B. Afandi, M. Hassanein, S. Shaikh, G. Ibrahim, M. Alarouj
Introduction: A novel clinical calculator was developed to assist physicians in classifying the risk for individuals with diabetes planning to observe fasting during the holy month of Ramadan. The aim of this study was to evaluate the necessity to use this approach. Methods: A survey with twenty-six clinical scenario questions was developed. All cases were pre-scored using the proposed Diabetes and Ramadan Risk Calculator. The survey was sent to 350 reputable practicing physicians with considerable expertise in managing patients with diabetes. The survey sought expert opinion on patients’ risk classification during Ramadan fasting. Quantitative methods were used for data analysis. Results: Responses of 312 participants were valid for analysis. There was a wide variation in evaluating patients’ risk, particularly in moderate-risk cases. Overall, responses to case scenarios were classified correctly with 33–85% variation in correct response. Geographical and inter-specialty differences were noted. Conclusion: There is a broad variation among physicians on how to estimate the risk for patients with diabetes planning to fast during the month of Ramadan. A practical method using many variables might help physicians in the decision making.
{"title":"Variability among Physicians in Risk Stratification for People with Diabetes during Ramadan Fasting","authors":"B. Afandi, M. Hassanein, S. Shaikh, G. Ibrahim, M. Alarouj","doi":"10.1159/000527474","DOIUrl":"https://doi.org/10.1159/000527474","url":null,"abstract":"Introduction: A novel clinical calculator was developed to assist physicians in classifying the risk for individuals with diabetes planning to observe fasting during the holy month of Ramadan. The aim of this study was to evaluate the necessity to use this approach. Methods: A survey with twenty-six clinical scenario questions was developed. All cases were pre-scored using the proposed Diabetes and Ramadan Risk Calculator. The survey was sent to 350 reputable practicing physicians with considerable expertise in managing patients with diabetes. The survey sought expert opinion on patients’ risk classification during Ramadan fasting. Quantitative methods were used for data analysis. Results: Responses of 312 participants were valid for analysis. There was a wide variation in evaluating patients’ risk, particularly in moderate-risk cases. Overall, responses to case scenarios were classified correctly with 33–85% variation in correct response. Geographical and inter-specialty differences were noted. Conclusion: There is a broad variation among physicians on how to estimate the risk for patients with diabetes planning to fast during the month of Ramadan. A practical method using many variables might help physicians in the decision making.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"27 1","pages":"55 - 61"},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87942550","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}
Mohamed Hassanein, Hani Sabbour, Fatheya Al Awadi, Salah Abusnana, Bachar Afandi, Juma Al Kaabi, Alaaeldin Bashier, Francesco Cosentino, Hassan El Tamimi, Mohammed Farghali, M. Hamed Farooqi, Khadija Hafidh, Hussein Heshmat, Rabih Hijazi, Abdul Jabbar, Sami Kenz, Seema Elkhider Nour, Abdullah Shehab, Jeff Shook, Mohamed Suliman, Hosam Zaky, Wael Almahmeed
Background: Cardiovascular diseases (CVDs) are the major cause of mortality and disability in patients with type 2 diabetes mellitus (T2DM). The increased risk of major cardiovascular (CV) events in patients with T2DM causes an estimated 12-year reduction in life expectancy. Despite their heightened CV risks, most T2DM patients do not meet treatment targets for multiple CV risk factors. Moreover, in the UAE, the incidence of cardiometabolic diseases is exceedingly high, impacting young patients and leading to a high burden of premature CV events. Summary: We propose this comprehensive cardiometabolic evaluation to address both glycemic control and early diagnosis of CV complications as well as early implementation of multifactorial intensive therapies that are evidence and guideline based. Widespread utilization and implementation of the guidelines in primary diabetic care, coupled with early referral to a CV or the relevant specialists, will result in a significant reduction of CV events and CV hospitalization in the UAE population. Hence, the Emirates Diabetes and Endocrine Society with the Emirates Cardiac Society collaborated for the first time to develop these recommendations. These will aid in the early identification of CV risk factors in persons with prediabetes and diabetes, as well as their effective assessment and management. These guidelines are aimed not just at primary care physicians but also specialists, perhaps leading to a more collaborative and multidisciplinary approach to the prevention, diagnosis, and treatment of patients with diabetes and CVD. Key Message: The establishment of combined cardiometabolic clinics providing comprehensive assessment and management in every major cardiology and diabetology center, particularly in patients who have already had a CV event, where the combined involvement of a cardiologist and a diabetologist in an intensive multifactorial outpatient program is urgently required to prevent recurrent CV events. In addition, establishing a National Cardiometabolic Registry is an essential element of this recommendation.
{"title":"Cardiometabolic Guidelines: Cardiovascular Risk Assessment and Management in Patients with Dysglycemia","authors":"Mohamed Hassanein, Hani Sabbour, Fatheya Al Awadi, Salah Abusnana, Bachar Afandi, Juma Al Kaabi, Alaaeldin Bashier, Francesco Cosentino, Hassan El Tamimi, Mohammed Farghali, M. Hamed Farooqi, Khadija Hafidh, Hussein Heshmat, Rabih Hijazi, Abdul Jabbar, Sami Kenz, Seema Elkhider Nour, Abdullah Shehab, Jeff Shook, Mohamed Suliman, Hosam Zaky, Wael Almahmeed","doi":"10.1159/000531107","DOIUrl":"https://doi.org/10.1159/000531107","url":null,"abstract":"Background: Cardiovascular diseases (CVDs) are the major cause of mortality and disability in patients with type 2 diabetes mellitus (T2DM). The increased risk of major cardiovascular (CV) events in patients with T2DM causes an estimated 12-year reduction in life expectancy. Despite their heightened CV risks, most T2DM patients do not meet treatment targets for multiple CV risk factors. Moreover, in the UAE, the incidence of cardiometabolic diseases is exceedingly high, impacting young patients and leading to a high burden of premature CV events. Summary: We propose this comprehensive cardiometabolic evaluation to address both glycemic control and early diagnosis of CV complications as well as early implementation of multifactorial intensive therapies that are evidence and guideline based. Widespread utilization and implementation of the guidelines in primary diabetic care, coupled with early referral to a CV or the relevant specialists, will result in a significant reduction of CV events and CV hospitalization in the UAE population. Hence, the Emirates Diabetes and Endocrine Society with the Emirates Cardiac Society collaborated for the first time to develop these recommendations. These will aid in the early identification of CV risk factors in persons with prediabetes and diabetes, as well as their effective assessment and management. These guidelines are aimed not just at primary care physicians but also specialists, perhaps leading to a more collaborative and multidisciplinary approach to the prevention, diagnosis, and treatment of patients with diabetes and CVD. Key Message: The establishment of combined cardiometabolic clinics providing comprehensive assessment and management in every major cardiology and diabetology center, particularly in patients who have already had a CV event, where the combined involvement of a cardiologist and a diabetologist in an intensive multifactorial outpatient program is urgently required to prevent recurrent CV events. In addition, establishing a National Cardiometabolic Registry is an essential element of this recommendation.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135009239","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: Travel has become an integral part of life, whether for business, pleasure, sport, or pilgrimage. The increasing number of patients with diabetes mellitus translates to a greater number of travelers with this condition. Primary care physicians have little knowledge to guide patients with diabetes planning travel. Summary: A structured pre-travel evaluation coupled with patient education diminishes health problems during travel. Proper preparation should include completion of all required immunizations, evaluation of diabetes, its co-morbidities, and their control prior to departure. This article discusses travel on foot, by road, railroad, sea route, and air travel; the supplies needed; and the unique features of each modality. This article discusses blood glucose monitoring, air travel security, precautions with continuous glucose monitors and insulin pumps during ascent and descent of aircraft, insulin dosage adjustments during travel beyond time zones, proper preservation of insulin in extreme temperatures, and adaptation to high altitude, hot and cold environments for patients with diabetes. Key Messages: There is a need for standardized guidelines based on expert opinions and best practices for travelers with diabetes, disposal of sharps, used test strips, and swabs in the absence of prospective studies.
{"title":"Travel with Diabetes: A Comprehensive Review for Clinicians","authors":"V. Rajkumar","doi":"10.1159/000527144","DOIUrl":"https://doi.org/10.1159/000527144","url":null,"abstract":"Background: Travel has become an integral part of life, whether for business, pleasure, sport, or pilgrimage. The increasing number of patients with diabetes mellitus translates to a greater number of travelers with this condition. Primary care physicians have little knowledge to guide patients with diabetes planning travel. Summary: A structured pre-travel evaluation coupled with patient education diminishes health problems during travel. Proper preparation should include completion of all required immunizations, evaluation of diabetes, its co-morbidities, and their control prior to departure. This article discusses travel on foot, by road, railroad, sea route, and air travel; the supplies needed; and the unique features of each modality. This article discusses blood glucose monitoring, air travel security, precautions with continuous glucose monitors and insulin pumps during ascent and descent of aircraft, insulin dosage adjustments during travel beyond time zones, proper preservation of insulin in extreme temperatures, and adaptation to high altitude, hot and cold environments for patients with diabetes. Key Messages: There is a need for standardized guidelines based on expert opinions and best practices for travelers with diabetes, disposal of sharps, used test strips, and swabs in the absence of prospective studies.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"9 1","pages":"121 - 130"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85352377","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}
G. F. Fadlalbari, Samar S. Hassan, A. Abdalla, Samar Omer Abusamra, Abeer Mohamed Abdalrhman, M. A. Abdullah
Background: Graves’ disease (GD)-related bone marrow injury presents usually as agranulocytosis or less commonly as pancytopenia. However, acute lymphoblastic leukemia (ALL) has been reported recently in an adult patient with GD. The underlying pathogenesis is not fully understood. Nevertheless, the harmful effects of anti-thyroid drugs or autoimmune reaction to bone marrow cells are anticipated to be the causative factors. Case Presentation: We report a 16.5-year-old girl with GD who was on carbimazole for the first 14 months of her illness, with irregular follow-up; then it was withdrawn because she developed hypothyroidism. Meanwhile, she developed severe anemia without fever which necessitated blood transfusion. Eight months later, she presented with thyrotoxicosis relapse, febrile illness, bone pain, and pancytopenia which was proved to be ALL on bone marrow examination. Conclusion: The presence of ALL in a young GD patient is an unprecedented event. Although it is difficult to demonstrate the causality between them, need for further studies cannot be denied.
{"title":"Acute Lymphoblastic Leukemia in an Adolescent Girl with Graves’ Disease: A Coincidence or Consequence","authors":"G. F. Fadlalbari, Samar S. Hassan, A. Abdalla, Samar Omer Abusamra, Abeer Mohamed Abdalrhman, M. A. Abdullah","doi":"10.1159/000527187","DOIUrl":"https://doi.org/10.1159/000527187","url":null,"abstract":"Background: Graves’ disease (GD)-related bone marrow injury presents usually as agranulocytosis or less commonly as pancytopenia. However, acute lymphoblastic leukemia (ALL) has been reported recently in an adult patient with GD. The underlying pathogenesis is not fully understood. Nevertheless, the harmful effects of anti-thyroid drugs or autoimmune reaction to bone marrow cells are anticipated to be the causative factors. Case Presentation: We report a 16.5-year-old girl with GD who was on carbimazole for the first 14 months of her illness, with irregular follow-up; then it was withdrawn because she developed hypothyroidism. Meanwhile, she developed severe anemia without fever which necessitated blood transfusion. Eight months later, she presented with thyrotoxicosis relapse, febrile illness, bone pain, and pancytopenia which was proved to be ALL on bone marrow examination. Conclusion: The presence of ALL in a young GD patient is an unprecedented event. Although it is difficult to demonstrate the causality between them, need for further studies cannot be denied.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"1 1","pages":"143 - 146"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82948567","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}
Hana AL Sughaiyer, Abeer AL Haj, Samia Murad Ibrahim Abdulrahman
Introduction: We aimed to evaluate the clinical characteristics of patients presenting with DKA and COVID-19 infection and describe the clinical outcomes compared to those without COVID-19. Methods: A retrospective study in a single tertiary care hospital in Dubai was conducted on patients admitted between 1st March 2020 and 30th July 2020 with a diagnosis of DKA with and without COVID-19 infection. Results: A total of 32 patients with DKA were identified. Eleven patients had a positive COVID-19 test and 21 patients were negative. The majority of DKA patients were males (84.4%). In the COVID-19 group, the mean age was 41.3 years old. Seven patients had preexisting diabetes (63.7%) and 4 patients (36.4%) had newly diagnosed diabetes. COVID-19 patients had a longer median length of hospital stay (7 days vs. 4 days; p = 0.278), shorter duration of DKA (16 h vs. 24 h; p = 0.043), and higher mortality (18.2% vs. 0%; p = 0.047). Conclusion: COVID-19 infection can precipitate DKA in patients with either newly diagnosed or preexisting diabetes. DKA patients with COVID-19 infection had higher mortality compared to those without COVID-19. This should urge physicians to be more vigilant in assessing the glycemic status of patients presenting with COVID-19 infection.
{"title":"Diabetic Ketoacidosis in COVID-19 Patients: Clinical Characteristics and Outcomes – A Retrospective Study in a Single Tertiary Care Hospital, Dubai, United Arab Emirates","authors":"Hana AL Sughaiyer, Abeer AL Haj, Samia Murad Ibrahim Abdulrahman","doi":"10.1159/000531683","DOIUrl":"https://doi.org/10.1159/000531683","url":null,"abstract":"Introduction: We aimed to evaluate the clinical characteristics of patients presenting with DKA and COVID-19 infection and describe the clinical outcomes compared to those without COVID-19. Methods: A retrospective study in a single tertiary care hospital in Dubai was conducted on patients admitted between 1st March 2020 and 30th July 2020 with a diagnosis of DKA with and without COVID-19 infection. Results: A total of 32 patients with DKA were identified. Eleven patients had a positive COVID-19 test and 21 patients were negative. The majority of DKA patients were males (84.4%). In the COVID-19 group, the mean age was 41.3 years old. Seven patients had preexisting diabetes (63.7%) and 4 patients (36.4%) had newly diagnosed diabetes. COVID-19 patients had a longer median length of hospital stay (7 days vs. 4 days; p = 0.278), shorter duration of DKA (16 h vs. 24 h; p = 0.043), and higher mortality (18.2% vs. 0%; p = 0.047). Conclusion: COVID-19 infection can precipitate DKA in patients with either newly diagnosed or preexisting diabetes. DKA patients with COVID-19 infection had higher mortality compared to those without COVID-19. This should urge physicians to be more vigilant in assessing the glycemic status of patients presenting with COVID-19 infection.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135009230","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}
These are abstract of the free communications of 12th Emirates Diabetes and Endocrine Congress held virtually on February 24-26, 2022, Dubai, UAE. The abstracts spanned a very wide range of basic, epidemiological and clinical subjects within the specialties’ of diabetes, endocrinology and metabolism and several other associated discipline. The abstracts are presented as were submitted with basic language check and style adjustments to meet the requirements of the journal. We hope by publishing them in this journal, we give them an early opportunity for dissemination and encourage communication and collaboration between research workers of similar interests.
{"title":"Proceedings of Abstracts 12th Emirates Diabetes & Endocrine Virtual Congress, February 24-26, 2022, Dubai, UAE","authors":"","doi":"10.1159/000531455","DOIUrl":"https://doi.org/10.1159/000531455","url":null,"abstract":"These are abstract of the free communications of 12th Emirates Diabetes and Endocrine Congress held virtually on February 24-26, 2022, Dubai, UAE. The abstracts spanned a very wide range of basic, epidemiological and clinical subjects within the specialties’ of diabetes, endocrinology and metabolism and several other associated discipline. The abstracts are presented as were submitted with basic language check and style adjustments to meet the requirements of the journal. We hope by publishing them in this journal, we give them an early opportunity for dissemination and encourage communication and collaboration between research workers of similar interests.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008654","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}
M. Hassanein, A. Almansari, Ebtesam M. Ba-Essa, F. Alawadi, H. Elbadawi, R. Sahay, R. Malik, R. Abdul Ghani, S. Abusnana, S. Shaikh, S. B. Zainudin, T. Elhadd, Yousef Al Saleh
Background: Injectable glucagon-like peptide-1 receptor agonists (GLP-1RAs) are proven to be well tolerated and efficacious in people with type 2 diabetes mellitus (T2DM) fasting during Ramadan. The first oral GLP-1RA semaglutide, also indicated for the treatment of T2DM, has specific dosing instructions to optimize treatment exposure, which may need to be altered during Ramadan fasting to ensure optimal efficacy. Summary: Given the lack of current published evidence for the effect of oral semaglutide during Ramadan, a panel of experts formulated recommendations for the administration of oral semaglutide during Ramadan. Key Messages: This statement reports recommendations for oral semaglutide administration during Ramadan.
{"title":"Recommendations for Titration and Administration of Oral Semaglutide for the Treatment of Type 2 Diabetes during Ramadan","authors":"M. Hassanein, A. Almansari, Ebtesam M. Ba-Essa, F. Alawadi, H. Elbadawi, R. Sahay, R. Malik, R. Abdul Ghani, S. Abusnana, S. Shaikh, S. B. Zainudin, T. Elhadd, Yousef Al Saleh","doi":"10.1159/000527475","DOIUrl":"https://doi.org/10.1159/000527475","url":null,"abstract":"Background: Injectable glucagon-like peptide-1 receptor agonists (GLP-1RAs) are proven to be well tolerated and efficacious in people with type 2 diabetes mellitus (T2DM) fasting during Ramadan. The first oral GLP-1RA semaglutide, also indicated for the treatment of T2DM, has specific dosing instructions to optimize treatment exposure, which may need to be altered during Ramadan fasting to ensure optimal efficacy. Summary: Given the lack of current published evidence for the effect of oral semaglutide during Ramadan, a panel of experts formulated recommendations for the administration of oral semaglutide during Ramadan. Key Messages: This statement reports recommendations for oral semaglutide administration during Ramadan.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"1 1","pages":"131 - 135"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79896019","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}
Payal S. Kubsad, Vani Hebbal Nagarajappa, Dhanya Soodhana Mohan
“Hyperandrogenism” is one of the commonest reasons for consultation in the adolescent age group. The most common reason being polycystic ovarian syndrome (PCOS) caused due to the changing lifestyle and adopting to a more sedentary type of living. PCOS is an endocrine disorder becoming increasingly common in adolescent, with an incidence of 6–18% in the female population. HAIR-AN syndrome being a specific subtype of PCOS consists of hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN) with adipose tissue dysfunction as the initial pathophysiological stimulant. We report a 16-year-old developmentally normal adolescent girl with excessive facial hair growth, an irregular menstrual cycle, and hyperpigmentation who attained menarche at the age of 12. On clinical examination, she had features suggestive of HA and IR. Biochemical investigations showed highly elevated serum insulin with elevated testosterone and normal blood glucose.A multidisciplinary approach with lifestyle modifications combined with hormonal medications like oral contraceptive pills with metformin and spironolactone were required to control the disease and prevent the systemic manifestation and decrease the degree of virilization. As HAIR-AN syndrome is a disorder characterized by high IR, pediatricians, adolescent specialists, and obstetricians should be familiar with this condition in order to assess and manage it efficiently.
{"title":"A Rare Case of Adolescent Girl with Beard-PCOS with a Difference: “HAIR-AN Syndrome”","authors":"Payal S. Kubsad, Vani Hebbal Nagarajappa, Dhanya Soodhana Mohan","doi":"10.1159/000526616","DOIUrl":"https://doi.org/10.1159/000526616","url":null,"abstract":"“Hyperandrogenism” is one of the commonest reasons for consultation in the adolescent age group. The most common reason being polycystic ovarian syndrome (PCOS) caused due to the changing lifestyle and adopting to a more sedentary type of living. PCOS is an endocrine disorder becoming increasingly common in adolescent, with an incidence of 6–18% in the female population. HAIR-AN syndrome being a specific subtype of PCOS consists of hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN) with adipose tissue dysfunction as the initial pathophysiological stimulant. We report a 16-year-old developmentally normal adolescent girl with excessive facial hair growth, an irregular menstrual cycle, and hyperpigmentation who attained menarche at the age of 12. On clinical examination, she had features suggestive of HA and IR. Biochemical investigations showed highly elevated serum insulin with elevated testosterone and normal blood glucose.A multidisciplinary approach with lifestyle modifications combined with hormonal medications like oral contraceptive pills with metformin and spironolactone were required to control the disease and prevent the systemic manifestation and decrease the degree of virilization. As HAIR-AN syndrome is a disorder characterized by high IR, pediatricians, adolescent specialists, and obstetricians should be familiar with this condition in order to assess and manage it efficiently.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"394 1","pages":"147 - 150"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78047741","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}
Context: India is an epicenter of type 2 diabetes mellitus (T2DM) in the entire world. Compliance is essential for chronic diseases treatment and has a significant impact on health and health care costs. The current study was planned to assess compliance to the appointment, treatment, and diet in T2DM patients at a private diabetic clinic in Rajkot city. Aims: The aim was to assess compliance to physician’s appointment, antidiabetic treatment, and diet among T2DM patients attending private diabetic clinic at Rajkot city. Settings and Design: This was an interview-based, prospective study done at a private diabetes clinic. Methods and Material: T2DM patients (>18 years) of either gender who were on antidiabetic treatment (at least 3 months before enrollment) at a private outpatient diabetic clinic during 2019 were included after ethical approval and obtaining informed consent. Juvenile diabetes, gestational diabetes, and noncompliant T2DM patients were excluded. Statistical Analysis Used: The χ2 test was used for the statistical association of sociodemographic and disease variables with compliance using GraphPad version 7 (p value <0.05 was considered significant). Results: Of 370 enrolled patients, 21 patients were lost to follow-up (noncompliant). From 349 T2DM patients, the majority of patients were in the middle age-group (60%, 41–60 years), preobese and obese (69.99%), and with comorbidity (42.7%). Compliance to appointment, treatment, and diet was observed above 85% in this study. Old age (>60 years) was significantly associated with poor appointment compliance, and comorbidity is significantly associated with the poor appointment, treatment, and diet compliance. An increasing number of comorbidities were significantly associated with poor appointment compliance. Conclusions: A higher compliance to appointment, treatment, and diet was achieved.
背景:印度是全球2型糖尿病(T2DM)的中心。遵医嘱对慢性病治疗至关重要，并对健康和保健费用产生重大影响。本研究计划评估拉杰果德市一家私人糖尿病诊所的2型糖尿病患者对预约、治疗和饮食的依从性。目的:目的是评估在拉杰果特市私人糖尿病诊所就诊的2型糖尿病患者对医生预约、抗糖尿病治疗和饮食的依从性。环境与设计:这是一项在一家私人糖尿病诊所进行的基于访谈的前瞻性研究。方法和材料:在伦理批准并获得知情同意后，纳入2019年期间在私立糖尿病门诊接受降糖治疗(入组前至少3个月)的T2DM患者(>18岁)，无论性别。排除了青少年糖尿病、妊娠糖尿病和非依从性T2DM患者。使用统计学分析:使用GraphPad version 7 (p值为60年)对社会人口学和疾病变量与依从性的统计关联(χ2检验)进行χ2检验，合并症与不良的预约依从性显著相关，治疗和饮食依从性显著相关。越来越多的合并症与较差的预约依从性显著相关。结论:患者对预约、治疗和饮食的依从性较高。
{"title":"Compliance of Appointment, Antidiabetic Treatment, and Diet in Type 2 Diabetes Mellitus Patients at Private Diabetes Clinic","authors":"K. Piparva, Ashutosh Kumar Singh, N. Joshi","doi":"10.1159/000525373","DOIUrl":"https://doi.org/10.1159/000525373","url":null,"abstract":"Context: India is an epicenter of type 2 diabetes mellitus (T2DM) in the entire world. Compliance is essential for chronic diseases treatment and has a significant impact on health and health care costs. The current study was planned to assess compliance to the appointment, treatment, and diet in T2DM patients at a private diabetic clinic in Rajkot city. Aims: The aim was to assess compliance to physician’s appointment, antidiabetic treatment, and diet among T2DM patients attending private diabetic clinic at Rajkot city. Settings and Design: This was an interview-based, prospective study done at a private diabetes clinic. Methods and Material: T2DM patients (>18 years) of either gender who were on antidiabetic treatment (at least 3 months before enrollment) at a private outpatient diabetic clinic during 2019 were included after ethical approval and obtaining informed consent. Juvenile diabetes, gestational diabetes, and noncompliant T2DM patients were excluded. Statistical Analysis Used: The χ2 test was used for the statistical association of sociodemographic and disease variables with compliance using GraphPad version 7 (p value <0.05 was considered significant). Results: Of 370 enrolled patients, 21 patients were lost to follow-up (noncompliant). From 349 T2DM patients, the majority of patients were in the middle age-group (60%, 41–60 years), preobese and obese (69.99%), and with comorbidity (42.7%). Compliance to appointment, treatment, and diet was observed above 85% in this study. Old age (>60 years) was significantly associated with poor appointment compliance, and comorbidity is significantly associated with the poor appointment, treatment, and diet compliance. An increasing number of comorbidities were significantly associated with poor appointment compliance. Conclusions: A higher compliance to appointment, treatment, and diet was achieved.","PeriodicalId":34679,"journal":{"name":"Dubai Diabetes and Endocrinology Journal","volume":"22 1","pages":"112 - 118"},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85985805","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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