Academic literature on the topic 'Non-insulin-dependent diabetes Saudi Arabia'

A total of 25 337 Saudis [11 713 males [46.2%] and 13 624 females [53.8%] were screened for diabetes mellitus and impaired glucose tolerance using WHO criteria for diagnosis. The prevalence of insulin-dependent diabetes mellitus, non-insulin-dependent diabetes mellitus and impaired glucose tolerance in the total Saudi male population was 0.23%, 5.63% and 0.50% respectively, and in the total Saudi female population was 0.30%, 4.53% and 0.72% respectively. Differences were observed in the prevalence of diabetes mellitus and impaired glucose tolerance between the provinces. Non-insulin-dependent diabetes mellitus increased to 28.82% and 24.92% in males and females respectively over the age of 60 years, while impaired glucose tolerance increased to 1.60% and 3.56%

Saudi Arabia is a country with high prevalence of diabetes, uncontrolled diabetes, and diabetes-related complications. Poor glycemic control is multifactorial and could be explained in part by physician and patient reluctance toward insulin or insulin inertia. This study aimed to address physician barriers toward insulin therapy in primary care settings. It included 288 physicians from 168 primary healthcare centers (PHC) in the Jazan region of Saudi Arabia. Participants responded to questionnaire investigating physicians’ attitude and barriers to insulin initiation and intensification in PHCs. In physician opinion, the most common barriers among their patients were fear of injection, lack of patient education, fear of hypoglycemia, and difficult administration. Physicians were reluctant to initiate insulin for T2D patients mostly due to patient non-adherence to blood sugar measurement, non-adherence to appointment or treatment, elderly patients, or due to patient refusal. Physicians’ fear of hypoglycemia, lack of staff for patient education, and lack of updated knowledge were the primary clinician-related barriers. Exaggerated fears of insulin side effects, patient non-adherence, limited staff for patient’s education, patient refusal, and inadequate consultation time were the main barriers to insulin acceptance and prescription.

Diabetes mellitus, a chronic illness, is characterized by pancreatic and insulin dysfunction. Under the influence of sunlight, vitamin D (V-D) is produced in the skin in a non-enzymatic manner. Furthermore, V-D can be obtained via fish or plant sources. Different studies conducted in Saudi Arabia have been shown high occurrence of V-D inadequacy. Obesity and type 2 diabetes are both linked to V-D insufficiency. Still, this relationship's causality is unknown. A growing body of research suggests that changes in V-D and calcium homeostasis may play a role in the development of type 2 diabetes. This study aimed to ascertain the occurrence of V-D deficiency in the Northern borders (NB) of Saudi Arabia and to verify the connection between V-D deficiency and other features of study subjects. During the period from July 2018 to February 2019, a cross-sectional study was carried out. A random sampling method was employed to choose the required numbers of subjects who have type 1 or type II diabetes and are registered in NB region health centers and hospitals. The sample size was calculated using the one-sample proportion formula and the results of similar studies. These results revealed the situation in the NB Region of Saudi Arabia among diabetic patients and highlight the importance of addressing the issue. The correlation between V-D and hypertension was also found in the study, requiring further investigation and explanation. Keywords: Diabetes mellitus; vitamin D deficiency; hypertension; Saudi Arabia

Diabetes mellitus (DM) consists of a clinically heterogenous array of metabolic conditions hallmarked by hyperglycemia caused by defective insulin secretion, action, or both. DM can cause various oral complications such as salivary gland dysfunction, infections including candidiasis, delayed wound healing, increased caries susceptibility, gingival and periodontal diseases, lichen planus and burning mouth disorders. Inadequate oral public health awareness of the connection between diabetes and oro-dental health issues has been noted in many studies from across the globe. Based on the current literature, it is evident that oral health is not prioritized by the majority of diabetic patients in Saudi Arabia. Saudi diabetic patients with lesser education demonstrate lower awareness levels about oral health issues in general. Similarly, more older patients have been seen to possess less oral health awareness relative to their younger counterparts. Further, they have been found to be less compliant towards meeting dental appointment targets and adopting recommended oral hygiene practices as compared to other populations studied in the Western nations. Also, non-professional advice has been noted as the dominant outlet of dental health information in case of most Saudi patients with diabetes. It is vital to reinforce the need for routinely visits to dentists for education on oral health when patients visit their diabetic clinic. Organization of structured patient education programs targeting all age groups and different types of diabetes is necessary to improve oral health awareness. It is also vital that individuals are provided with the latest recommendations on methods to practice oral health related self-care techniques in order to minimize the risk of periodontal destruction and tooth loss, thereby reducing the burden of dental illnesses on the Saudi health infrastructure.

Aims: The use of insulin pump therapy in patients with diabetes continues to expand worldwide. Although insulin pumps have been demonstrated to be successful and safe, physicians’ insufficient knowledge may carry a risk to the patients using insulin pumps. This study aimed to assess the attitude and knowledge among physicians in Saudi Arabia regarding insulin pump therapy. Methods: Three hundred and seven physicians, including 82 family physicians, 76 pediatricians, 48 internists, 27 pediatric endocrinologists, 17 adult endocrinologists, and 57 physicians from other specialties, completed a questionnaire that evaluated their knowledge and attitude toward insulin pump therapy. Results: Among the evaluated physicians, 56.7% had poor knowledge level, while 53.4% had positive attitude. Statistical tests revealed that older age, years of practice, consultancy, and endocrinology specialty were the influential factors of knowledge (p < 0.001). Non-endocrinologists demonstrated poor knowledge despite seeing patients with insulin pumps; however, those who had previously cared for such patients scored significantly higher knowledge scores. Conclusions: There was a significant lack of knowledge among physicians regarding insulin pump therapy; however, the perceived attitude of physicians toward this therapy was deemed positive. These findings support the implementation of insulin pump education programs.

Uncontrolled diabetes is associated with macrovascular and microvascular complications that compromise the quality of life; however, the patients’ perspectives about medication non-adherence are unclear. We aimed to understand patient behavior and explore the barriers to medication adherence in uncontrolled diabetes patients. We employed a qualitative method of face-to-face interviews conducted with adult patients in Saudi Arabia who had uncontrolled diabetes mellitus (glycosylated hemoglobin >7% or fasting blood glucose >7.2 mmol/L). All interviews were audio-recorded and analyzed using thematic analysis. The interviews were conducted for 68 patients. Sixty-seven patients were suffering from Diabetes Mellitus Type 2, and one patient was suffering from Diabetes Mellitus Type 1. We identified the barriers to medication adherence and classified them under six main factors: patients-, medications-, healthcare-, provider-, social-, and disease-related factors. The main barriers identified were the use of alternatives, hard-pressed for time, polypharmacy, bad relationship with the physician, cultured beliefs, self-alteration of the dose, exposed side effects, ineffective medications, refusal of insulin, multiple doctor visits, uncontrolled diet, and forgetfulness. Multiple barriers that prevented the patients from medication adherence were related to poor knowledge, counseling, psychological management, and social support. Appropriate educational programs, suitable patient-specific counseling, and close follow-ups would be required to improve the knowledge, outcomes, and quality of life in uncontrolled diabetes patients.

Uncontrolled diabetes is associated with macrovascular and microvascular complications that compromise the quality of life; however, the patients’ perspectives about medication non-adherence are unclear. We aimed to understand patient behavior and explore the barriers to medication adherence in uncontrolled diabetes patients. We employed a qualitative method of face-to-face interviews conducted with adult patients in Saudi Arabia who had uncontrolled diabetes mellitus (glycosylated hemoglobin >7% or fasting blood glucose >7.2 mmol/L). All interviews were audio-recorded and analyzed using thematic analysis. The interviews were conducted for 68 patients. Sixty-seven patients were suffering from Diabetes Mellitus Type 2, and one patient was suffering from Diabetes Mellitus Type 1. We identified the barriers to medication adherence and classified them under six main factors: patients-, medications-, healthcare-, provider-, social-, and disease-related factors. The main barriers identified were the use of alternatives, hard-pressed for time, polypharmacy, bad relationship with the physician, cultured beliefs, self-alteration of the dose, exposed side effects, ineffective medications, refusal of insulin, multiple doctor visits, uncontrolled diet, and forgetfulness. Multiple barriers that prevented the patients from medication adherence were related to poor knowledge, counseling, psychological management, and social support. Appropriate educational programs, suitable patient-specific counseling, and close follow-ups would be required to improve the knowledge, outcomes, and quality of life in uncontrolled diabetes patients.

Objective: To evaluate the causes of high admission rate of diabetic ketoacidosis (DKA) in adults with diabetes mellitus presenting to a tertiary care hospital in Saudi Arabia with specific emphasis on the clinical and biochemical phenotype and identify components of intervention and improve clinical outcomes in these patients. Study Design: Observational study. Place and Duration of the Study: Department of Diabetes & Endocrinology, Armed Forces Hospital Al-Hada, Taif, Kingdom of Saudi Arabia from 1st August 2015 to 31st January 2020. Methodology: One hundred and fifteen patients with diabetes mellitus presenting with diabetic ketoacidosis during the last 5 years were enrolled. Approximately 50 different variables pertaining to the patients at the time of presentation were thoroughly scrutinized. Results: There were 31 (28%) males and 81 (72 %) were females with type 1 DM 92%, type 2 DM 7% and 1% unclassified DM with a mean age of 20.90±7.4 years. 18% were diagnosed to have DM for the first time and others had a mean duration of DM of 8.0±3.6 years with an average daily insulin requirement being 64.0±20.2 units. Moreover 84% of patients were on basal bolus regimen and only 5% were on mixed insulin. 73% of the DKA episodes occurred in 15-25 years of age group. The commonest precipitating factors were non-compliance with insulin (44%) and respiratory tract infections (17%). Most common presenting symptoms were vomiting and abdominal pain present in 81% and 53% of patients. The mean blood sugar on presentation was 463±157.3 mg/dl whereas the mean HbA1c was 14±2.9. The mean pH and bicarbonate levels on presentation were 7.16±0.128 and 7±4.83 meq/L respectively. 80% of the patients were admitted to the general wards however 19% required ICU care. 69% of patients had a history of readmission with DKA and 29% were transferred from another periphery hospital. The mean duration of stay in the hospital was 2±3.8 days and the mortality was 0.9%. Conclusion: A very low mortality rate is witness to excellent acute management of these very sick patients. However a very high non-compliance rate of 44%, combined with a readmission rate of 69% and a mean HbA1c of 14% are very alarming as far as long term prognosis is concerned. Keywords: Diabetes mellitus, Ketoacidosis, Characteristics, DKA, Tertiary level care

Abstract Background Little is known about the model of care affecting quality of life(QoL)and treatment satisfaction among people with type 1 diabetes(PWT1D). Objectives To compare QoL, treatment satisfaction and cardiometabolic indices among PWT1D receiving different care models in Saudi Arabia. Methods QoL was measure using Audit of Diabetes Dependent Quality of Life(ADDQoL) and treatment satisfaction was measure using Diabetes Treatment Satisfaction Questionnaire status version(DTSQs). Out of 177 respondents to internet validated Arabic versions of ADDQoL and DTSQs,105 are receiving care at specialized diabetes clinics(SDC), whereas 72 are receiving traditional care at general endocrine clinics(GEC). In SDC,where care is delivered jointly by an interdisciplinary team,PWT1D are evaluated from their first visit simultaneously and thereafter as recommended by 6 care providers: diabetes specialist,educator,podiatrist,nutritionist,optometrist, and mental health specialist, while in GEC, PWT1D will be followed every 6-12months and referred to other services as needed where referrals require a long waiting period. ADDQoL and DTSQs scores,sociodemographic characteristics, and cardiometabolic indices were compared between the two groups. The association between patients’ characteristics and their ADDQoL and DTSQs scores were examined. Results Among the respondents,109(61.6%)females,132(74.6%)never married,136(76.8%) belongs to age group(18-30)years old, with a mean duration of diabetes(11.4±7.5years). Both groups are comparable across nearly all sociodemographic characteristics except for half of the SDC attendees reported higher income categories(≥10000 Saudi Riyals)(51.4%vs. 23.6%,p&lt;0. 001). Compared to participants in GEC, larger proportion of participants in SDC use insulin pump(29% vs. 0%, p&lt;0. 0001),continuous glucose monitoring(CGM)(73.3%vs. 13.9%, p&lt;0. 0001),have higher body mass index(26.3±6.4 kg/m2vs. 24.1±5.1 kg/m2,p=0. 016),and lower HbA1c(8.3±1.6%vs. 9.3±2.4%, p=0. 004). Receiving care in SDC is associated with higher DTSQs score(30.5±5.1vs. 26.2±7.9, p&lt;0. 0001),lower level of negative impact of diabetes on ADDQoL score(-2.2±1.9vs. -3.5±2.4, p&lt;0. 0001). Irrespective of clinic type, using insulin pump and CGM is associated with both higher DTSQs score(insulin pump(32±3.9)vs. MDI(28.5±7), p=0. 029), CGM(30.5±5.5)vs. glucometer(27.9±7.1), or not monitoring (22. 0±9.2), p&lt;0. 0001), and lower negative impact of diabetes on ADDQoL score(insulin pump(-1.3±1.1)vs. MDI(-2.9±2.3), p=0. 002),(CGM (-2.3±2.1)vs. glucometer(-3.1±2.4),or not monitoring(-3.5±2.2), p=0. 036). Another factor associated with a higher DTSQs score is: (being never married (29.3±6.5), or married(28.7±7)vs. divorced/widow(20.6±4.7), p=0. 018), whereas other factors associated with lower level of negative impact of diabetes on ADDQoL score are: (younger age(18-30years(-2.5±2.2),or 31-40years(-3.1±2. 0)vs. &gt;40years(-4.4±2.8), p=0. 013)),(being never married(-2.5±2.1)vs. married(-3.4±2.3),or divorced/window(-4.7±3.3), p=0. 010),(having bachelor degree or more (-2.4±1.9) vs. less than bachelor degrees (secondary school(-3.2±2.7),primary school(-3.9± 4.8),intermediate school(-5. 0±2.4), p=0. 005),and(being student(-2.2±1.9)vs. employed(-3.2±2.4), or unemployed(-3.2±2.5), p=0. 010). Conclusion QoL, treatment satisfaction and glycemic control among PWT1D can be enhanced by providing structured care and using devices(insulin pump and CGM). This necessitates a call for healthcare policymakers to utilize the existing health resources to optimize care for PWT1D. Presentation: No date and time listed