{"title":"Journal of Diabetes and Endocrine Practice 2022 and Beyond","authors":"E. Al-Ozairi, N. Aljohani, S. Beshyah","doi":"10.1055/s-0042-1748864","DOIUrl":"https://doi.org/10.1055/s-0042-1748864","url":null,"abstract":"","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114450415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Alsaffar, W. Abdullah, Khadija A. Hasan, L. A. Yazidi
Introduction The novel coronavirus disease 2019 (COVID-19) pandemic had an impact on different health services due to the lockdowns, curfews, or reducing provision of some clinical services to infection control. Aims This study looked at the impact of the pandemic on the pediatric diabetes services in Arab countries during the first 6 months of pandemic. Methods and Material An online survey using SurveyMonkey was e-mailed to the pediatric endocrine consultants practicing in Arab countries. The survey was active for the last 2 weeks of August 2020. Results Responses received from 34 consultants. Most responses were from Saudi Arabia, Iraq, and Oman. 18% of consultants have more than 500 pediatric patients with type-1 diabetes mellitus (T1DM) under each of their care. A quarter of responding consultants had suspended their clinics completely during the pandemic period. The median number of children live with diabetes used to be seen in diabetes clinics has dropped significantly from 22 to only 4 patients per week during the pandemic. Half of respondents fed back those virtual clinics were useful. The number of elective and urgent admissions during the studied period were less than before the pandemic. A total of 17.6% of responders reported an increased incidence of Diabetic Ketoacidosis (DKA) during the pandemic. Also, 36.4% thought the research activity had markedly decreased during the COVID-19 pandemic. Conclusion The pandemic has led to reducing the number of patients attending the diabetes clinic in Arab countries. However, virtual clinics and tele-consultations emerged evidently during the pandemic. It is expected to continue using the virtual clinics when the pandemic is over.
{"title":"Pediatric Diabetes Services in Arab Countries during the First 6 Months of the COVID-19 Pandemic","authors":"H. Alsaffar, W. Abdullah, Khadija A. Hasan, L. A. Yazidi","doi":"10.1055/s-0042-1748670","DOIUrl":"https://doi.org/10.1055/s-0042-1748670","url":null,"abstract":"\u0000 Introduction The novel coronavirus disease 2019 (COVID-19) pandemic had an impact on different health services due to the lockdowns, curfews, or reducing provision of some clinical services to infection control.\u0000 Aims This study looked at the impact of the pandemic on the pediatric diabetes services in Arab countries during the first 6 months of pandemic.\u0000 Methods and Material An online survey using SurveyMonkey was e-mailed to the pediatric endocrine consultants practicing in Arab countries. The survey was active for the last 2 weeks of August 2020.\u0000 Results Responses received from 34 consultants. Most responses were from Saudi Arabia, Iraq, and Oman. 18% of consultants have more than 500 pediatric patients with type-1 diabetes mellitus (T1DM) under each of their care. A quarter of responding consultants had suspended their clinics completely during the pandemic period. The median number of children live with diabetes used to be seen in diabetes clinics has dropped significantly from 22 to only 4 patients per week during the pandemic. Half of respondents fed back those virtual clinics were useful. The number of elective and urgent admissions during the studied period were less than before the pandemic. A total of 17.6% of responders reported an increased incidence of Diabetic Ketoacidosis (DKA) during the pandemic. Also, 36.4% thought the research activity had markedly decreased during the COVID-19 pandemic.\u0000 Conclusion The pandemic has led to reducing the number of patients attending the diabetes clinic in Arab countries. However, virtual clinics and tele-consultations emerged evidently during the pandemic. It is expected to continue using the virtual clinics when the pandemic is over.","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132157613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background In Syria, a country at war for one decade, medical care has been severely affected by shortages in medications, resources, food, and physicians. Objectives This study reviews the quality of care for patients with type-1 diabetes (T1D) receiving treatment in a private endocrinology service in Raqqa City, Syria. Patients and Method A cross-sectional medical record review for patients with T1D followed-up at a private clinic run by a certified endocrinologist in Raqqa, Syria. All medical records were evaluated for patients' characteristics and multiple diabetes care indicators. Results One hundred and ninety-seven patients with T1D were evaluated; 109 (55.3%) patients were females. The median age of participants was 16 (1.7–42) years, median duration of diabetes was 4 (0–27) years, and mean hemoglobin was A1C, 9.1% (8.7–9.5%). One hundred and twenty-five (63.5%) patients used premixed insulin. Eighty-one (42.4%) patients performed regular self-monitoring of blood glucose (SMBG) at least twice daily. Episodes of hypoglycemia and diabetic ketoacidosis (DKA) were reported in 62.4 and 54.4% of patients, respectively. There were significant correlations between the incidence of DKA and female gender and premixed insulin regimens. Conclusion In this private endocrine practice in Raqqa City, Syria, the majority of patients are treated with premixed insulin. Only a minority have their glycosylated A1c monitored regularly. Our unprivileged population is poorly controlled with increased risk of hypoglycemia and admissions with diabetic ketoacidosis.
{"title":"Challenges in Type-1 Diabetes Management during the Conflict in Syria","authors":"I. Alali, B. Afandi","doi":"10.1055/s-0042-1748667","DOIUrl":"https://doi.org/10.1055/s-0042-1748667","url":null,"abstract":"\u0000 Background In Syria, a country at war for one decade, medical care has been severely affected by shortages in medications, resources, food, and physicians.\u0000 Objectives This study reviews the quality of care for patients with type-1 diabetes (T1D) receiving treatment in a private endocrinology service in Raqqa City, Syria.\u0000 Patients and Method A cross-sectional medical record review for patients with T1D followed-up at a private clinic run by a certified endocrinologist in Raqqa, Syria. All medical records were evaluated for patients' characteristics and multiple diabetes care indicators.\u0000 Results One hundred and ninety-seven patients with T1D were evaluated; 109 (55.3%) patients were females. The median age of participants was 16 (1.7–42) years, median duration of diabetes was 4 (0–27) years, and mean hemoglobin was A1C, 9.1% (8.7–9.5%). One hundred and twenty-five (63.5%) patients used premixed insulin. Eighty-one (42.4%) patients performed regular self-monitoring of blood glucose (SMBG) at least twice daily. Episodes of hypoglycemia and diabetic ketoacidosis (DKA) were reported in 62.4 and 54.4% of patients, respectively. There were significant correlations between the incidence of DKA and female gender and premixed insulin regimens.\u0000 Conclusion In this private endocrine practice in Raqqa City, Syria, the majority of patients are treated with premixed insulin. Only a minority have their glycosylated A1c monitored regularly. Our unprivileged population is poorly controlled with increased risk of hypoglycemia and admissions with diabetic ketoacidosis.","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124567353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mussa H. Almalki, M. M. Ahmad, Ali Alqahtani, Wael M. Almistehi, A. Ekhzaimy, M. Asha, Khaled M. Aldahmani
Abstract Acromegaly is a rare, chronic disease that is, in more than 95% of cases, caused by a growth hormone (GH)-secreting pituitary adenoma. Overproduction of insulin-like growth factor-1 (IGF-1) due to GH hypersecretion leads to various clinical features characterized by somatic overgrowth, physical changes, multiple comorbidities, and increased mortality. The average age at diagnosis is 40 to 50 years, with no sex predilection. The mean delay in diagnosis is 4.5 to 5 years due to the insidious onset and slow clinical progression of the disease. The diagnosis is confirmed by increased levels of IGF-1 and insuppressible GH measured by an oral glucose tolerance test. Treatment is aimed at normalizing GH/IGF-1 levels and controlling tumor volume. Medical treatment and radiotherapy can be utilized when surgery fails to control GH/IGF-1 hypersecretion. This article aims to review recent updates in acromegaly diagnosis and treatment to raise awareness about acromegaly clinical presentation and management.
{"title":"Contemporary Management of Acromegaly: A Practical Approach","authors":"Mussa H. Almalki, M. M. Ahmad, Ali Alqahtani, Wael M. Almistehi, A. Ekhzaimy, M. Asha, Khaled M. Aldahmani","doi":"10.1055/s-0042-1760392","DOIUrl":"https://doi.org/10.1055/s-0042-1760392","url":null,"abstract":"Abstract Acromegaly is a rare, chronic disease that is, in more than 95% of cases, caused by a growth hormone (GH)-secreting pituitary adenoma. Overproduction of insulin-like growth factor-1 (IGF-1) due to GH hypersecretion leads to various clinical features characterized by somatic overgrowth, physical changes, multiple comorbidities, and increased mortality. The average age at diagnosis is 40 to 50 years, with no sex predilection. The mean delay in diagnosis is 4.5 to 5 years due to the insidious onset and slow clinical progression of the disease. The diagnosis is confirmed by increased levels of IGF-1 and insuppressible GH measured by an oral glucose tolerance test. Treatment is aimed at normalizing GH/IGF-1 levels and controlling tumor volume. Medical treatment and radiotherapy can be utilized when surgery fails to control GH/IGF-1 hypersecretion. This article aims to review recent updates in acromegaly diagnosis and treatment to raise awareness about acromegaly clinical presentation and management.","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116305367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Ahmadieh, Khaled Aboudib, Iman Al Khalaf, Weam Dassouki, Loulwa Charbaji
Abstract Background Polycystic ovarian syndrome (PCOS) is a common disorder in females with many different presentations and potentially life-threatening complications. However, the awareness of females about this disorder tends to be lacking. This study aims to assess the knowledge about PCOS among Lebanese women in the reproductive age group. Methods This cross-sectional study was performed on 421 women aged between 18 and 51 years from all governorates in Lebanon. Participants signed informed consent prior to their participation, and they were selected through convenient sampling. A well-conducted questionnaire was utilized after the Institutional Review Board's Committee approved the study at Beirut Arab University prior to data collection. Data entry was completed with SPSS (IBM version 23.1) and analyzed using mean, standard deviation, percentages, chi-squared test, and p -values. Results Among 421 participants, 75% were aware of PCOS. Around 50% knew about PCOS's various signs and symptoms, whereas only a minority knew about its complications. Furthermore, most participants were aware of the importance of lifestyle modifications in alleviating PCOS symptoms. Conclusion The results of this study show that Lebanese women were aware of common symptoms of PCOS. On the other hand, their knowledge was minimal regarding its more complex manifestations and complications.
背景多囊卵巢综合征(PCOS)是一种常见的女性疾病，有许多不同的表现和潜在的危及生命的并发症。然而，女性对这种疾病的认识往往是缺乏的。本研究旨在评估黎巴嫩育龄妇女对多囊卵巢综合征的了解情况。方法本横断面研究对来自黎巴嫩各省的421名年龄在18至51岁之间的妇女进行。参与者在参与前签署知情同意书，通过方便抽样的方式进行选择。机构审查委员会在数据收集之前核准了贝鲁特阿拉伯大学的研究后，使用了一份编制良好的调查表。数据录入采用SPSS (IBM version 23.1)软件完成，采用均数、标准差、百分比、卡方检验和p值进行分析。结果421名参试者中，75%的人知晓PCOS。大约50%的人知道多囊卵巢综合征的各种体征和症状，而只有少数人知道其并发症。此外，大多数参与者都意识到改变生活方式对减轻多囊卵巢综合征症状的重要性。结论本研究结果表明黎巴嫩妇女对多囊卵巢综合征的常见症状有所了解。另一方面，他们对其更复杂的表现和并发症知之甚少。
{"title":"Lebanese Women's Awareness of Polycystic Ovarian Syndrome and Its Complications: A Cross-Sectional Study","authors":"H. Ahmadieh, Khaled Aboudib, Iman Al Khalaf, Weam Dassouki, Loulwa Charbaji","doi":"10.1055/s-0042-1760340","DOIUrl":"https://doi.org/10.1055/s-0042-1760340","url":null,"abstract":"Abstract Background Polycystic ovarian syndrome (PCOS) is a common disorder in females with many different presentations and potentially life-threatening complications. However, the awareness of females about this disorder tends to be lacking. This study aims to assess the knowledge about PCOS among Lebanese women in the reproductive age group. Methods This cross-sectional study was performed on 421 women aged between 18 and 51 years from all governorates in Lebanon. Participants signed informed consent prior to their participation, and they were selected through convenient sampling. A well-conducted questionnaire was utilized after the Institutional Review Board's Committee approved the study at Beirut Arab University prior to data collection. Data entry was completed with SPSS (IBM version 23.1) and analyzed using mean, standard deviation, percentages, chi-squared test, and p -values. Results Among 421 participants, 75% were aware of PCOS. Around 50% knew about PCOS's various signs and symptoms, whereas only a minority knew about its complications. Furthermore, most participants were aware of the importance of lifestyle modifications in alleviating PCOS symptoms. Conclusion The results of this study show that Lebanese women were aware of common symptoms of PCOS. On the other hand, their knowledge was minimal regarding its more complex manifestations and complications.","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"568 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122930777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background There are a few studies from the Middle East and North Africa. Several notable cases of acromegaly and giantism in the west found their way to public life and media. Case History One of the cases is discussed in this article. The case lived between 1943 and 1991. He was one of few individuals in medical history to reach or surpass 8 feet in height. In the 1960s, he reportedly underwent repeated (perhaps 4) pituitary surgery at 17 in Rome, Italy, to halt his growth. A few photos and one short video clip in Italian demonstrate his physical features. He was one of the tallest basketball players ever at 245 cm, though when he featured as a basketball player, he was closer to 239 cm and played for Libya. He was a medical anomaly and the eighteenth tallest person in the history of the world. He was also credited with being the tallest actor in history by appearing in a single Italian fantasy drama movie in 1969. He died in 1991 due to heart disease. Conclusion The case presented in this vignette is depicted in the public domain and is imprinted in the folk memory of the residents of Tripoli, Libya. However, due to its uniqueness, it deserves a place in the regional medical literature.
{"title":"The Giant of Tripoli: The Case of Late Recognition and Management of an Extreme Acromegalic Gigantism in Resource-Poor Settings","authors":"S. Beshyah","doi":"10.1055/s-0042-1760393","DOIUrl":"https://doi.org/10.1055/s-0042-1760393","url":null,"abstract":"Abstract Background There are a few studies from the Middle East and North Africa. Several notable cases of acromegaly and giantism in the west found their way to public life and media. Case History One of the cases is discussed in this article. The case lived between 1943 and 1991. He was one of few individuals in medical history to reach or surpass 8 feet in height. In the 1960s, he reportedly underwent repeated (perhaps 4) pituitary surgery at 17 in Rome, Italy, to halt his growth. A few photos and one short video clip in Italian demonstrate his physical features. He was one of the tallest basketball players ever at 245 cm, though when he featured as a basketball player, he was closer to 239 cm and played for Libya. He was a medical anomaly and the eighteenth tallest person in the history of the world. He was also credited with being the tallest actor in history by appearing in a single Italian fantasy drama movie in 1969. He died in 1991 due to heart disease. Conclusion The case presented in this vignette is depicted in the public domain and is imprinted in the folk memory of the residents of Tripoli, Libya. However, due to its uniqueness, it deserves a place in the regional medical literature.","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"144 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129487094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The 58th European Association for the Study of Diabetes (EASD) Annual Meeting was held between 19 and 23 September 2022 in Stockholm, Sweden. It was also fully streamlined online. The authors attended the conference, giving a narrative commentary on what they felt were the highlights of the meeting. Several interesting lectures were presented. The ADA-EASD hyperglycemia management consensus was among the landmark presentations. The development of a particular model that could predict severe hypoglycemia risk in people with type 2 diabetes (T2D) was interesting. The remission of T2D data from the ReTUNE analysis backs the “personal fat threshold” concept was very promising. Interestingly, a link between autoimmunity degree and latent autoimmune diabetes in adults' cardiovascular disease (CVD) risk was proposed. A benefit of high-intensity exercise for people with impaired hypoglycemia awareness was demonstrated. The CLOuD, namely, early and sustained closed-loop therapy does not stave off β-cell decline, data were shared. Also, subjective energy levels were shown to predict CV events in T2D. Also, C-peptide may be better than C-reactive protein for predicting CV risk in T2D. Furthermore, a fatty liver index may predict mortality and CVD risk in people with T1D. New data suggest that topical esmolol hydrochloride might aid in the healing of diabetic foot ulcers. Finally, microalbuminuria in pregnancy forecasts adverse outcomes. We hope this short account helps those who did not attend the conference to get a glimpse of the program.
{"title":"58th EASD Annual Meeting from 19 to 23 September 2022, Stockholm, Sweden (Virtual)","authors":"W. Hussein, M. Hassanein","doi":"10.1055/s-0042-1759707","DOIUrl":"https://doi.org/10.1055/s-0042-1759707","url":null,"abstract":"Abstract The 58th European Association for the Study of Diabetes (EASD) Annual Meeting was held between 19 and 23 September 2022 in Stockholm, Sweden. It was also fully streamlined online. The authors attended the conference, giving a narrative commentary on what they felt were the highlights of the meeting. Several interesting lectures were presented. The ADA-EASD hyperglycemia management consensus was among the landmark presentations. The development of a particular model that could predict severe hypoglycemia risk in people with type 2 diabetes (T2D) was interesting. The remission of T2D data from the ReTUNE analysis backs the “personal fat threshold” concept was very promising. Interestingly, a link between autoimmunity degree and latent autoimmune diabetes in adults' cardiovascular disease (CVD) risk was proposed. A benefit of high-intensity exercise for people with impaired hypoglycemia awareness was demonstrated. The CLOuD, namely, early and sustained closed-loop therapy does not stave off β-cell decline, data were shared. Also, subjective energy levels were shown to predict CV events in T2D. Also, C-peptide may be better than C-reactive protein for predicting CV risk in T2D. Furthermore, a fatty liver index may predict mortality and CVD risk in people with T1D. New data suggest that topical esmolol hydrochloride might aid in the healing of diabetic foot ulcers. Finally, microalbuminuria in pregnancy forecasts adverse outcomes. We hope this short account helps those who did not attend the conference to get a glimpse of the program.","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128039538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of reproductive age that may present to endocrinologists, gynecologists, dermatologists, or even the psychiatric services. 1 The economic healthcare burden is considerable and estimated at $4.6 billion in the United States alone; however, the associated disorders of menstrual irregularity, infertility, hirsutism, obesity, and impaired quality of life have a major impact on those with PCOS, and havethe potential for the developmentofdiabetes, endometrial cancer, and cardiovascular disease. 1,2 PCOS is a diagnosis of exclusion of other conditions such as hyper-prolactinemia, congenital adrenal hyperplasia, and thyroid dysfunction before the application of the diagnostic criteria reported for the Rotterdam criteria, androgen excess society guidelines, or the National Institute of Health consensus. 3 There have been several articles that have given recommendations from international evidence-based guidelines for the assessment and management of PCOS. 4 A survey of man-agementofPCOSbyphysiciansfromtheMiddleEastandAfrica is published in the current issue of Journal of Diabetes and Endocrine Practice (JDEP). 5 The question is how does physicians within the Middle East and Africa re fl ect published guidelines? From the report, the overall response rate was unclear, but 190 responders in total were available for analy-sis. 5 Therewasabiasforendocrinologists torespond,thatmay have affected the overall practice, that was reported. In addi-tion, the availability of resources may have had a major effect onthepracticeineachofthecentersthatresponded.Overall,it
多囊卵巢综合征(PCOS)是育龄妇女最常见的内分泌疾病，可能会出现在内分泌学家、妇科医生、皮肤科医生甚至精神科医生那里。1 .经济医疗负担是相当大的，仅在美国就估计为46亿美元;然而，月经不规律、不孕症、多毛症、肥胖和生活质量下降等相关疾病对多囊卵巢综合征患者有重大影响，并有可能发展为糖尿病、子宫内膜癌和心血管疾病。1,2多囊卵巢综合征是在应用鹿特丹标准、雄激素过量社会指南或国家卫生研究所共识的诊断标准之前，排除其他疾病如高催乳素血症、先天性肾上腺增生和甲状腺功能障碍的诊断。已经有几篇文章给出了国际基于证据的PCOS评估和管理指南的建议。《糖尿病与内分泌实践杂志》(Journal of Diabetes and Endocrine Practice, JDEP)上发表了一项关于中东和非洲医生对糖尿病并发症管理的调查。问题是中东和非洲的医生如何反映已公布的指导方针?从报告来看，总体反应率尚不清楚，但总共有190名反应者可供分析。有报道称，这可能会影响到整个实践，因此没有妇产科医生对此作出回应。此外，资源的可用性可能对响应中心的实践产生重大影响。总的来说,它
{"title":"Diagnosis and Management of Polycystic Ovary Syndrome by Physicians from the Middle East and Africa","authors":"S. Atkin","doi":"10.1055/s-0042-1759644","DOIUrl":"https://doi.org/10.1055/s-0042-1759644","url":null,"abstract":"Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of reproductive age that may present to endocrinologists, gynecologists, dermatologists, or even the psychiatric services. 1 The economic healthcare burden is considerable and estimated at $4.6 billion in the United States alone; however, the associated disorders of menstrual irregularity, infertility, hirsutism, obesity, and impaired quality of life have a major impact on those with PCOS, and havethe potential for the developmentofdiabetes, endometrial cancer, and cardiovascular disease. 1,2 PCOS is a diagnosis of exclusion of other conditions such as hyper-prolactinemia, congenital adrenal hyperplasia, and thyroid dysfunction before the application of the diagnostic criteria reported for the Rotterdam criteria, androgen excess society guidelines, or the National Institute of Health consensus. 3 There have been several articles that have given recommendations from international evidence-based guidelines for the assessment and management of PCOS. 4 A survey of man-agementofPCOSbyphysiciansfromtheMiddleEastandAfrica is published in the current issue of Journal of Diabetes and Endocrine Practice (JDEP). 5 The question is how does physicians within the Middle East and Africa re fl ect published guidelines? From the report, the overall response rate was unclear, but 190 responders in total were available for analy-sis. 5 Therewasabiasforendocrinologists torespond,thatmay have affected the overall practice, that was reported. In addi-tion, the availability of resources may have had a major effect onthepracticeineachofthecentersthatresponded.Overall,it","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133217493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acromegaly, Polycystic Ovary, and Other Stories","authors":"S. Beshyah","doi":"10.1055/s-0042-1760394","DOIUrl":"https://doi.org/10.1055/s-0042-1760394","url":null,"abstract":"","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116364322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Beshyah, M. Bashir, A. Ekhzaimy, A. Mansour, H. Mustafa, N. Elbarbary, G. Ghazeeri, Hisham Mohamed Abdel Rahim, D. Abdelmannan
Abstract Background Studies from several regions examined the approach to diagnosing and managing polycystic ovary syndrome (PCOS). Limited data are available from the Middle East and Africa (MEA). Objective The aim of this study was to understand the practice pattern for diagnosing and managing PCOS by relevant specialists across the MEA region. Methods We used an online survey consisting of an established questionnaire. The questionnaire consisted of 25 questions grouped to capture information on (a) the characteristics of the respondents, (b) patients with PCOS seen by respondents, (c) the diagnostic criteria, (d) biochemical parameters for differential diagnosis of hyperandrogenism, (e) long-term concerns, and, finally (f) management choices. Results A total of 190 questionnaires were available for final analysis; 73.7% of the respondents were senior physicians; 59.5% and 17.4% were endocrinologists and gynecologists, respectively. Menstrual irregularity was the most frequent criterion used for the diagnosis of PCOS (90.5%), followed by hirsutism (75.7%), and biochemical hyperandrogenism (71.4%). Dehydroepiandrosterone was the most frequent biochemical parameter used for the differential diagnosis of hyperandrogenism (52.4%) followed by total testosterone (45.4%). Obesity and type 2 diabetes mellitus were the principal long-term concerns for PCOS (45.1%), followed by infertility (29.9%). Metformin was the most commonly prescribed treatment (43.8%), followed by lifestyle modification (27.0%), and oral contraceptives (18.9%). Infertility treatments include metformin alone, clomiphene citrate alone, or their combination prescribed by 23.1, 9.9, or 52.7%, respectively, whereas only 3.8% contemplated ovulation induction. Some differences and similarities were observed in previous studies, including gynecologists and endocrinologists. Conclusions This survey provides a baseline for the perspective in diagnosing and treating PCOS in the MEA region. Some deviation is observed from mainline recommended practices. More education on PCOS diagnostic criteria and treatment of PCOS is needed in line with the recently published evidence international guideline.
{"title":"Diagnosis and Management of Polycystic Ovary Syndrome: A Survey of Physicians from the Middle East and Africa","authors":"S. Beshyah, M. Bashir, A. Ekhzaimy, A. Mansour, H. Mustafa, N. Elbarbary, G. Ghazeeri, Hisham Mohamed Abdel Rahim, D. Abdelmannan","doi":"10.1055/s-0042-1759643","DOIUrl":"https://doi.org/10.1055/s-0042-1759643","url":null,"abstract":"Abstract Background Studies from several regions examined the approach to diagnosing and managing polycystic ovary syndrome (PCOS). Limited data are available from the Middle East and Africa (MEA). Objective The aim of this study was to understand the practice pattern for diagnosing and managing PCOS by relevant specialists across the MEA region. Methods We used an online survey consisting of an established questionnaire. The questionnaire consisted of 25 questions grouped to capture information on (a) the characteristics of the respondents, (b) patients with PCOS seen by respondents, (c) the diagnostic criteria, (d) biochemical parameters for differential diagnosis of hyperandrogenism, (e) long-term concerns, and, finally (f) management choices. Results A total of 190 questionnaires were available for final analysis; 73.7% of the respondents were senior physicians; 59.5% and 17.4% were endocrinologists and gynecologists, respectively. Menstrual irregularity was the most frequent criterion used for the diagnosis of PCOS (90.5%), followed by hirsutism (75.7%), and biochemical hyperandrogenism (71.4%). Dehydroepiandrosterone was the most frequent biochemical parameter used for the differential diagnosis of hyperandrogenism (52.4%) followed by total testosterone (45.4%). Obesity and type 2 diabetes mellitus were the principal long-term concerns for PCOS (45.1%), followed by infertility (29.9%). Metformin was the most commonly prescribed treatment (43.8%), followed by lifestyle modification (27.0%), and oral contraceptives (18.9%). Infertility treatments include metformin alone, clomiphene citrate alone, or their combination prescribed by 23.1, 9.9, or 52.7%, respectively, whereas only 3.8% contemplated ovulation induction. Some differences and similarities were observed in previous studies, including gynecologists and endocrinologists. Conclusions This survey provides a baseline for the perspective in diagnosing and treating PCOS in the MEA region. Some deviation is observed from mainline recommended practices. More education on PCOS diagnostic criteria and treatment of PCOS is needed in line with the recently published evidence international guideline.","PeriodicalId":294186,"journal":{"name":"Journal of Diabetes and Endocrine Practice","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129499973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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