Pub Date : 2024-04-01DOI: 10.18502/dde.v30i1.15901
F. Alawadi
This is an Editorial and does not have an abstract. Please download the PDF or view the article in HTML.
本文为社论，无摘要。请下载 PDF 或查看 HTML 版文章。
{"title":"Editorial – Publisher Transition Dynamics: Embracing the Change for Dubai Diabetes and Endocrinology Journal","authors":"F. Alawadi","doi":"10.18502/dde.v30i1.15901","DOIUrl":"https://doi.org/10.18502/dde.v30i1.15901","url":null,"abstract":"This is an Editorial and does not have an abstract. Please download the PDF or view the article in HTML.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"697 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776953","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}
Childhood hypoglycaemia results from impairment or defects in glucose homeostasis and has a blood glucose (BG) operational threshold of 60 mg/dL (<3.3 mmol/L) as below this level, neurological symptoms occur, and if the BG falls below 50 mg/dL (2.8 mmol/L), it is highly likely to cause long-term neurological consequences. A 38-month-old previously healthy boy presented with hypoglycaemic seizures (BG: 30 mg/dL [1.7 mmol/L]) after a brief period of being unwell. The sepsis screen was normal. Hypoglycaemia screen detected a low cortisol level (28 nmol/L [83–555]). This was also associated with a low thyroid-stimulating-hormone (0.768 mIU/mL [0.5–5.5]) and a low-normal T4 (5.57 μg/dL [5–12]). Hydrocortisone and levothyroxine replacement was started. Four weeks from the time of discharge, the short synacthen test (SST; generic name: tetracosactide acetate) for adrenal function revealed a low stimulated cortisol (2/1.51/1.52 nmol/L at 0, 30, and 60 min, respectively, post synacthen [normal range: 83–550; peak >420 μg/dL]) and low basal adrenocorticotropic hormone (4.6 pg/mL [10–60]). A rare diagnosis of isolated secondary adrenocortical insufficiency was made, and the neuroimaging demonstrated a reduced pituitary height (3 mm). Three months later, levothyroxine was tapered and omitted as the child was euthyroid, but the SST showed a similar flat response to the synacthen. The genetic testing demonstrated a pathogenic heterozygous mutation in the nuclear factor kappa B subunit 2 (NFKB2) gene responsive for common variable immunodeficiency (CVID), and this entity has been described as deficient anterior pituitary hormone with CVID syndrome (DAVID syndrome). The immunoglobulin profile showed a decrease in three types of immunoglobulin (IgM, IgG, and IgE), meeting the diagnostic criteria for CVID. Till date, less than 35 cases are reported worldwide, and of which, less than 5 of them presented with adrenal insufficiency prior to immunodeficiency, making this case rare and teaching us a lesson to think beyond the usual causes of hypoglycaemia.
{"title":"Hypoglycaemia in a Child Unmasks a Unique Association","authors":"Diksha Shirodkar, Shaila Bhattacharyya","doi":"10.1159/000535883","DOIUrl":"https://doi.org/10.1159/000535883","url":null,"abstract":"Childhood hypoglycaemia results from impairment or defects in glucose homeostasis and has a blood glucose (BG) operational threshold of 60 mg/dL (<3.3 mmol/L) as below this level, neurological symptoms occur, and if the BG falls below 50 mg/dL (2.8 mmol/L), it is highly likely to cause long-term neurological consequences. A 38-month-old previously healthy boy presented with hypoglycaemic seizures (BG: 30 mg/dL [1.7 mmol/L]) after a brief period of being unwell. The sepsis screen was normal. Hypoglycaemia screen detected a low cortisol level (28 nmol/L [83–555]). This was also associated with a low thyroid-stimulating-hormone (0.768 mIU/mL [0.5–5.5]) and a low-normal T4 (5.57 μg/dL [5–12]). Hydrocortisone and levothyroxine replacement was started. Four weeks from the time of discharge, the short synacthen test (SST; generic name: tetracosactide acetate) for adrenal function revealed a low stimulated cortisol (2/1.51/1.52 nmol/L at 0, 30, and 60 min, respectively, post synacthen [normal range: 83–550; peak >420 μg/dL]) and low basal adrenocorticotropic hormone (4.6 pg/mL [10–60]). A rare diagnosis of isolated secondary adrenocortical insufficiency was made, and the neuroimaging demonstrated a reduced pituitary height (3 mm). Three months later, levothyroxine was tapered and omitted as the child was euthyroid, but the SST showed a similar flat response to the synacthen. The genetic testing demonstrated a pathogenic heterozygous mutation in the nuclear factor kappa B subunit 2 (NFKB2) gene responsive for common variable immunodeficiency (CVID), and this entity has been described as deficient anterior pituitary hormone with CVID syndrome (DAVID syndrome). The immunoglobulin profile showed a decrease in three types of immunoglobulin (IgM, IgG, and IgE), meeting the diagnostic criteria for CVID. Till date, less than 35 cases are reported worldwide, and of which, less than 5 of them presented with adrenal insufficiency prior to immunodeficiency, making this case rare and teaching us a lesson to think beyond the usual causes of hypoglycaemia.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"54 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533148","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}
Dhanya Soodhana Mohan, Vani Hn, R. K. Madegowda, Raghupathy Palany
Purpose: The psychosocial aspects of type 1 diabetes mellitus (T1DM) are still a neglected area, especially among children in India. This study was planned to evaluate and screen the children with T1DM for family support, symptoms of anxiety and depression, and to assess the role of these psychosocial aspects in glycemic control. Methods: This cross-sectional observational questionnaire-based study conducted over a year included 70 children aged 8–18 years diagnosed with T1DM for at least a year. The child and caregiver answered pre-validated standard questionnaires and the children underwent HbA1C testing once every 3 months. The methods used for inferential statistical analysis were reliability analysis, correlation analysis, χ2 test, and factor analysis. Results: Poorer glycemic control was noted by children raised by single parents (mean HbA1C 14.4, p < 0.001). It was also noted that children whose mothers had formal education beyond 10th standard had better glycemic control. 14 children (20%) had anxiety/depression of medium to high severity. The relationship between family conflict and glycemic control was not significant in either the parent or the child scoring. Conclusion: Children with T1DM experience considerable stress related to the diagnosis and management. Many families experience significant depression and anxiety which leads to increase in family conflicts which have a negative effect on parenting, the child’s quality of life, and their glycemic control.
{"title":"Psychosocial Factors and the Role of Family in Children with Type 1 Diabetes Mellitus","authors":"Dhanya Soodhana Mohan, Vani Hn, R. K. Madegowda, Raghupathy Palany","doi":"10.1159/000535051","DOIUrl":"https://doi.org/10.1159/000535051","url":null,"abstract":"Purpose: The psychosocial aspects of type 1 diabetes mellitus (T1DM) are still a neglected area, especially among children in India. This study was planned to evaluate and screen the children with T1DM for family support, symptoms of anxiety and depression, and to assess the role of these psychosocial aspects in glycemic control. Methods: This cross-sectional observational questionnaire-based study conducted over a year included 70 children aged 8–18 years diagnosed with T1DM for at least a year. The child and caregiver answered pre-validated standard questionnaires and the children underwent HbA1C testing once every 3 months. The methods used for inferential statistical analysis were reliability analysis, correlation analysis, χ2 test, and factor analysis. Results: Poorer glycemic control was noted by children raised by single parents (mean HbA1C 14.4, p < 0.001). It was also noted that children whose mothers had formal education beyond 10th standard had better glycemic control. 14 children (20%) had anxiety/depression of medium to high severity. The relationship between family conflict and glycemic control was not significant in either the parent or the child scoring. Conclusion: Children with T1DM experience considerable stress related to the diagnosis and management. Many families experience significant depression and anxiety which leads to increase in family conflicts which have a negative effect on parenting, the child’s quality of life, and their glycemic control.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"29 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139442690","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}
Shoroogh Marei, Dalia Ra’a Said, R. Almazrouei, Walid Kaplan, N. Al Hassani
Background: COVID-19 pandemic led to delayed diagnosis and increase in number and severity of type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA) cases in pediatric population worldwide. The indirect impact of the pandemic on pediatric DKA admissions to COVID-19-free hospitals worth to be evaluated. Objectives: Our aim was to evaluate the characteristics and severity of DKA admissions before and during the pandemic to COVID-19-free hospital. Methods: This descriptive retrospective study included 130 episodes of DKA for patients aged below 16 years admitted to Tawam Hospital, a COVID-19-free hospital, between March 2017 and Feb 2021. Data from March 2020 to Feb 2021 (pandemic) were compared to the previous 3 years, March 2017 to Feb 2020 (pre-pandemic). Data were retrieved from the electronic records and analyzed using STATA13. Results: We evaluated 130 DKA admissions (63 pandemic and 67 pre-pandemic). The majority of patients in the pandemic group were in, the age group of (6–11.9 years) (54% vs. 23.9%, p = 0.001), and higher proportion of them was diagnosed with new-onset diabetes (42.9% vs. 25.4%, p = 0.035). Overall, there was no significant difference in symptoms duration, DKA severity, or time to DKA resolution, but there was a difference in the median (IQR) HbA1C, 11% (9.4–12.95) vs. 10.15% (9.27–11.80) (p = 0.0297) in the pandemic and pre-pandemic groups, respectively. Conclusion: In our COVID-19-free hospital, the pandemic and service reallocation has led to an increased rate of DKA admissions with increased number of newly diagnosed T1DM. Clinical presentation and severity were not adversely affected.
{"title":"Clinical and Biochemical Characteristics of Pediatric Diabetic Ketoacidosis Admissions to COVID-19 Free UAE Tertiary Center during Pandemic","authors":"Shoroogh Marei, Dalia Ra’a Said, R. Almazrouei, Walid Kaplan, N. Al Hassani","doi":"10.1159/000534940","DOIUrl":"https://doi.org/10.1159/000534940","url":null,"abstract":"Background: COVID-19 pandemic led to delayed diagnosis and increase in number and severity of type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA) cases in pediatric population worldwide. The indirect impact of the pandemic on pediatric DKA admissions to COVID-19-free hospitals worth to be evaluated. Objectives: Our aim was to evaluate the characteristics and severity of DKA admissions before and during the pandemic to COVID-19-free hospital. Methods: This descriptive retrospective study included 130 episodes of DKA for patients aged below 16 years admitted to Tawam Hospital, a COVID-19-free hospital, between March 2017 and Feb 2021. Data from March 2020 to Feb 2021 (pandemic) were compared to the previous 3 years, March 2017 to Feb 2020 (pre-pandemic). Data were retrieved from the electronic records and analyzed using STATA13. Results: We evaluated 130 DKA admissions (63 pandemic and 67 pre-pandemic). The majority of patients in the pandemic group were in, the age group of (6–11.9 years) (54% vs. 23.9%, p = 0.001), and higher proportion of them was diagnosed with new-onset diabetes (42.9% vs. 25.4%, p = 0.035). Overall, there was no significant difference in symptoms duration, DKA severity, or time to DKA resolution, but there was a difference in the median (IQR) HbA1C, 11% (9.4–12.95) vs. 10.15% (9.27–11.80) (p = 0.0297) in the pandemic and pre-pandemic groups, respectively. Conclusion: In our COVID-19-free hospital, the pandemic and service reallocation has led to an increased rate of DKA admissions with increased number of newly diagnosed T1DM. Clinical presentation and severity were not adversely affected.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"5 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138598361","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}
Talal Ashour, Sami Azar, Akram Echtay, Muhammad Farooqi, Tarek Fiad, Mohamed Hassanein, Ahmed Hassoun, Abdul Jabbar, Amin Jayyousi, Kari Ranta, Hani Sabbour, Fatih Tangi, Ibrahim Turfanda
Background: Current guidelines recommend that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with proven cardiovascular benefit should be considered for first-line therapy in patients with type 2 diabetes (T2D) who have/are at high risk of atherosclerotic cardiovascular disease (CVD). Summary: Only one GLP-1 RA – dulaglutide – has demonstrated superiority versus placebo in reducing cardiovascular risk in patients with T2D with or without a history of CVD in a cardiovascular outcomes trial (CVOT). This trial – REWIND – is the only GLP-1 RA-based CVOT that recruited patients with a CVD prevalence (31%) that is similar to the estimated prevalence in primary care T2D populations in the Gulf and Levant region. In contrast, baseline CVD prevalence in all other GLP-1 RA-based CVOTs ranged from 73 to 100%. REWIND’s results provided the European Association for the Study of Diabetes and American Diabetes Association with data on which to base updated guidelines. These organisations subsequently recommended that GLP-1 RAs should be considered for primary CVD prevention in high cardiovascular-risk patients with T2D, and acknowledged that present evidence supporting GLP-1 RAs for primary prevention of CVD in T2D is strongest for dulaglutide but limited for other GLP-1 RAs. The Emirates Diabetes Society guidelines also support the use of GLP-1 RAs for primary cardiovascular prevention in patients with T2D. The cardiovascular benefit conferred by dulaglutide in patients with no CVD history, and the close alignment of the REWIND cohort with patient populations in the Gulf and Levant region, may better inform physicians in the early use of dulaglutide in patients with T2D and multiple cardiovascular-risk factors, regardless of CVD history. Utilizing published data and author opinion, this review explores the importance of taking a cardiocentric approach to T2D management, and discusses the clinical implications of REWIND for people with T2D in the Gulf and Levant region. Key Messages: Guideline recommendations, including those of the Emirates Diabetes Society, state that GLP-1 RAs with proven cardiovascular benefit should be considered for primary CVD prevention in high cardiovascular-risk patients with T2D. This recommendation was informed, in part, by REWIND; REWIND was the only CVOT to show that a GLP-1 RA (dulaglutide) reduces cardiovascular risk in patients with T2D with or without established CVD. Demonstration of cardiovascular benefit in the REWIND cohort, which aligns closely with patient populations in the Gulf and Levant region, may better inform physicians in the early use of dulaglutide in patients with T2D, regardless of CVD history.
{"title":"From Clinical Trial Evidence to Clinical Guidelines: Perspectives on REWIND from Clinicians in the Gulf and Levant Region","authors":"Talal Ashour, Sami Azar, Akram Echtay, Muhammad Farooqi, Tarek Fiad, Mohamed Hassanein, Ahmed Hassoun, Abdul Jabbar, Amin Jayyousi, Kari Ranta, Hani Sabbour, Fatih Tangi, Ibrahim Turfanda","doi":"10.1159/000534713","DOIUrl":"https://doi.org/10.1159/000534713","url":null,"abstract":"Background: Current guidelines recommend that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with proven cardiovascular benefit should be considered for first-line therapy in patients with type 2 diabetes (T2D) who have/are at high risk of atherosclerotic cardiovascular disease (CVD). Summary: Only one GLP-1 RA – dulaglutide – has demonstrated superiority versus placebo in reducing cardiovascular risk in patients with T2D with or without a history of CVD in a cardiovascular outcomes trial (CVOT). This trial – REWIND – is the only GLP-1 RA-based CVOT that recruited patients with a CVD prevalence (31%) that is similar to the estimated prevalence in primary care T2D populations in the Gulf and Levant region. In contrast, baseline CVD prevalence in all other GLP-1 RA-based CVOTs ranged from 73 to 100%. REWIND’s results provided the European Association for the Study of Diabetes and American Diabetes Association with data on which to base updated guidelines. These organisations subsequently recommended that GLP-1 RAs should be considered for primary CVD prevention in high cardiovascular-risk patients with T2D, and acknowledged that present evidence supporting GLP-1 RAs for primary prevention of CVD in T2D is strongest for dulaglutide but limited for other GLP-1 RAs. The Emirates Diabetes Society guidelines also support the use of GLP-1 RAs for primary cardiovascular prevention in patients with T2D. The cardiovascular benefit conferred by dulaglutide in patients with no CVD history, and the close alignment of the REWIND cohort with patient populations in the Gulf and Levant region, may better inform physicians in the early use of dulaglutide in patients with T2D and multiple cardiovascular-risk factors, regardless of CVD history. Utilizing published data and author opinion, this review explores the importance of taking a cardiocentric approach to T2D management, and discusses the clinical implications of REWIND for people with T2D in the Gulf and Levant region. Key Messages: Guideline recommendations, including those of the Emirates Diabetes Society, state that GLP-1 RAs with proven cardiovascular benefit should be considered for primary CVD prevention in high cardiovascular-risk patients with T2D. This recommendation was informed, in part, by REWIND; REWIND was the only CVOT to show that a GLP-1 RA (dulaglutide) reduces cardiovascular risk in patients with T2D with or without established CVD. Demonstration of cardiovascular benefit in the REWIND cohort, which aligns closely with patient populations in the Gulf and Levant region, may better inform physicians in the early use of dulaglutide in patients with T2D, regardless of CVD history.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"36 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139251114","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}
Dileep Kumar, Kashif Gulzar, F. Alalawi, A. Seddik, Hind Alnour, Maseer Ahmed, S. Najad, Hussein Yousif, Mohamed Hussain Railey, A. Alhadari
Background: De novo post-transplant diabetes mellitus (PTDM) is a frequent complication among renal transplant recipients; it confers a high risk for graft failure and patient mortality. This single-centre study aimed to determine the incidence and risk factors of PTDM and its effects on graft outcome and mortality. Methods: In a single-centre longitudinal cohort analysis of 383 non-diabetic renal transplant follow-up recipients, outcomes were analysed through a detailed chart review. We hypothesized that different donor and recipient characters such as age, gender, and HLA mismatch would affect PTDM development in renal transplant recipients. PTDM is defined on basis of fasting plasma sugar (≥7 mmol/L or ≥126 mg/dL), random plasma sugar (≥11.1 mmol/L or ≥200 mg/dL), and glycated haemoglobin (HBA1C: >6.5% or 48 mmol/mol). We assessed PTDM incidence, risk factors, and its effect on patient mortality and graft outcome using Cox regression. Results: The mean age at the time of transplantation was 35.70 (±14.27) years, and 50.91% were male. PTDM incidence in the study period was 23.30%. Independent risk factors include older age at the time of transplantation, cyclosporine immunosuppression, cytomegalovirus, and hepatitis C virus infection. PTDM is not associated with graft dysfunction, whereas it significantly carries high mortality. Conclusion: PTDM is common among renal transplant recipients. Older age at the time of transplantation, cyclosporine immunosuppression, cytomegalovirus, and hepatitis C virus are risk factors. PTDM carries high mortality but is not associated with graft failure.
{"title":"Post-Transplant Diabetes Mellitus in Renal Transplant Recipients, Single-Centre Data: Incidence, Risk Factors, and Effect on Graft Function and Mortality","authors":"Dileep Kumar, Kashif Gulzar, F. Alalawi, A. Seddik, Hind Alnour, Maseer Ahmed, S. Najad, Hussein Yousif, Mohamed Hussain Railey, A. Alhadari","doi":"10.1159/000531665","DOIUrl":"https://doi.org/10.1159/000531665","url":null,"abstract":"Background: De novo post-transplant diabetes mellitus (PTDM) is a frequent complication among renal transplant recipients; it confers a high risk for graft failure and patient mortality. This single-centre study aimed to determine the incidence and risk factors of PTDM and its effects on graft outcome and mortality. Methods: In a single-centre longitudinal cohort analysis of 383 non-diabetic renal transplant follow-up recipients, outcomes were analysed through a detailed chart review. We hypothesized that different donor and recipient characters such as age, gender, and HLA mismatch would affect PTDM development in renal transplant recipients. PTDM is defined on basis of fasting plasma sugar (≥7 mmol/L or ≥126 mg/dL), random plasma sugar (≥11.1 mmol/L or ≥200 mg/dL), and glycated haemoglobin (HBA1C: >6.5% or 48 mmol/mol). We assessed PTDM incidence, risk factors, and its effect on patient mortality and graft outcome using Cox regression. Results: The mean age at the time of transplantation was 35.70 (±14.27) years, and 50.91% were male. PTDM incidence in the study period was 23.30%. Independent risk factors include older age at the time of transplantation, cyclosporine immunosuppression, cytomegalovirus, and hepatitis C virus infection. PTDM is not associated with graft dysfunction, whereas it significantly carries high mortality. Conclusion: PTDM is common among renal transplant recipients. Older age at the time of transplantation, cyclosporine immunosuppression, cytomegalovirus, and hepatitis C virus are risk factors. PTDM carries high mortality but is not associated with graft failure.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"72 1","pages":"99 - 106"},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90802636","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: Metabolic syndrome (MS) is a global health challenge. Its prevalence is on the rise in the developing countries. A shift from the indigenous African diet rich in dietary fibre and micronutrients as well as sedentary lifestyle have been implicated in its aetiology. Currently, accurate definition and diagnosis of MS in Africa constitute a challenge as none of the different definitions recognized African-specific cut-off points for the different MS components. Summary: PubMed and Google databases were searched for studies between 2005 and 2022 that met the eligibility criteria of the study using expressions such as MS in Africans and components of MS in Africans. Key Messages: Observations from this review showed that the current criteria for MS diagnosis are not definite for Africans. This review article, therefore, discusses the necessity to develop African-specific criteria for MS diagnosis, which will enhance its proper diagnosis and management in Africans.
{"title":"Redefining the Metabolic Syndrome in Africa: A Systematic Review between 2005 and 2022","authors":"M. Charles-Davies, O. Ajayi","doi":"10.1159/000531552","DOIUrl":"https://doi.org/10.1159/000531552","url":null,"abstract":"Background: Metabolic syndrome (MS) is a global health challenge. Its prevalence is on the rise in the developing countries. A shift from the indigenous African diet rich in dietary fibre and micronutrients as well as sedentary lifestyle have been implicated in its aetiology. Currently, accurate definition and diagnosis of MS in Africa constitute a challenge as none of the different definitions recognized African-specific cut-off points for the different MS components. Summary: PubMed and Google databases were searched for studies between 2005 and 2022 that met the eligibility criteria of the study using expressions such as MS in Africans and components of MS in Africans. Key Messages: Observations from this review showed that the current criteria for MS diagnosis are not definite for Africans. This review article, therefore, discusses the necessity to develop African-specific criteria for MS diagnosis, which will enhance its proper diagnosis and management in Africans.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"21 1","pages":"89 - 98"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79712214","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}
A. Bashier, M. Farghaly, Juwairia Alali, A. Alhadari, Yasmin Ajaz, Vani Krishna Warrier, E. Abdelgadir, M. Farooqi, Sana Qamar, Mohamed Alsayed, Mohamed Samir Fahmy, Dali Tannouri, Arun Jayarame Gowda, Nancy Awad, B. C. Ramachandrachar, Ashok Natarajan
Aims: The current study evaluated the demographics, clinical characteristics, treatment patterns, and economic burden of patients with type 2 diabetes mellitus (T2DM) with comorbidities (heart failure [HF], chronic kidney disease [CKD], and cardiovascular disease [CVD] without HF) in Dubai, United Arab Emirates (UAE). Methods: This observational, retrospective study collected data from January 01, 2014, to December 31, 2019, from the Dubai Real-World Claims Database (adults ≥18 years; at least 1 T2DM diagnosis claim). Patients were stratified into 5 cohorts: T2DM alone (cohort 1), T2DM and CKD (cohort 2), T2DM and CVD without CKD and HF (cohort 3), T2DM and HF (cohort 4), and T2DM with HF and CKD (cohort 5). An evaluation of demographics and clinical characteristics during pre-index period, as well as treatment patterns, healthcare resource utilization, and costs during the post-index period was conducted. Results: The sample had 374,271 patients with T2DM (age 43–56 years; male [72–84%]). Patients in cohorts 4 and 5 had Deyo-Charlson Comorbidity Index scores of 4.4 and 5.8, respectively. General practitioners (GPs) routinely prescribed biguanides for patients in cohorts 1–4 (24–38%), and insulin to patients in cohort 5 (27.7%). Prescription rates of novel antihyperglycemic drugs, such as glucagon-like peptide-1 (GLP-1 RA), were very low (∼2–8%) even in cohorts with cardiovascular and renal comorbidities (cohorts 2–5). A similar observation was noted with prescribing rates (0.6–4.4%) of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in cohorts 2–5. Endocrinologists preferred to prescribe GLP-1 RA and SGLT2i to T2DM patients with comorbidities. During the 5-year study period, median outpatient claims were the highest in cohort 5 (8.0 [range, 1.0–168.0]), followed by cohort 2 (5.5 [range, 1.0–52.0]). The median cost for inpatient claims was higher in cohort 5 (16,429 [range, 3,732–29,126] AED) compared to other cohorts. The median cost for drugs and procedures was highest in cohort 5 (4,525 [range, 38–31,546] AED and 2,297 [range, 56–105,074] AED, respectively). Conclusion: Continued and increased usage of drugs such as SGLT2i and GLP-1 RA with proven cardiorenal benefits could improve long-term outcomes and reduce associated healthcare costs in patients with T2DM and comorbidities in Dubai, UAE.
{"title":"Real-World Evaluation of Demographics, Treatment Pattern, and Economic Burden of Heart Failure and Kidney Disease in Type 2 Diabetes Mellitus Patient Population in Dubai, United Arab Emirates","authors":"A. Bashier, M. Farghaly, Juwairia Alali, A. Alhadari, Yasmin Ajaz, Vani Krishna Warrier, E. Abdelgadir, M. Farooqi, Sana Qamar, Mohamed Alsayed, Mohamed Samir Fahmy, Dali Tannouri, Arun Jayarame Gowda, Nancy Awad, B. C. Ramachandrachar, Ashok Natarajan","doi":"10.1159/000530467","DOIUrl":"https://doi.org/10.1159/000530467","url":null,"abstract":"Aims: The current study evaluated the demographics, clinical characteristics, treatment patterns, and economic burden of patients with type 2 diabetes mellitus (T2DM) with comorbidities (heart failure [HF], chronic kidney disease [CKD], and cardiovascular disease [CVD] without HF) in Dubai, United Arab Emirates (UAE). Methods: This observational, retrospective study collected data from January 01, 2014, to December 31, 2019, from the Dubai Real-World Claims Database (adults ≥18 years; at least 1 T2DM diagnosis claim). Patients were stratified into 5 cohorts: T2DM alone (cohort 1), T2DM and CKD (cohort 2), T2DM and CVD without CKD and HF (cohort 3), T2DM and HF (cohort 4), and T2DM with HF and CKD (cohort 5). An evaluation of demographics and clinical characteristics during pre-index period, as well as treatment patterns, healthcare resource utilization, and costs during the post-index period was conducted. Results: The sample had 374,271 patients with T2DM (age 43–56 years; male [72–84%]). Patients in cohorts 4 and 5 had Deyo-Charlson Comorbidity Index scores of 4.4 and 5.8, respectively. General practitioners (GPs) routinely prescribed biguanides for patients in cohorts 1–4 (24–38%), and insulin to patients in cohort 5 (27.7%). Prescription rates of novel antihyperglycemic drugs, such as glucagon-like peptide-1 (GLP-1 RA), were very low (∼2–8%) even in cohorts with cardiovascular and renal comorbidities (cohorts 2–5). A similar observation was noted with prescribing rates (0.6–4.4%) of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in cohorts 2–5. Endocrinologists preferred to prescribe GLP-1 RA and SGLT2i to T2DM patients with comorbidities. During the 5-year study period, median outpatient claims were the highest in cohort 5 (8.0 [range, 1.0–168.0]), followed by cohort 2 (5.5 [range, 1.0–52.0]). The median cost for inpatient claims was higher in cohort 5 (16,429 [range, 3,732–29,126] AED) compared to other cohorts. The median cost for drugs and procedures was highest in cohort 5 (4,525 [range, 38–31,546] AED and 2,297 [range, 56–105,074] AED, respectively). Conclusion: Continued and increased usage of drugs such as SGLT2i and GLP-1 RA with proven cardiorenal benefits could improve long-term outcomes and reduce associated healthcare costs in patients with T2DM and comorbidities in Dubai, UAE.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"29 1","pages":"42 - 54"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87746560","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, Fauzia Rashid, Elamin Ibrahim Abdelgadir
Backgrounds: The Twelfth Diabetes and Endocrine Virtual Congress (EDEC 2022) was held on 24–26 February 2022 due to the COVID pandemic. Objectives: We aimed to present highlights of the congress proceeding. Methods: Three rapporteurs prepared this congress report. They prepared assigned sections, reviewed the rest of the manuscript, and approved its final version. Conference Highlights: The conference contents over 3 days included a wide range of lectures by world-class experts and key opinion leaders on various topical subjects, endocrinology, diabetes care, and metabolism, in addition to original data from submitted abstracts. The virtual EDEC 2022 provided a comprehensive review of topical issues concerning clinical practice and research in diabetes, endocrinology, and metabolism. The clinical approach to managing a pituitary mass, contemporary management of acromegaly, and the challenging prolactin disorders, thyroid nodules, hyperparathyroidism, polycystic ovary, and premature ovarian failure were also discussed. On the diabetes side, emphasis on the cardiovascular outcomes, using newer agents when compelling indications exist, hypoglycemia, hypertension, and halting of chronic kidney disease progression were discussed. Other presentations considered type 1 diabetes care, the latest guidelines, role of technology in diabetes care, including telemedicine and some regional experiences. Use and abuse of testosterone were reviewed. The newer and future lipid-modifying therapies in adults and children were discussed. Conclusions: This EDEC 2022 session provided a comprehensive review of topical issues in clinical practice and research in diabetes, endocrinology, and metabolism.
{"title":"Highlights of the Twelfth Emirates Diabetes and Endocrine (Virtual) Congress, 24–26 February 2022","authors":"S. Beshyah, Fauzia Rashid, Elamin Ibrahim Abdelgadir","doi":"10.1159/000530604","DOIUrl":"https://doi.org/10.1159/000530604","url":null,"abstract":"Backgrounds: The Twelfth Diabetes and Endocrine Virtual Congress (EDEC 2022) was held on 24–26 February 2022 due to the COVID pandemic. Objectives: We aimed to present highlights of the congress proceeding. Methods: Three rapporteurs prepared this congress report. They prepared assigned sections, reviewed the rest of the manuscript, and approved its final version. Conference Highlights: The conference contents over 3 days included a wide range of lectures by world-class experts and key opinion leaders on various topical subjects, endocrinology, diabetes care, and metabolism, in addition to original data from submitted abstracts. The virtual EDEC 2022 provided a comprehensive review of topical issues concerning clinical practice and research in diabetes, endocrinology, and metabolism. The clinical approach to managing a pituitary mass, contemporary management of acromegaly, and the challenging prolactin disorders, thyroid nodules, hyperparathyroidism, polycystic ovary, and premature ovarian failure were also discussed. On the diabetes side, emphasis on the cardiovascular outcomes, using newer agents when compelling indications exist, hypoglycemia, hypertension, and halting of chronic kidney disease progression were discussed. Other presentations considered type 1 diabetes care, the latest guidelines, role of technology in diabetes care, including telemedicine and some regional experiences. Use and abuse of testosterone were reviewed. The newer and future lipid-modifying therapies in adults and children were discussed. Conclusions: This EDEC 2022 session provided a comprehensive review of topical issues in clinical practice and research in diabetes, endocrinology, and metabolism.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"8 1","pages":"1 - 32"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84256266","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}
Dhanya Soodhana Mohan, A. Hegde, Vani Hebbal Nagarajappa, Raghupathy Palany
Background: Turner syndrome (TS) is the commonest chromosomal abnormality in females with an incidence of 25–50 per 100,000 females. Girls with TS universally have short stature (95%), along with gonadal failure (>90%) and infertility (99%); however, the ethnic differences are not well elaborated. Objectives: This study has been planned to evaluate the presentation and course of Indian girls with TS. Methods: Patients with TS presenting to our referral endocrinology clinic were included in this study. Diagnosis of TS was done by karyotyping. A retrospective chart review of these patients formed the basis of this study. Results: A total of 55 patients with TS karyotype were seen, and the mean age at diagnosis was 12.3 years. The commonest presenting features were short stature alone seen in 37 (65.45%) and short stature with delayed puberty in 18 (32.72%). The earliest age at presentation was 4.5 years who presented with short stature. The mean height was 124.17 cm and mean BMI 17.54 kg/m2. The most common karyotype was 45, XO found in 34 (61.6%) of the cases. 15 (27.27%) the cases were started on growth hormone therapy. 26 cases (47.27%) required pubertal induction. Conclusion: A vast number of cases with TS in India remain undiagnosed until puberty or present very late. A high degree of clinical suspicion can help us diagnose these children earlier. If TS is diagnosed earlier, growth can be achieved up to their maximum potential. Early identification and management will help us provide multidisciplinary care and hence prevent complications.
{"title":"Clinical Profile of Turner Syndrome: A Tertiary Center Experience","authors":"Dhanya Soodhana Mohan, A. Hegde, Vani Hebbal Nagarajappa, Raghupathy Palany","doi":"10.1159/000529379","DOIUrl":"https://doi.org/10.1159/000529379","url":null,"abstract":"Background: Turner syndrome (TS) is the commonest chromosomal abnormality in females with an incidence of 25–50 per 100,000 females. Girls with TS universally have short stature (95%), along with gonadal failure (>90%) and infertility (99%); however, the ethnic differences are not well elaborated. Objectives: This study has been planned to evaluate the presentation and course of Indian girls with TS. Methods: Patients with TS presenting to our referral endocrinology clinic were included in this study. Diagnosis of TS was done by karyotyping. A retrospective chart review of these patients formed the basis of this study. Results: A total of 55 patients with TS karyotype were seen, and the mean age at diagnosis was 12.3 years. The commonest presenting features were short stature alone seen in 37 (65.45%) and short stature with delayed puberty in 18 (32.72%). The earliest age at presentation was 4.5 years who presented with short stature. The mean height was 124.17 cm and mean BMI 17.54 kg/m2. The most common karyotype was 45, XO found in 34 (61.6%) of the cases. 15 (27.27%) the cases were started on growth hormone therapy. 26 cases (47.27%) required pubertal induction. Conclusion: A vast number of cases with TS in India remain undiagnosed until puberty or present very late. A high degree of clinical suspicion can help us diagnose these children earlier. If TS is diagnosed earlier, growth can be achieved up to their maximum potential. Early identification and management will help us provide multidisciplinary care and hence prevent complications.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"130 1","pages":"62 - 66"},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77079568","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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