy
- Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | | | | | | | - Nader Lessan
- Imperial College London Diabetes Centre, Abu Dhabi, UAE
| | | | - Wan Mohamad Wan Bebakar
- School of Medical Sciences, Universiti Sains Malaysia, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
| | | | - Sarah Abdo
- Bankstown - Lidcombe Hospital, Sydney, Australia
| | | | - Yousef Al Saleh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA
| | | | - Tomader Ali
- Imperial College London Diabetes Centre, Abu Dhabi, UAE
| | | | | | | | | | | | | | - Said Norou Diop
- Department of Medicine, Universite Cheikh Anta Diop De Dakar, Senegal
| | | | | | | | | | | | | | - Hinde Iraqi
- Endocrinologie et Maladies Métaboliques, CHU de Rabat, Maroc
| | | | | | - Kamlesh Khunti
- University of Leicester, Leicester General Hospital, Leicester, UK
| | - Salma Maher
- Diabetes UK, Meethi Zindagi Pakistan, Baqai Institute Pakistan, MywayDiabetes UK, Digibete UK
| | - Rachid Malek
- Department of internal Medicine, Setif hospital University, Algeria
| | | | | | | | - Nazeer Ahmed Mohamed
- Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, South Africa
| | - Sameer Pathan
- International Diabetes Federation, Brussels, Belgium
| | | | | | | | | | | | - Ines Slim
- Multidisciplinary Private Clinic "Les Oliviers", Sousse, Tunisia
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12
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Abstract
BACKGROUND Optimum glycemic control is necessary to reduce and even prevent the risk of micro- and macrovascular complications of type 1 diabetes mellitus (T1DM). The main aim of this study was to assess the prevalence of T1DM patients with adequate glycemic control in 4 Arabian Gulf countries. METHODS This study was a multicenter, observational, cross-sectional disease registry. Data were collected from adult T1DM patients who were treated with insulin within 6 months prior to the study visit. RESULTS Out of 241 patients whose data were eligible for primary endpoint analysis, 27.4% had adequate glycemic control (HbA1c < 7%). The patients' age ranged from 18 to 64 years, and 53% were males. The mean (SD) duration of diabetes was 14.6 (9) years and the mean HbA1c was 8.11 (1.8) %. At the time of T1DM diagnosis, mean HbA1c was 10.7 (2.17) %. About 98% of the patients were normotensive and the lipid profile of patients was found to be optimal. The main variables associated with adequate glycemic control were low HbA1c at diagnosis (P < 0.001) and absence of a family history of diabetes (P = 0.002). CONCLUSIONS We found that the glycemic control of T1DM adult patients in Kuwait, UAE, Oman and Bahrain is suboptimal. More efforts are necessary to pinpoint the causes of inadequate control in this population.
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Affiliation(s)
- Khadija Hafidh
- Department of Medicine, Rashid Hospital, Dubai Health Authority, Rashid Hospital, P.0.Box 4545, Dubai, UAE.
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13
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Hassoun A, Dhanwal DK, Nafach J, Ajaz Y, Khan AM, Ben Nakhi A, AlArouj M, Hafidh K, AlNajjar M, Reyas A, Qamar S, Alsayed M, Bdair A. Real-World Assessment of Efficacy and Safety Parameters for Dapagliflozin in Management of Type 2 Diabetes Mellitus: REWARD Study. Dubai Diabetes Endocrinol J 2022. [DOI: 10.1159/000519871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> While ample evidence on improved glycemic control, weight reduction, and lowered blood pressure (BP) with sodium-glucose cotransporter type 2 inhibitors (SGLT2is) exists, real-world data on the potential benefit of SGLT2i on the diabetic population in the Middle East are lacking. The aim of our study was to describe the glycemic control, changes in body weight, body mass index (BMI), lipid profile, and BPs in patients receiving dapagliflozin with other antidiabetic medication. <b><i>Methods:</i></b> The REWARD study was a multicenter, post-authorization, prospective, open-label, noninterventional, real-world, cohort study. We enrolled 511 adult, type 2 diabetes mellitus patients on antidiabetic medications. These patients were started on dapagliflozin and followed up for 1 year to assess changes in their clinical and laboratory outcomes. <b><i>Results:</i></b> The mean HbA1c decreased significantly from 8.5 ± 1.6% at baseline to 7.6 ± 1.3% after 12 months (<i>p</i> value <0.001), with an absolute change of 0.9%. Of the study population, 41.6% of patients reached an HbA1c level less than 7% (53 mmol/mol). The systolic pressure improved (mean change = −1.9 mm Hg, <i>p</i> value = 0.003), yet no change in the diastolic pressure was observed. Both body weight and BMI significantly decreased by 0.7 kg and 0.2 kg/m<sup>2</sup>, respectively (<i>p</i> value <0.001). About 84.5% of patients were on antidyslipidemic agents, while 57.4% were on antihypertensives. Approximately 83.6% of adverse events were mild. A total of 90 hypoglycemic episodes were reported; none were severe. <b><i>Conclusion:</i></b> In a real-world setting, dapagliflozin in combination with other antidiabetic medications exhibited significant improvement in glycemic control, weight, BMI, and systolic BP. Additionally, it demonstrated a well-tolerated safety profile.
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14
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Hafidh K, Malek R, Al-Rubeaan K, Kok A, Bayram F, Echtay A, Rajadhyaksha V, Hadaoui A. Prevalence and risk factors of vascular complications in type 2 diabetes mellitus: Results from discover Middle East and Africa cohort. Front Endocrinol (Lausanne) 2022; 13:940309. [PMID: 36017310 PMCID: PMC9396276 DOI: 10.3389/fendo.2022.940309] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We evaluated the prevalence of vascular complications and associated risk factors in individuals with type 2 diabetes mellitus (T2DM) initiating second-line glucose-lowering therapy from the Middle East and Africa (MEA) cohort of the 3-year prospective DISCOVER study involving 15,992 patients in 38 countries. METHODS Baseline cross-sectional data collected from healthcare settings were used to assess micro and macrovascular complications prevalence as crude and age- and sex-standardised. The multi-variable analysis assessed factors associated with these complications. RESULTS Of 3,525 enrolled patients (mean age: 54.3 ± 10.8 years), >40% had hypertension and hyperlipidaemia. Metformin monotherapy was the first-line therapy in 56.5%, followed by metformin+sulphonylurea (20.3%). Crude and standardised prevalence of microvascular complications were 17.7% and 16.9% (95% confidence interval [CI], 16.77-16.98) and macrovascular complications were 10.7% and 8.7% (95% CI, 8.59-8.76). Factors significantly (p<0.05) associated with micro and macrovascular complications (odds ratios [95% CI]) were age (1.24 [1.12-1.39] and 1.58 [1.35-1.84]), male sex (1.33 [1.04-1.70] and 1.71 [1.22-2.40]), hyperlipidaemia (1.33 [1.07-1.65] and 1.96 [1.46-2.63]) and hypertension (1.75 [1.40-2.19] and 2.84 [2.07-3.92]). CONCLUSION A substantial burden of vascular complications with prominent risk factors in the MEA cohort calls for early preventive interventions.
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Affiliation(s)
- Khadija Hafidh
- Diabetes Unit, Rashid Hospital, Dubai, United Arab Emirates
- *Correspondence: Khadija Hafidh,
| | - Rachid Malek
- Internal Medicine, Setif University Hospital, Setif, Algeria
| | - Khalid Al-Rubeaan
- Research and Scientific Centre, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Adri Kok
- University of the Witwatersrand, Netcare Union and Clinton Hospitals, Alberton, South Africa
| | - Fahri Bayram
- Endocrinology and Metabolism, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Akram Echtay
- Endocrinology Division, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Viraj Rajadhyaksha
- Medical Affairs Department, AstraZeneca Middle East and Africa, Luton, United Kingdom
| | - Ahmed Hadaoui
- Medical Affairs Department, AstraZeneca Algeria, Algiers, Algeria
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15
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Beshyah SA, Ali KF, Hajjaji IM, Hafidh K, Raza SA, Ghour N, Khochtali I. Knowledge gaps and perceptions of future research directions on management of diabetes during Ramadan fasting: An online survey of physicians. Diabetes Res Clin Pract 2021; 177:108923. [PMID: 34146601 DOI: 10.1016/j.diabres.2021.108923] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Current knowledge and research on diabetes and Ramadan form the basis for evidence-based clinical practice. In this context, we aimed to explore physicians' perceptions of current knowledge gaps about research fasting (RF), barriers to, and foreseeable directions for advancement of the field. METHODS We conducted an online survey of a convenience sample of 260 physicians from 27 countries. The survey questionnaire addressed three main domains: perceived current knowledge gaps and unmet needs in research about RF and diabetes, barriers to the conduct of research, and future directions for furthering the evidence in this field. RESULTS Majority of respondents (65.7%) were senior physicians in adult endocrinology/diabetes (45.9%) working at tertiary centers (65.2%). The majority (67.3%) reported seeing an average of 20+ patients with diabetes weekly and felt "very or fairly confident" in managing diabetes during RF (67.7%). The knowledge gaps identified were the management of high-risk patients with diabetes (54.1%), such as renal impairment (59.8%), and pregnancy (61.5%). The main barriers to research were lack of adequate funding to academic centers (75.7%) and lack of interest of institutions in the subject (64.6%). Future efforts should be directed at the conduct of large epidemiological studies (49.5%) or double-blinded, placebo-controlled clinical trials (48.6%) to address the former gaps. Research findings should be widely disseminated via hands-on workshops (recommended by 70.3% of respondents) or international conferences (61.2%). CONCLUSIONS There is a wide agreement regarding the knowledge gaps in the management of diabetes during RF. Future efforts should focus on addressing these critical deficiencies.
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Affiliation(s)
- Salem A Beshyah
- Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates.
| | - Khawla F Ali
- Department of Medicine, Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya, Bahrain.
| | - Issam M Hajjaji
- Department of Medicine, Faculty of Medicine, University of Tripoli, Tripoli, Libya; National Centre for Diabetes, Tripoli, Libya
| | - Khadija Hafidh
- Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates; Department of Diabetes and Endocrinology, Rashid Hospital, DHA, Dubai, United Arab Emirates
| | - Syed Abbas Raza
- Department of Endocrinology, Shaukat Khanum Hospital, and Research Center, Lahore, Pakistan
| | - Nazim Ghour
- Queen Elizabeth University Hospital, Glasgow, Scotland, United Kingdom; Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, United Kingdom; University of Glasgow, Glasgow, Scotland, United Kingdom.
| | - Ines Khochtali
- Endocrinology and Internal Medicine Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
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16
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Aschner P, Galstyan G, Yavuz DG, Litwak L, Gonzalez-Galvez G, Goldberg-Eliaschewitz F, Hafidh K, Djaballah K, Tu ST, Unnikrishnan AG, Khunti K. Glycemic Control and Prevention of Diabetic Complications in Low- and Middle-Income Countries: An Expert Opinion. Diabetes Ther 2021; 12:1491-1501. [PMID: 33840067 PMCID: PMC8099945 DOI: 10.1007/s13300-021-00997-0] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/06/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Trends on glycemic control and diabetes complications are known for high-income countries, but comprehensive data from low- and middle-income countries (LMIC) are lacking. METHODS This is an expert opinion based on two retrospective studies. Here we examine the recent subset analysis of relevant data from the IDMPS Wave 7 (International Diabetes Management-Practices Study, 2015-2016) and the GOAL study conducted in multiple LMICs. RESULTS Wave 7 sub-analysis was performed in 6113 people with type 2 diabetes from 24 LMIC. Poorly controlled diabetes (hemogloblin A1c [HbA1c] ≥ 7%) was found in 58.6, 73.0 and 78.3% of participants with diabetes duration of < 5, 5-12 and > 12 years, respectively (in association with a high prevalence of macro- and microvascular complications). Moreover, 37.7% of participants with diabetes duration of 5-12 years were treated only with oral antihyperglycemic drugs. The GOAL study investigated the efficacy of insulin in 2704 poorly controlled participants (mean HbA1c 9.7%; diabetes duration 10.1 ± 6.7 years; 10 LMIC). A significant 2% reduction in mean HbA1c levels was observed after 12 months of treatment. Only 7.2% of participants experienced a symptomatic episode of hypoglycemia (nocturnal or severe hypoglycemia events were infrequent). CONCLUSION The rate of well-controlled participants (HbA1c < 7.0%) in the Wave 7 sub-analysis was lower than that observed in the USA (NHANES survey) or in European countries (GUIDANCE study), and the incidence of microvascular complications was higher. The GOAL study showed that insulin treatment improves glycemic control and reduces this gap. The Expert Panel recommends intensifying diabetes treatment as soon as possible, as well as patients' education and other preventive measures, initiatives which require modest costs compared to hospitalization and treatment of diabetes complications.
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Affiliation(s)
- Pablo Aschner
- Javeriana University School of Medicine and San Ignacio University Hospital, Bogota, Colombia.
| | | | - Dilek G Yavuz
- Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey
| | - Leon Litwak
- Endocrine, Metabolism and Nuclear Medicine Service, Diabetes Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | | | | | - Shih-Te Tu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
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17
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Al-Ozairi E, Jallo MK, Hafidh K, Alhajeri DM, Ashour T, Mahmoud EFN, Abd ElAal Z, Loulou M. Prevalence of Cardiovascular and Renal Co-morbidities in Patients with Type 2 Diabetes in the Gulf, a Cross-sectional Observational Study. Diabetes Ther 2021; 12:1193-1207. [PMID: 33694092 PMCID: PMC7994503 DOI: 10.1007/s13300-021-01038-6] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/19/2021] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Understanding comorbid conditions with type 2 diabetes mellitus (T2DM) is critical for clinical decision-making regarding the choice of pharmacotherapy. This study aimed at describing the prevalence and co-prevalence of comorbidities, including chronic kidney disease (CKD) and cardiovascular disease (CVD) (coronary artery disease (CAD), cerebrovascular disease, peripheral arterial disease (PAD) and congestive heart failure (CHF)) among patients with T2DM. METHODS A cross-sectional multi-center observational study on 300 patients with T2DM. Data were collected from patients' records during the enrollment visit. RESULTS Overall, 38%, 10% and 2% of the patients had one, two and three comorbidities, respectively, with the number of comorbidities significantly increasing with age. The most prevalent comorbidities were CVD (17.3%), CAD (15%) and CKD (44.3%), mostly stages 2 and 3. However, the prevalence of CHF (0.7%), PAD (2.3%) and cerebrovascular diseases (1.3%) was low. The highest percentage of anti-hyperglycemic agents used was metformin (81%), dipeptidyl peptidase-4 inhibitors (46%), sodium-glucose co-transporter 2 inhibitors (37%), insulin (36%) and sulfonylurea (34%). The choice of the anti-hyperglycemic class did not change across age groups and gender. CONCLUSION Half of the patients had T2DM only. The most prevalent comorbidity found was CKD, mainly stage 2. The comorbidity burden tended to increase significantly in older age groups.
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Affiliation(s)
- Ebaa Al-Ozairi
- Clinical Research Department, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Mahir K Jallo
- Thumbay Academic Health Centre, Gulf Medical University, Ajman, UAE
| | - Khadija Hafidh
- Rashid Hospital, Dubai Health Authority, Dubai Medical University, Dubai, UAE
| | - Dalal M Alhajeri
- Kaifan Clinic, Capital Health Area, Ministry of Health, Kuwait City, Kuwait
| | | | | | - Zeyad Abd ElAal
- MSD IDEA Middle East, Dubai Healthcare City, Al Faris Building #39, 3rd Floor, MSD Office, Dubai, UAE.
| | - Maysoon Loulou
- MSD IDEA Middle East, Dubai Healthcare City, Al Faris Building #39, 3rd Floor, MSD Office, Dubai, UAE
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18
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Hassanein M, Hussein Z, Shaltout I, Wan Seman WJ, Tong CV, Mohd Noor N, Buyukbese MA, El Tony L, Shaker GM, Alamoudi RM, Hafidh K, Fariduddin M, Batais MA, Shaikh S, Malek PR, Alabbood M, Sahay R, Alshenqete AM, Yakoob Ahmedani M. The DAR 2020 Global survey: Ramadan fasting during COVID 19 pandemic and the impact of older age on fasting among adults with Type 2 diabetes. Diabetes Res Clin Pract 2021; 173:108674. [PMID: 33493579 PMCID: PMC7826018 DOI: 10.1016/j.diabres.2021.108674] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/14/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The DAR Global survey of Ramadan-fasting during the COVID-19 pandemic aimed to describe the characteristics and care in participants with type 2 diabetes (T2D) with a specific comparison between those <65 years and ≥65 years. METHODS Participants were consented to answer a physician-administered questionnaire following Ramadan 2020. Impact of COVID-19 on the decision of fasting, intentions to fast and duration of Ramadan and Shawal fasting, hypoglycaemia and hyperglycaemia events were assessed. Specific analysis comparing age categories of <65 years and ≥65 years were performed. RESULTS Among the 5865 participants, 22.5% were ≥65 years old. Concern for COVID-19 affected fasting decision for 7.6% (≥65 years) vs 5.4% (<65 years). More participants ≥65 years old did not fast (28.8% vs 12.7%, <65 years). Of the 83.6%, participants fulfilling Ramadan-fasting, 94.8% fasted ≥15 days and 12.6% had to break fast due to diabetes-related illness. The average number of days fasting within and post-Ramadan were 27 and 6 days respectively, regardless of age. Hypoglycaemia and hyperglycaemia occurred in 15.7% and 16.3% of participants respectively, with 6.5% and 7.4% requiring hospital care respectively. SMBG was performed in 73.8% of participants and 43.5% received Ramadan-focused education. CONCLUSION During the COVID-19 pandemic, universally high rates of Ramadan-fasting were observed regardless of fasting risk level. Glycemic complications occurred frequently with older adults requiring higher rates of acute hospital care. Risk stratification is essential followed by pre-Ramadan interventions, Ramadan-focused diabetes education and self-monitoring to reduce and prevent complications, with particular emphasis in older adults.
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Affiliation(s)
- Mohamed Hassanein
- Dubai Hospital, DHA, United Arab Emirates; Gulf Medical University, United Arab Emirates; Postgraduate Diabetes Education, Cardiff University, UK
| | - Zanariah Hussein
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia.
| | - Inass Shaltout
- Department of Internal Medicine, Hospital Melaka, Melaka, Malaysia
| | | | | | - Nurain Mohd Noor
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia
| | | | | | - Gamal Mohamed Shaker
- Strategic Data Analysis, Research and Studies Department Dubai Health Authority, United Arab Emirates.
| | - Reem M Alamoudi
- Department of Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Research Center, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
| | - Khadija Hafidh
- Rashid Hospital, Diabetes Unit, Dubai Health Authority, United Arab Emirates.
| | - M Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Mohammed A Batais
- Diabetes & Chronic Disease Management, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College & Osmania General Hospital, Hyderabad, India
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Beshyah SA, Ali KF, Hafidh K, Hajjaji IM. Ramadan fasting and diabetes 2019: The year in review. Diabetes Res Clin Pract 2021; 172:108593. [PMID: 33316310 DOI: 10.1016/j.diabres.2020.108593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 09/16/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The literature on health aspects of Ramadan fasting is widely spread in many journals making it not readily available to those interested in the subject. MATERIALS AND METHODS A narrative, non-systematic review of the international literature from two major online databases (viz. Scopus, PubMed) in one year (2019). The search term "Ramadan fasting AND Diabetes" was used, and relevant literature was narrated in a concise thematic account. RESULTS Research design included qualitative, quantitative, and mixed methods. Articles included controlled trials, critical appraisals, literature narrations, and systematic reviews, and meta-analyses. The publications spanned a vast array of topics related to Ramadan fasting, including assessments of current safety and efficacy profiles of newer diabetes therapies, modes of insulin delivery, and utilization of advanced technology for the treatment and monitoring of blood glucose during Ramadan fasting. Increased interest was particularly evident in capturing the experience element manifested by perceptions, attitudes, and practices of both patients and healthcare professionals during Ramadan. The current literature consolidates previous data on the safety of fasting practices amongst the well-controlled. On the other hand, it emphasizes the need for more aggressive interventions for high-risk patients, promoting the usage of newer anti-diabetic agents and advanced glucose monitoring technology for safer fasting practices. CONCLUSIONS The volume of global literature production related to Ramadan fasting and Diabetes remains modest. Observational studies of small size prevail. Greater improvements in both quality and quantity of research on Ramadan are needed.
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Affiliation(s)
- Salem A Beshyah
- Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates; The Endocrinology Clinic, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates.
| | - Khawla F Ali
- Department of Medicine, Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya, Bahrain
| | - Khadija Hafidh
- Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates; Department of Diabetes and Endocrinology, Rashid Hospital, DHA, Dubai, United Arab Emirates
| | - Issam M Hajjaji
- National Centre for Diabetes, Tripoli, Libya; Department of Medicine, Faculty of Medicine, University of Tripoli, Tripoli, Libya
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Hassanein M, Alamoudi RM, Kallash MA, Aljohani NJ, Alfadhli EM, Tony LE, Khogeer GS, Alfadhly AF, Khater AE, Ahmedani MY, Buyukbese MA, Shaltout I, Belkhadir J, Hafidh K, Chowdhury TA, Hussein Z, Elbarbary NS. Ramadan fasting in people with type 1 diabetes during COVID-19 pandemic: The DaR Global survey. Diabetes Res Clin Pract 2021; 172:108626. [PMID: 33321160 PMCID: PMC7836519 DOI: 10.1016/j.diabres.2020.108626] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The DaR Global survey was conducted to determine the impact of the COVID-19 pandemic on the intentions to fast and the outcomes of fasting in <18 years versus ≥18 years age groups with type 1 diabetes mellitus (T1DM). METHODS Muslim people with T1DM were surveyed in 13 countries between June and August 2020, shortly after the end of Ramadan (23rd April-23rd May 2020) using a simple questionnaire. RESULTS 71.1% of muslims with T1DM fasted during Ramadan. Concerns about COVID-19 were higher in individuals ≥18 years (p = 0.002). The number of participants who decided not to fast plus those who received Ramadan-focused education were significantly higher in the ≥18-year group (p < 0.05). Hypoglycemia (60.7%) as well as hyperglycemia (44.8%) was major complications of fasting during Ramadan in both groups irrespective of age. CONCLUSION COVID-19 pandemic had minor impact on the decision to fast Ramadan in T1DM cohort. This was higher in the age group of ≥18 years compared to those <18 years group. Only regional differences were noted for fasting attitude and behavior among T1DM groups. This survey highlights the need for Ramadan focused diabetes education to improve glucose control and prevent complications during fasting.
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Affiliation(s)
- Mohamed Hassanein
- Department of Endocrinology and Diabetes, Dubai Hospital, Dubai, United Arab Emirates.
| | - Reem M Alamoudi
- Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Naji J Aljohani
- Department of Obesity, Endocrine and Metabolic Center, King Abdulaziz bin Saud University for Health Sciences, Saudi Arabia
| | - Eman M Alfadhli
- Department of Medicine, Medical College, Taibah University Madinah, Saudi Arabia
| | - Lobna El Tony
- Department of Diabetes and Endocrine Centre, Assiut University, Egypt
| | - Ghofran S Khogeer
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Abdulaziz F Alfadhly
- Department of Family Medicine, Prince Mansour Military Hospital, Taif City, Saudi Arabia
| | - Ahmed ElMamoon Khater
- Studies & Research & Data analysis Department, Dubai Health Authority, Dubai, United Arab Emirates
| | - Muhammad Yakoob Ahmedani
- Department of Medicine, Baqai Institute of Diabetology & Endocrinology, Baqai Medical University, Karachi, Pakistan
| | | | - Inass Shaltout
- Department of Internal Medicine and Diabetes, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Jamal Belkhadir
- Moroccan League for the Fight Against Diabetes, IDF Middle East and North Africa, Morocco
| | - Khadija Hafidh
- Diabetes Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Tahseen A Chowdhury
- Department of Diabetes and Metabolism, The Royal London Hospital, Whitechapel, London, United Kingdom
| | - Zanariah Hussein
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia
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Hafidh K, Abbas S, Khan A, Kazmi T, Nazir Z, Aldaham T. The Clinical Characteristics and Outcomes of COVID-19 Infections in Patients with Diabetes at a Tertiary Care Center in the UAE. Dubai Diabetes Endocrinol J 2021. [DOI: 10.1159/000512232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Uncontrolled glycemia is a well-recognized predictor of severity and deaths in previous respiratory viral outbreaks. We aimed to describe the characteristics and clinical course of patients with diabetes admitted with COVID-19 infection at a tertiary care center in the Emirate of Dubai, UAE, and assess the impact of hyperglycemia on the clinical outcomes. <b><i>Methods:</i></b> This study is a single-center, observational, retrospective chart review of 250 cases during the months of March to May 2020. <b><i>Results:</i></b> Among the 250 cases studied, 235 (94%) were male. The mean age of the study group was 49.6 ± 10.4 years, with an age range of 21–78 years. Diabetes was previously known in 166 (66.4%) of the patients. The mortality (<i>p</i> = 0.03) and requirement for mechanical ventilation (<i>p</i> = 0.02) were higher for the cases with newly diagnosed diabetes when compared to those with pre-existing diabetes. <b><i>Conclusion:</i></b> Uncontrolled hyperglycemia adversely affects patients with COVID-19 infection. Newly diagnosed and previously undiagnosed hyperglycemia poses an added risk for complications. In the context of the COVID-19 pandemic, optimizing glycemia in hospitalized patients is of paramount importance and screening to detect undiagnosed cases of diabetes may be particularly relevant.
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Bel′eed-Akkari K, Hafidh K, Hajjaji I, Beshyah S, Elkhammas E. Solid organ transplantation medicine in Arab countries: A Narrative Review Focused on Ethical Aspects. Ibnosina J Med Biomed Sci 2021. [DOI: 10.4103/ijmbs.ijmbs_16_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hafidh K, Ali K, Beshyah S. Ramadan fasting in health and disease (2020): A narrative review. Ibnosina J Med Biomed Sci 2021. [DOI: 10.4103/ijmbs.ijmbs_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hafidh K, Beshyah S. Highlights of the Ninth Diabetes and Ramadan International Alliance conference (mena-zone virtual), January 21–22, 2021. Ibnosina J Med Biomed Sci 2021. [DOI: 10.4103/ijmbs.ijmbs_33_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beshyah S, Ali K, Hafidh K. Attitudes of physicians and scientists to peer reviewing for biomedical journals: A survey from the Middle East and Africa. Ibnosina J Med Biomed Sci 2021. [DOI: 10.4103/ijmbs.ijmbs_141_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beshyah S, Ali K, Mustafa H, Hajjaji I, Hafidh K, Abdelmannan D. Doctors' attitude and engagement in research: A survey from two emerging regions. Ibnosina Journal of Medicine and Biomedical Sciences 2020. [DOI: 10.4103/ijmbs.ijmbs_137_20] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: Research is an essential component in the advancement of medicine. Evidence indicates that developing regions have low research productivity and contribution to the international literature. It is unclear if physicians' attitudes and perceptions of research could be contributory. Objectives: This study examined the attitudes to research, perceived barriers to research, and experiences of prior participation in research projects among physicians from the Middle East and Africa. Subjects and Methods: A cross-sectional electronic survey was developed based on the published literature to address these questions and was E-mailed to a large sample of practising clinicians and academics. Results: A total of 283 responses received, 61.1% were men with a mean age of 48 years. Responses originated from 23 countries. The majority were from the Middle East (79.2%), whereas 29.9% were from African countries. Over half of physicians (51.1%) held high-level speciality qualifications and were senior clinicians or academics (50.9%). Regarding engagement in research, 41.3% were interested in research but not involved at the time of the survey, 38.5% were involved but not formally employed in a research role, 12.7% had formal research roles, and 7.4% were not interested in research. Majority conducting research held lead-investigator roles (44.2%) followed by co-investigator roles in 37.9% of respondents. Most of the research work was self-initiated original research (42.6%) followed by clinical case series (35.7%). Main motivators to conduct research were contributing to the practice and improving patients' care. Main deterrents to research were lack (41.7% of respondents) and/or difficulty in acquiring research funding (50.2%), in addition to the lack of research-protected time (40.5%). Conclusions: The majority of physicians interested and/or involved in research are not formally employed in a research role. The facilitators seem to stem from personal interest and professional recognition, whereas barriers result from lack of time, support, and expertise.
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Affiliation(s)
- Salem Beshyah
- Department of Medicine, Dubai Medical College, Dubai
- The Endocrinology Clinic, Mediclinic Airport Road Hospital, Abu Dhabi
| | - Khawla Ali
- Department of Medicine, Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya
| | - Huda Mustafa
- Healthplus Centre for Diabetes and Endocrinology, Abu Dhabi
| | - Issam Hajjaji
- National Centre for Diabetes
- Department of Medicine, Faculty of Medicine, University of Tripoli, Tripoli
| | - Khadija Hafidh
- Department of Medicine, Dubai Medical College, Dubai
- Department of Diabetes and Endocrinology, Rashid Hospital, DHA, Dubai, United Arab Emirates
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Ali K, Abdulla S, Badi A, Hafidh K, Beshyah S. Ramadan fasting in health and disease (2019): A narrative review. Ibnosina Journal of Medicine and Biomedical Sciences 2020. [DOI: 10.4103/ijmbs.ijmbs_139_20] [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: 11/04/2022]
Abstract
Introduction: Literature on the health aspects of Ramadan fasting (RF) is widespread in many journals, making it less readily available to those interested in the subject. Materials and Methods: This is a narrative, nonsystematic review of international literature from two major online databases (viz., Scopus and PubMed) in 1 year (2019). The search term “RF” was used, and relevant literature was narrated in a concise thematic account excluding diabetes. Results: The publications spanned the fundamental, clinical, ethical, professional, cultural, and advocacy facets of the subject. The publications crossed the conventional disciplinary lines and geographical locations and appeared in journals with different access systems. The content is presented under relevant themes depending on the available literature. Basic coverage included changes in physiology, nutrition, and metabolism during Ramadan. Clinical aspects such as the impact of RF on kidney function, pregnancy outcome, fetal life, structure and function of eyes, and athletes' well-being received comparatively prominent coverage by researchers in 2019. Gut, liver, skin, skeleton, and blood were also covered. Other workers focused on documenting the perception, attitudes, and practices of both patients and health-care professionals during Ramadan. Conclusions: The health aspects of RF received sustained academic interest with a wide spectrum in 2019. We provided a scoping overview to help researchers and clinicians catch up quickly with the state-of-the-art today.
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Affiliation(s)
- Khawla Ali
- Department of Medicine, Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya
| | - Sara Abdulla
- Department of Biochemistry, Faculty of Medicine, University of Benghazi, Benghazi
| | - Amal Badi
- Obstetrics and Gynecology Clinic, Medical International Specialist Center, Dubai
| | - Khadija Hafidh
- Department of Medicine, Dubai Medical College, Dubai
- Department of Diabetes and Endocrinology, Rashid Hospital, DHA, Dubai
| | - Salem Beshyah
- Department of Medicine, Dubai Medical College, Dubai
- The Endocrinology Department, Mediclinic Airport Road Hospital, Abu Dhabi
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Beshyah SA, Hafidh K, Shaikh TG. Evolving physicians' perceptions and practices regarding use of SGLT2 inhibitors for type 2 diabetes during Ramadan fasting. Diabetes Res Clin Pract 2020; 168:108389. [PMID: 32858101 DOI: 10.1016/j.diabres.2020.108389] [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: 07/20/2020] [Accepted: 08/19/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES We followed up the evolving perceptions and practices regarding use of SGLT-2 inhibitors in Ramadan. METHODS We compared results of the three survey in 2015, 2017, 2019. RESULTS Senior doctors represented 43.5-66.4% and endocrinologists accounted for 38.1-60.2%. There was a steady reduction in the proportions of respondents who did not know SGLT2-Is at all, who have just heard about the class and those who are quite familiar with the class but have not yet used any. Whereas the proportions of those using the SGLT2-Is class occasionally only was stable. However those who use the SGLT2-Is regularly increased from 11.0% to 45.6% and 62.6%. The respondents' who SGLT2-Is are safe and may be used in all fasting diabetic patients increased from 15.5%, 14.7% to 23.1%. Whereas the view that SGLT2-Is should not be used decreased progressively. Majority of respondents in the three surveys suggested that specific advice is given if they allow the use of SGLT2-Is during Ramadan. More respondents advise taking the medication with the first evening meal than before the last pre-dawn meal and advised to attend to their hydration status. One third of respondents would resume SGLT2-Is immediately after the end of Ramadan; 15% after 1-2 weeks, or prefer to wait till the next medical or educator's clinic visit and others would re-evaluate patients' management plan. CONCLUSIONS The medical professions' knowledge and perceptions regarding the use of SGLT2-Is during Ramadan fasting have evolved over the last few years due to increasing research and experience.
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Affiliation(s)
- Salem A Beshyah
- The Endocrinology Clinic, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates; Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates.
| | - Khadija Hafidh
- Department of Diabetes and Endocrinology, Rashid Hospital, DHA, Dubai, United Arab Emirates
| | - Tariq Gul Shaikh
- The Endocrinology Clinic, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
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Abdulrahman M, Tabatabaei Z, Maqbool S, Hafidh K, Husain ZS, Al Raeesi FH, Abo Sada NM, Akbar M, Hubaishi NM, Tahlak MAR, Carrick FR. A review of gestational diabetes mellitus management, risk factors, maternal and neonatal outcomes in two major maternity hospitals in the United Arab Emirates: A report from Dubai. J Neonatal Perinatal Med 2020; 13:555-562. [PMID: 32568122 DOI: 10.3233/npm-200410] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study was conducted in order to explore and analyze the status of gestational diabetes (GDM) amongst pregnant women in Dubai, United Arab Emirates (UAE); a country with high prevalence of diabetes. We aimed to describe GDM-associated risk factors and clinical outcomes of pregnant women and their neonates. Our objective was to contribute to the broader literature on reproductive health disparities and to inform efforts to improve GDM care at our region. METHODS Chart review of case records were used to collect data on both maternal and neonatal parameters and outcomes during the specified study period from two main maternity hospitals in Dubai. RESULTS UAE national women with GDM were more prone to be obese or overweight compared to non-UAE women (p < 0.0001, and p < 0.0001 respectively). In addition, UAE national women with GDM had higher history of GDM in previous pregnancies (p < 0.0001) and more family history of diabetes (p < 0.0001).The neonate admission into NICU was significantly associated with cesarean section (p < 0.0001), twins (p < 0.0001), preeclampsia (p = 0.02), receiving MgSO4 (p = 0.02), birth weight less than 2500 g (p < 0.0001), low Apgar scores (p < 0.0001), baby with congenital anomaly (p < 0.0001), and neonatal hypoglycemia (p < 0.0001). CONCLUSIONS Our results demonstrate that pregnant women with GDM who are UAE nationals and have higher parity need to be under special attention during their pregnancy in order to improve both maternal and neonatal outcomes.
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Affiliation(s)
- Mahera Abdulrahman
- Health Informatics & Smart Health Department, Dubai, United Arab Emirates
| | | | - Sadia Maqbool
- Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Khadija Hafidh
- Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Zahra Sm Husain
- Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | - Madiha Akbar
- Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | - Frederick Robert Carrick
- University of Central Florida College of Medicine, Orlando, FL USA.,Adjunct Professor MGH Institute for Health Professions, Boston, MA, USA.,Centre for Mental Health Research in Association with University of Cambridge, Cambridge UK
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Alawadi F, Abusnana S, Afandi B, Aldahmani K, Alhajeri O, Aljaberi K, Alkaabi J, Almadani A, Bashier A, Beshyah S, bin Belaila B, Fargaly M, Farooqi M, Hafidh K, Hassanein M, Hassoun A, Jabbar A, Ksseiry I, Mustafa H, Saadi H, Suliman S. Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus – 2020. Dubai Diabetes Endocrinol J 2020. [DOI: 10.1159/000506508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Rapid urbanisation and socioeconomic development in the United Arab Emirates (UAE) have led to the widespread adoption of a sedentary lifestyle and Westernised diet in the local population and consequently a high prevalence of obesity and diabetes. In 2019, International Diabetes Federation statistics reported a diabetes prevalence rate of 16.3% for the adult population in the UAE. In view of the wealth of recent literature on diabetes care and new pharmacotherapeutics, the Emirates Diabetes Society convened a panel of experts to update existing local guidelines with international management recommendations. The goal is to improve the standard of care for people with diabetes through increased awareness of these management practices among healthcare providers licensed by national health authorities. These consensus guidelines address the screening, diagnosis and management of type 2 diabetes mellitus in adults including individuals at risk of developing the disease.
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Abdelgadir E, Alsaeed M, Hafidh K, Bashier A, Rashid F, Altayb F, Sayyah F, Farooqi MH, Alawadi F. Lipid Control in Patients with Diabetes across Primary and Tertiary Government Health Sectors in Dubai: A Five-year Pattern. Oman Med J 2019; 34:290-296. [PMID: 31360316 PMCID: PMC6642714 DOI: 10.5001/omj.2019.58] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives A key aspect for the prevention of vascular complications in diabetes is control of hyperlipidemia, and that has always been a global challenge. The prevalence of diabetes mellitus in the UAE is estimated to be 18.98%. However, despite this high prevalence, very few studies have evaluated the control of lipids in patients with diabetes in our region. We sought to assess lipid control in patients with diabetes across the different sectors of the Dubai Health Authority (DHA) over five years (2012–2016). Additionally, we aimed to compare lipids control in both primary and tertiary care as well as between nationalities and diabetes types. Methods We conducted a retrospective analysis of the electronic medical records of all patients within the DHA over five years. All patients with diabetes were included, and evaluation of lipids panel control was done according to the American Diabetes Association standards. Results This review includes a total of 26 447 patients. The mean low-density lipoprotein (LDL) was lower in tertiary care patients across the years. Annual means of all lipid parameters were higher in primary care patients. Around 60.5% of patients achieved LDL levels < 100 mg/dL. Non-high-density lipoprotein cholesterol levels < 130 mg/dL were achieved in 67.9% of patients in tertiary care in 2012 compared to 60.9% in primary care. UAE nationals had better lipids control across the study duration compared to expatriates. Conclusions This is the largest cohort of patients evaluated for diabetes and lipids control in the UAE and the Middle East region. The percentage of patients with diabetes across the DHA primary and tertiary health care centers achieving lipid targets is amongst the highest reported in the region and, perhaps, globally. Significantly better lipid control indices were achieved in tertiary care compared to primary care.
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Affiliation(s)
- Elamin Abdelgadir
- Department of Endocrinology, Dubai Hospital, Dubai, UAE
- Address correspondence and reprints request to: Elamin Abdelgadir, Department of Endocrinology, Dubai Hospital, Dubai, UAE. E-mail:
| | | | - Khadija Hafidh
- Department of Endocrinology, Rashid Hospital, Dubai, UAE
| | | | - Fauzia Rashid
- Department of Endocrinology, Dubai Hospital, Dubai, UAE
| | - Fawzi Altayb
- Department of Endocrinology, Dubai Hospital, Dubai, UAE
| | - Fatima Sayyah
- Department of Endocrinology, Dubai Hospital, Dubai, UAE
| | | | - Fatheya Alawadi
- Department of Endocrinology, Dubai Diabetes Center, Dubai, UAE
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Hassanein MM, Sahay R, Hafidh K, Djaballah K, Li H, Azar S, Shehadeh N, Hanif W. Safety of lixisenatide versus sulfonylurea added to basal insulin treatment in people with type 2 diabetes mellitus who elect to fast during Ramadan (LixiRam): An international, randomized, open-label trial. Diabetes Res Clin Pract 2019; 150:331-341. [PMID: 30772385 DOI: 10.1016/j.diabres.2019.01.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 01/03/2019] [Accepted: 01/31/2019] [Indexed: 12/21/2022]
Abstract
AIMS Adding lixisenatide to basal insulin (BI) instead of sulfonylurea (SU), versus continuing SU + BI was assessed in people with type 2 diabetes mellitus (T2DM) who intended to fast during Ramadan 2017. METHODS LixiRam (NCT02941367) was a phase 4, randomized, open-label, 12-22-week study in people with T2DM insufficiently controlled with SU + BI ± 1 oral anti-diabetic. Endpoints included the percentage of participants with ≥1 documented symptomatic hypoglycemia event (plasma glucose ≤70 mg/dL; primary endpoint) and any hypoglycemia during Ramadan fasting. RESULTS A numerically lower percentage of participants with lixisenatide + BI (3.3%, 3/91) versus SU + BI (8.9%, 8/90) had ≥1 documented symptomatic hypoglycemia event (intent-to-treat visit 4) during Ramadan fasting (OR: 0.34; 95% CI 0.09, 1.35; proportion difference -0.06, 95% CI -0.13, 0.01); the difference was statistically significant for the 'any hypoglycemia' category (lixisenatide + BI: 4.3%, 4/92; SU + BI: 17.4%, 16/92; OR: 0.22; 95% CI 0.07, 0.68; proportion difference -0.13, 95% CI -0.22, -0.04; intent-to-treat). No new treatment-emergent adverse events occurred. CONCLUSIONS Compared with SU + BI, lixisenatide + BI provided lower rates of any hypoglycemia in people with T2DM during Ramadan fasting. Lixisenatide + BI therapy may be a suitable treatment option during fasting.
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Affiliation(s)
| | | | | | | | - Haoyu Li
- Sanofi-Aventis (China), Chaoyang District, Beijing, China.
| | - Sami Azar
- American University of Beirut Medical Center, Beirut, Lebanon.
| | | | - Wasim Hanif
- University Hospital Birmingham & Institute of Translational Medicine, Edgbaston, Birmingham, UK.
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Alawadi F, Abdelgadir E, Bashier A, Hassanein M, Rashid F, Alsaeed M, Hafidh K, Elsayed MA, Abuelkheir S, Farooqi MH. Glycemic Control in Patients with Diabetes across Primary and Tertiary Government Health Sectors in the Emirate of Dubai, United Arab Emirates: A Five-Year Pattern. Oman Med J 2019; 34:20-25. [PMID: 30671180 PMCID: PMC6330187 DOI: 10.5001/omj.2019.04] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Indexed: 11/28/2022] Open
Abstract
Objectives In the UAE, the comparative prevalence of diabetes is reported as 18.98%, but there are very few studies evaluating glycemic control. Attaining the optimum glycemic control has been a global challenge over the years. However, there is a trend of global improvement with the availability of newer options of antidiabetic medications, increasing numbers of physicians, and patient awareness. Our primary aim was to assess the level of glycemic control across Dubai Health Authority points of care over the past five years. Additionally, we aimed to compare the differences in glycemic control between primary and tertiary centers, between nationalities, and type I and II diabetes. Methods We conducted a retrospective analysis of the electronic medical records of all patients who attended primary and tertiary care centers within the Dubai Health Authority between 2012 and 2016. All patients with any type of diabetes were included in this assessment. Results A total of 26 447 patients were included in the study; of these, 73.8% (n = 19 508) were UAE nationals while the other nationalities accounted for 26.2% (n = 6939) of patients. The overall mean glycated hemoglobin (HbA1c) levels from 2012 to 2016 was 7.76%. Patients attending primary care clinics had a mean HbA1c of 7.64% compared to 7.68% for the tertiary care cohort. Out of the total population, 37.7% achieved HbA1c < 7%. Over 40% of the patients attending primary care centers achieved HbA1c < 7% compared to 34.9% of those who attended tertiary care centers. Conclusions Optimum glycemic target was achieved by less than 40% of patients. Glycemic control is still below the desired levels. However, there has been a trend of improvement in the last few years and we are achieving the international average targets. Further collaborative actions from clinical, educational, and strategic sectors are needed to improve our goals further.
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Affiliation(s)
| | | | | | | | | | | | - Khadija Hafidh
- Internal Medicine Department, Rashid Hospital, Dubai, UAE
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Beshyah S, Hafidh K, Abdelmannan D, Jabbar A, Wafa W, Khalil A. Paradoxical Vitamin D deficiency in a sunny country: A narrative review of the literature from the United Arab Emirates (1992–2018). Ibnosina J Med Biomed Sci 2019. [DOI: 10.4103/ijmbs.ijmbs_50_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kazmi T, Abbas S, Hafidh K. Unexplained fever and arthritis in a teenager with Type 1 diabetes. Ibnosina Journal of Medicine and Biomedical Sciences 2018. [DOI: 10.4103/ijmbs.ijmbs_30_18] [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: 01/09/2023]
Abstract
Brucellosis is a relatively prevalent zoonotic infection in the Mediterranean region and the Arabian Peninsula. Due to the multi-system involvement and nonspecific nature of the complaints, making a diagnosis can sometimes be particularly challenging. We present the case of a Libyan-American adolescent with type 1 diabetes mellitus (T1DM) residing in the United Arab Emirates who presented with fever, flu-like symptoms, and arthritis. When his initial septic workup did not reveal a focus of infection, and he continued to be febrile with the development of multiple painful and swollen joints, a diagnosis of autoimmune arthritis was entertained given his background history of autoimmune T1DM. However, on further probing, we ascertained a history of raw camel cheese ingestion. This redirected us to look for and subsequently confirm the diagnosis of brucellosis. Appropriate antibiotic treatment led to rapid recovery of the patient.
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Affiliation(s)
- Touseef Kazmi
- Department of Medicine, Rashid Hospital, Dubai, United Arab Emirates
| | - Saira Abbas
- Department of Medicine, Rashid Hospital, Dubai, United Arab Emirates
| | - Khadija Hafidh
- Department of Medicine, Rashid Hospital, Dubai, United Arab Emirates
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Abdelgadir EIE, Hassanein MM, Bashier AMK, Abdelaziz S, Baki S, Chadli A, Askaoui S, Nawal EA, Slim IS, Ghizlane EM, Hafidh K, Alawadi F. A prospective multi-country observational trial to compare the incidences of diabetic ketoacidosis in the month of Ramadan, the preceding month, and the following month (DKAR international). J Diabetes Metab Disord 2016; 15:50. [PMID: 27826544 PMCID: PMC5097841 DOI: 10.1186/s40200-016-0272-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 10/10/2016] [Indexed: 11/10/2022]
Abstract
Background 1.7 billion Muslims worldwide obey divine commands of fasting for a month. This may increase the probability of the acute complications of diabetes during the fasting period. Design and methods We primarily aimed to compare the incidences and duration of Diabetic ketoacidosis (DKA) admissions during Ramadan compared to the month before (Shaaban) and the month after (Shawal) as well as the average pre-Ramadan six months' admissions. Our secondary objective was to assess the different incidence of DKA between Ramadan and the other months regarding precipitating factors, fasting practices in people admitted with DKA and gender differences. This was a prospective study that included all Muslims who were admitted with DKA to major hospitals in the United Arab Emirates, Sudan, Tunisia and Morocco during the pre-Ramadan month, Ramadan and post-Ramadan month, in addition to the average monthly admissions during the last six months before Ramadan. Demographics, clinical, and laboratory indices were collected and analyzed to assess primary and secondary end points. Results One hundred seventy patients were admitted during the study duration, 56 were admitted during Ramadan and 63 in Shawal. Six months before Ramadan showed an average admission of 56 + 7 per month. All those admitted during Ramadan were people with type1 diabetes. 29.8 % of those admitted during Ramadan did not receive structured education program on diabetes management in Ramadan. Non-compliance to medications represented the commonest cause for admission in the whole study period. Hospital stay was comparable through different months, but the duration of acidosis was longest during Ramadan month. Conclusion In concordance with DKAR1, DKAR international showed higher rates of DKA during Ramadan when compared to preceding Lunar month (Shaaban). In Shawal, however, the rates of DKA admission were higher than the average monthly DKA admissions. The duration of acidosis was longer in Ramadan group and positively correlated with duration of diabetes. Many patients did not receive structured education about diabetes and fasting Ramadan. Our study calls for formal pre-Ramadan education and enforces the need for advice against fasting in patients who already experienced DKA in the months preceding Ramadan.
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Affiliation(s)
- Elamin I E Abdelgadir
- Dubai Hospital, Dubai Health Authority, Alkhaleej Road, P.O. Box 7272, Dubai, United Arab Emirates
| | - Mohamed M Hassanein
- Dubai Hospital, Dubai Health Authority, Alkhaleej Road, P.O. Box 7272, Dubai, United Arab Emirates
| | - Alaaeldin M K Bashier
- Dubai Hospital, Dubai Health Authority, Alkhaleej Road, P.O. Box 7272, Dubai, United Arab Emirates
| | | | - Salwa Baki
- CHU Ibn Rochd- Faculty of Medicine and Pharmacy- Hassan II University, Marrakesh, Morocco
| | - Asma Chadli
- Mohamed II University Hospital Casablanca, Casablanca, Morocco
| | - Sara Askaoui
- Farhat Hached University Hospital, Tunisia, Tunisia
| | | | - Ines S Slim
- Farhat Hached University Hospital, Tunisia, Tunisia
| | | | - Khadija Hafidh
- Dubai Hospital, Dubai Health Authority, Alkhaleej Road, P.O. Box 7272, Dubai, United Arab Emirates
| | - Fatheya Alawadi
- Dubai Hospital, Dubai Health Authority, Alkhaleej Road, P.O. Box 7272, Dubai, United Arab Emirates
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Hafidh K, Abbas S. Type 1 diabetes presenting after bariatric surgery: A medical paradox leading to a delayed diagnosis and diabetic ketoacidosis. Ibnosina Journal of Medicine and Biomedical Sciences 2014. [DOI: 10.4103/1947-489x.210383] [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: 11/04/2022]
Abstract
The relationship between type 2 diabetes and obesity is well established;however obesity at onset of type 1 diabetes is fairly uncommon. We present a19 year old man who was diagnosed with type 1 diabetes after considerable weight loss following bariatric surgery. This unexpected medical paradox may have led to the delayed recognition of the type of diabetes resulting in decompensation into diabetic ketoacoidosis.
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Affiliation(s)
- Khadija Hafidh
- Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Saira Abbas
- Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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