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Al Jarad FAS, Narapureddy BR, Derkaoui HR, Aldayal ASA, Alotaibi MMH, Aladhyani FHA, Mohammed Asif S, Muthugounder K. Prevalence and Risk Factors of Obesity Among Type 2 Diabetic Participants in Abha, Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2025; 13:658. [PMID: 40150508 PMCID: PMC11942164 DOI: 10.3390/healthcare13060658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Revised: 03/10/2025] [Accepted: 03/13/2025] [Indexed: 03/29/2025] Open
Abstract
Background: The prevalence of obesity among type 2 diabetic participants is a growing concern globally, including in Abha, Saudi Arabia. This study aimed to investigate the prevalence and its associated risk factors of obesity among type 2 diabetic participants in Abha. Methods: A cross-sectional study targeted 400 type 2 diabetic participants in Abha, Saudi Arabia. A hybrid method (snowball sampling + purposive) techniques were used to obtain an adequate sample size. Data were collected after obtaining telephonic or digital consent; the questionnaire was shared with participants who were able and willing to complete it independently those with type 2 diabetes who wished to participate but were unable to complete the questionnaire on their own. The researcher conducted a telephonic interview and recorded their responses. The questionnaire captured demographic details, Anthropometric history, medical history, lifestyle habits, and type 2 Diabetes (T2DM) specific factors. Data were analyzed using IBM SPSS Statistics for Windows, Version 27.0. Results: The overall prevalence of obesity among the type 2 DM study participants was 46.0%, 115 participants (28.8%) fell into the Obesity Grade I category, 43 (10.8%) as Obesity Grade II, while 26 (6.5%) were classified as Obesity Grade III, the overall median BMI of participants was 29.3 ± 5.88. Significant bio-demographic factors associated with obesity included age, gender, educational level, marital status, and co-morbidities (p < 0.05). Notably, females and older adults exhibited higher obesity rates. Significant lifestyle factors included the frequency and type of physical activity, soft drink consumption, and attempts to control weight. Participants who exercised regularly and avoided soft drinks had lower obesity rates. Multiple logistic regression analysis identified age, gender, co-morbidities, family history of obesity, regular dinner consumption, soft drink consumption, and exercise frequency as significant predictors of obesity (p < 0.05). Conclusions: The study determined a high prevalence of obesity among type 2 diabetic participants in Abha, Saudi Arabia, with significant associations with bio-demographic and lifestyle factors. Interventions targeting weight management, physical activity, dietary habits, and health education are urgently needed to address obesity in this population. Further research is recommended to explore these associations longitudinally and to develop tailored intervention strategies.
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Affiliation(s)
| | - Bayapa Reddy Narapureddy
- Department of Public Health, College of Applied Medical Sciences, Khamis Musait, King Khalid University, Abha 62525, Saudi Arabia
| | - Hamza Radhwan Derkaoui
- Public Health, Population Health Management, Aseer Health Cluster, Ministry of Health, Abha 62312, Saudi Arabia;
| | - Abdulaziz Saud A. Aldayal
- College of Medicine, Shaqra University, Shaqra 11911, Saudi Arabia; (A.S.A.A.); (M.M.H.A.); (F.H.A.A.)
| | | | | | - Shaik Mohammed Asif
- Department of Diagnostic Science & Oral Biology, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Kandasamy Muthugounder
- Department of Community and Mental Health Nursing, College of Nursing, Khamis Mushait, King Khalid University, Abha 62525, Saudi Arabia;
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AlZeer I, AlBassam AM, AlFeraih A, AlMutairi A, AlAskar B, Aljasser D, AlRashed F, Alotaibi N, AlGhamdi S, AlRashed Z. Correlation Between Glycated Hemoglobin (HbA1c) Levels and Lipid Profile in Patients With Type 2 Diabetes Mellitus at a Tertiary Hospital in Saudi Arabia. Cureus 2025; 17:e80736. [PMID: 40242700 PMCID: PMC12003031 DOI: 10.7759/cureus.80736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2025] [Indexed: 04/18/2025] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is often associated with dyslipidemia, which increases the risk of cardiovascular disease. This study aimed to evaluate the relationship between glycated hemoglobin (HbA1c) levels and lipid profiles among newly diagnosed T2DM patients in Saudi Arabia. METHODS A cross-sectional retrospective study was conducted at King Fahad Medical City in Riyadh between January 2022 and December 2023. Data on demographic factors, body mass index (BMI), blood glucose levels, and lipid profiles were analyzed. RESULTS A total of 483 patients were included in the study, with the majority (42.2%) aged between 55 and 64 years. The study population consisted of 64.2% females with a mean BMI of 30.31±5.41. High HbA1c levels were observed in 68.3% of patients. Significant associations were found between HbA1c levels and triglycerides (TG) (p<0.001) as well as high-density lipoprotein cholesterol (HDL-c) (p<0.001), whereas low-density lipoprotein cholesterol (LDL-c) and total cholesterol (TC) showed no significant differences. Similarly, fasting blood glucose levels were associated with TG (p<0.001) and HDL-c (p=0.03) but not with TC or LDL-c. Regression analysis revealed that HDL-c was negatively correlated with HbA1c, whereas TG was positively correlated with HbA1c. No other parameter showed a significant correlation. CONCLUSION Poor glycemic control, as indicated by elevated HbA1c levels, is significantly associated with adverse lipid profile components, particularly higher TG levels and lower HDL-c.
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Lubega M, Ogwok J, Nabunya B, Mbalinda SN. Role of community-based health clubs in promoting patients' health education for diabetes self-care management: an interventional qualitative study in a Ugandan urban setting. BMJ Open Qual 2023; 12:e002473. [PMID: 38135300 DOI: 10.1136/bmjoq-2023-002473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Self-care management support is a core component of the Chronic Care Model that emphasises the need for empowering and preparing patients to manage their healthcare. In diabetes mellitus (DM) management, health education towards self-care empowers patients to make day-to-day decisions on their own disease and live with a healthy lifestyle. Although several strategies have been undertaken to improve the management of DM in Uganda, little has been done to empower patients to manage their own health. Community-based health clubs have been suggested as a novel way of improving diabetes management especially in settings with uneven distribution of healthcare facilities and inaccessibility to healthcare services that limit patients' awareness of the disease and self-care management. This interventional study was aimed at exploring the role of community-based health clubs in promoting patients' health education for diabetes self-care management. METHODS A cross-sectional qualitative study was conducted among 20 participants using focus group discussions with each having six to eight members. Only patients with diabetes who seek routine diabetes healthcare services at Wakiso Health Centre IV and had participated in the 8-week community-based health clubs' health education sessions were recruited for the study. The audio-recordings were transcribed verbatim and translated into English; thematic data analysis was conducted to generate codes and themes. Similar codes were merged and a group consensus was reached on coding discrepancies. RESULTS Three major themes on the role of health clubs in promoting patients' health education were merged from the study. These include promoting sharing of experiences among patients, improving awareness of healthy self-care practices and offering sufficient patient-health worker interaction time. CONCLUSIONS This is the first publication reporting on the role of community-based health clubs in promoting patients' health education towards diabetes self-care management in Uganda. The ability to share experiences among patients, improve patients' awareness on healthy living practices and the increased health worker-patient interaction time contribute heavily to the capacity-building for self-care among patients.
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Affiliation(s)
- Martin Lubega
- Department of Nursing, Makerere University College of Health Sciences, Kampala, Uganda
| | - James Ogwok
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Brenda Nabunya
- Department of Nursing, Makerere University College of Health Sciences, Kampala, Uganda
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Ekpor E, Akyirem S, Adade Duodu P. Prevalence and associated factors of overweight and obesity among persons with type 2 diabetes in Africa: a systematic review and meta-analysis. Ann Med 2023; 55:696-713. [PMID: 36821504 PMCID: PMC9970251 DOI: 10.1080/07853890.2023.2182909] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Type 2 diabetes and obesity are serious public health concerns globally and a growing burden in Africa. Both conditions have serious repercussions on health when they co-occur, yet the extent of their co-occurrence in Africa remains unknown. Therefore, this review aimed to identify the prevalence and associated factors of overweight and obesity among persons with type 2 diabetes in Africa. METHOD A systematic search was conducted on PubMed, MEDLINE, Embase, African Index Medicus (AIM), and African Journals Online (AJOL) for observational studies that reported the prevalence of overweight and/or obesity among type 2 diabetes patients in Africa. The prevalence data from individual studies were aggregated through a random-effects meta-analysis. The I2 statistic was used to evaluate between-studies heterogeneity, while subgroup analysis and mixed-effects meta-regression were performed to identify sources of heterogeneity. We assessed publication bias using funnel plots and Egger's test. This review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. RESULTS Of 1753 records retrieved, 80 articles were eligible for this review, with 74 cross-sectional studies included in the meta-analysis. The pooled prevalence of overweight and obesity was 35.6% and 25.6% respectively, while the overall prevalence of both overweight and obesity was 61.4%. Also, the pooled prevalence of both overweight and obesity across the five geographical areas in Africa ranged from 56.9% in East Africa to 88.5% in Southern Africa. Nineteen factors were significantly associated with overweight and obesity among patients with type 2 diabetes. CONCLUSION The high prevalence of overweight and obesity among patients with type 2 diabetes is a significant public health concern that transcends geographical boundaries within Africa. The findings from this review highlight the need for innovative weight management interventions that are tailored to the cultural context of the African setting.KEY MESSAGESThere was a high prevalence of overweight and obesity among the type 2 diabetes patients.Nineteen factors were identified to be significantly associated with overweight and obesity among type 2 diabetes patients.Only 12 out of the 80 included studies primarily focused on the prevalence of overweight and/or obesity which reflects a dearth of interest in this topic.
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Affiliation(s)
- Emmanuel Ekpor
- School of Nursing, University of Ghana, Legon, Ghana
- St. Martins de Porres Hospital, Eikwe, Ghana
| | - Samuel Akyirem
- Yale School of Nursing, Yale University, New Haven, CT, USA
| | - Precious Adade Duodu
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, England, UK
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Ibrahim UM, Babura SM, Zubairu Z, Namadi FA, Shehu UL, Ringim SH, Jalo RI, Tsiga-Ahmed FI, Abubakar N, Abdussalam K, Buba LF, Karkarna MZ, Jibo AM. Socio-demographic and Nutritional Factors Associated with Obesity amongst Adults from High Burden Kidney Diseases Areas of Jigawa State, Nigeria: A Community-based Survey. Niger Med J 2023; 64:799-815. [PMID: 38979057 PMCID: PMC11227637 DOI: 10.60787/nmj-64-6-388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
Background Obesity is a preventable public health problem associated with a significantly increased risk of non-communicable diseases. This study aimed to find the socio-demographic and nutritional factors associated with obesity amongst adults from high-burden kidney disease areas of Jigawa State, Nigeria. Methodology A cross-sectional survey was conducted to assess the socio-demographic and nutritional factors associated with obesity among 361 adults from four local government areas (LGAs) of Jigawa state identified to have a high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed, and data were analyzed using IBM SPSS version 22.0. Results The minimum age of the respondents was 18, and the maximum was 102 with a median of 45 (interquartile range = 30-80) years. The prevalence of obesity and overweight in the high-burden LGAs of Jigawa state was 33.0% and 27.1% respectively. Hadejia LGA had the highest (68.1%) prevalence of obesity. The prevalence of overweight was higher in Jahun LGA (38.9%). About one-third (38.2%) had a waist circumference (WC) greater than 88cm. Up to half of the female respondents had a waist-hip ratio (WHR) greater than 0.85. For male respondents, many (74.3%) had a WHR of greater than 0.9, and obesity was significantly higher (39.8%, P s< 0.001) among those ≥40 years of age. Obesity was significantly higher (39.8%,P < 0.001) among those ≥40 years of age, known diabetic, (57.1%, P=0.02), and rare consumption of vegetables, (45.8%, P<0.001).The odds of developing obesity were significantly higher among those who were known diabetics and were 3 times more likely to be obese than those who were not known to be diabetics (adjusted odds ratio [aOR] = 3.1, 95% CI = [1.1-8.9]. Conclusions The prevalence of obesity was high in the areas with high burdens of kidney disease. The government and relevant stakeholders should develop a cost-effective prevention, early diagnosis, and treatment model.
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Affiliation(s)
| | - Salisu Muazu Babura
- Department of Internal Medicine, Federal University Dutse/Rasheed Shekoni Teaching Hospital Dutse, Jigawa State, Nigeria
| | - Zahrau Zubairu
- Hemodialysis Unit, Department of Nursing Science, Aminu Kano Teaching Hospital, Kano State, Nigeria
| | | | - Usman L Shehu
- Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Nigeria
| | - Sadiq Hassan Ringim
- Department of Internal Medicine, Federal University Dutse/Rasheed Shekoni Teaching Hospital Dutse, Jigawa State, Nigeria
| | - Rabiu Ibrahim Jalo
- Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Nigeria
| | | | - Nuruddeen Abubakar
- Department of Biochemistry, Federal University Dutse, Jigawa State, Nigeria
| | - Kabiru Abdussalam
- Department of Chemical Pathology and Immunology, Bayero University/Aminu Kano Teaching Hospital, Nigeria
| | - Luka Fitto Buba
- Department of Environmental Management, Bayero University Kano, Nigeria
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Getahun MS, Deybasso HA, Komicha MA, Gurara AM. Magnitude of central obesity and associated factors among adult patients attending public health facilities in Adama town, Oromia region, Ethiopia, 2022. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:57. [PMID: 37330577 PMCID: PMC10276422 DOI: 10.1186/s41043-023-00397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/04/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Central obesity is excessive accumulation of fat around the abdomen, which is associated with the risk of coronary heart and cerebrovascular diseases. This study determined the magnitude of central obesity among adult patients using the waist-to-hip ratio, which has a superior capacity to measure the risk of developing non-communicable diseases compared to the body mass index used in previous studies in Ethiopia. METHODS Institutional-based cross-sectional study was conducted among a sample of 480 adults from April 1 to May 30, 2022. A systematic random sampling technique was used to select the study participants. Data were collected by using interviewer-administered structured questionnaires and anthropometric measurements. The data were entered into EPI INFO version 7 and analyzed by Statistical Software for Social Science Version 25. The associations between independent and dependent variables were checked using bivariate and multivariate logistic regression analyses. Adjusted odds ratio and 95% confidence interval were used to measure the strengths of the association. Statistical significance was declared at a P value of less than 0.05. RESULTS The magnitude of central obesity in this study was 40% (51.2% and 27.4% among females and males, respectively (95% CI 36-44%)). Being a female (AOR = 9.5, 95% CI 5.22-17.9), age range 35-44 (AOR = 7.0, 95% CI 2.9-16.7), 45-64 years (AOR = 10.1, 95% CI4.0-15.2), married (AOR = 2.5, 95% CI 1.3-4.7), high monthly income (AOR = 3.3, 95% CI 1.5-7.3), high consumption of milk and milk products (AOR = 0.3, 95% CI 0.1-0.6), family history of obesity (AOR = 1.8, 95% CI 1.1-3.2) were significantly associated with central obesity among the study participants. CONCLUSION The magnitude of central obesity was higher in the study area. Sex, age, marital status, monthly income, consumption of milk and milk products, and family history of obesity were independent determinants of central obesity. Therefore, it is important to raise awareness about central obesity through behavior change communication that targets the high-risk population.
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Affiliation(s)
| | - Haji Aman Deybasso
- Public Health Department, Adama Hospital Medical College, Adama, Ethiopia.
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Farag HFM, Elrewany E, Abdel-Aziz BF, Sultan EA. Prevalence and predictors of undiagnosed type 2 diabetes and pre-diabetes among adult Egyptians: a community-based survey. BMC Public Health 2023; 23:949. [PMID: 37231362 DOI: 10.1186/s12889-023-15819-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The global prevalence of abnormal glycemic level comprising diabetes mellitus (DM) and pre-diabetes (PDM) is rapidly increasing with special concern for the entity silent or undiagnosed diabetes; those unaware of their condition. Identification of people at risk became much easier with the use of risk charts than the traditional methods. The current study aimed to conduct a community-based screening for T2DM to estimate the prevalence of undiagnosed DM and to assess the AUSDRISK Arabic version as a predictive tool in an Egyptian context. METHODS A cross-sectional study was conducted among 719 Adults aging 18 years or more and not known to be diabetics through a population-based household survey. Each participant was interviewed to fill demographic and medical data as well as the AUSDRISK Arabic version risk score and undergo testing for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT). RESULTS The prevalence of DM and PDM were 5% and 21.7% respectively. The multivariate analysis revealed that age, being physically inactive, history of previous abnormal glycemic level and waist circumference were the predictors for having abnormal glycemic level among the studied participants. At cut off points ≥ 13 and ≥ 9, the AUSDRISK respectively discriminated DM [sensitivity (86.11%), specificity (73.35%), and area under the curve (AUC): 0.887, 95% CI: 0.824-0.950] and abnormal glycemic level [sensitivity (80.73%), specificity (58.06%), and AUC: 0.767, 95% CI: 0.727-0.807], p < 0.001. CONCLUSIONS Overt DM just occupies the top of an iceberg, its unseen big population have undiagnosed DM, PDM or been at risk of T2DM because of sustained exposure to the influential risk factors. The AUSDRISK Arabic version was proved to be sensitive and specific tool to be used among Egyptians as a screening tool for the detection of DM or abnormal glycemic level. A prominent association has been demonstrated between AUSDRISK Arabic version score and the diabetic status.
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Affiliation(s)
- Hassan Farag Mohamed Farag
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ehab Elrewany
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Basem Farouk Abdel-Aziz
- Department of Health Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Eman Anwar Sultan
- Department of Community Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
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Alawainati MA, Ayoob ZA, AlQari AA, Makhlooq F, Naser HS, Bukamal F. Prevalence and characteristics of obesity in patients with type-2 diabetes mellitus in primary care centers in Bahrain: A cross-sectional study. J Family Community Med 2023; 30:109-115. [PMID: 37303838 PMCID: PMC10252644 DOI: 10.4103/jfcm.jfcm_9_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Obesity is a complex health problem characterized by abnormal and excessive body weight. Globally, the epidemic of obesity is escalating, and today, around one-third of the world's adult population is overweight or obese. Obesity is a risk factor and a predictor of poor outcomes of diabetes. This study aimed to determine the prevalence and characteristics of obesity in adults with type-2 diabetes mellitus. MATERIALS AND METHODS This study was conducted at five primary care centers in Bahrain. Obesity was assessed using body mass index, while glycemic control status was assessed using glycated hemoglobin (HbA1c). Informed consent was obtained from all participants. Means and standard deviation were computed for continuous variables, while categorical variables were presented as frequencies and percentages. Student's t-test and Mann-WhitneyU test, as appropriate, were performed to determine statistical significance between two continuous variables. Chi-square or Fisher's Exact test were used to test for statistical significance for categorical variables. RESULTS A total of 732 participants were included; the mean age was 58.4 ± 11.3 years. Hypertension was the most prevalent comorbidity (63.5%), followed by hyperlipidemia (51.9%). Most participants (59.8%) had HbA1c levels of more than 7%, 20.9% had HbA1c levels between 7% and 8%, and 38.9% had HbA1c levels of more than 8%. Of the cohort, 47.5% were obese and 35.0% were overweight. Obesity was significantly higher in Bahraini patients and females (P < 0.001). Lower obesity rates were observed among patients who exercised regularly (P < 0.001) and patients who followed diet control measures (P = 0.039). In addition, we found higher obesity rates were found in patients with uncontrolled diabetes (P = 0.004), hypertension (P = 0.032), and hyperlipidemia (P = 0.048). CONCLUSION Obesity is prevalent among type-2 diabetic patients and is associated with poor glycemic outcomes. Thus, more efforts should be taken by physicians to address obesity in diabetic patients as it negatively impacts their glycemic control.
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Affiliation(s)
| | - Zahra A. Ayoob
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Aala A. AlQari
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Fatema Makhlooq
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Huda S. Naser
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
| | - Fajer Bukamal
- Department of Family Medicine, Primary Healthcare Centers, Manama, Bahrain
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Yang K, Cao F, Wang W, Tian Z, Yang L. The relationship between HMGB1 and autophagy in the pathogenesis of diabetes and its complications. Front Endocrinol (Lausanne) 2023; 14:1141516. [PMID: 37065747 PMCID: PMC10090453 DOI: 10.3389/fendo.2023.1141516] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels and has become the third leading threat to human health after cancer and cardiovascular disease. Recent studies have shown that autophagy is closely associated with diabetes. Under normal physiological conditions, autophagy promotes cellular homeostasis, reduces damage to healthy tissues and has bidirectional effects on regulating diabetes. However, under pathological conditions, unregulated autophagy activation leads to cell death and may contribute to the progression of diabetes. Therefore, restoring normal autophagy may be a key strategy to treat diabetes. High-mobility group box 1 protein (HMGB1) is a chromatin protein that is mainly present in the nucleus and can be actively secreted or passively released from necrotic, apoptotic, and inflammatory cells. HMGB1 can induce autophagy by activating various pathways. Studies have shown that HMGB1 plays an important role in insulin resistance and diabetes. In this review, we will introduce the biological and structural characteristics of HMGB1 and summarize the existing knowledge on the relationship between HMGB1, autophagy, diabetes, and diabetic complications. We will also summarize potential therapeutic strategies that may be useful for the prevention and treatment of diabetes and its complications.
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Affiliation(s)
- Kun Yang
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Feng Cao
- College of Acupuncture and Massage, Beijing University of Chinese Medicine, Beijing, China
- Department of Acupuncture, Haidian District Shuangyushu Community Health Service Center, Beijing, China
| | - Weili Wang
- Institute of Basic Research in Clinical Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhenyu Tian
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Lu Yang, ; Zhenyu Tian,
| | - Lu Yang
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- *Correspondence: Lu Yang, ; Zhenyu Tian,
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AbdAlla Salman M, Rabiee A, Salman A, Elewa A, Tourky M, Mahmoud AA, Moustafa A, El-Din Shaaban H, Ismail AA, Noureldin K, Issa M, Farah M, Barbary H, Elhaj MGF, Omar HSE. Predictors of type-2 diabetes remission following bariatric surgery after a two-year follow-up. Asian J Surg 2022; 45:2645-2650. [PMID: 35256262 DOI: 10.1016/j.asjsur.2021.12.070] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/05/2021] [Accepted: 12/24/2021] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Bariatric surgery is evolving as a successful tool for managing morbid obesity and T2DM. This study aimed to identify predictors of diabetes remission after two types of bariatric procedures. METHODS This prospective study enrolled 172 patients with morbid obesity associated with T2DM scheduled for bariatric surgery. Two laparoscopic bariatric procedures were done; single anastomosis gastric bypass (SAGB, n = 83) and sleeve gastrectomy (LSG, n = 68). Lipid accumulation product index (LAP) and quantitative insulin sensitivity check index (QUICKI) were used to evaluate lipid profile and insulin sensitivity. Two years after surgery condition of DM was evaluated as complete remission (CR), partial remission (PR), or improvement. The primary outcome measure was predictors of diabetes remission. RESULTS Two years after surgery, 151 patients were available for evaluation, where 75 patients (49.7%) achieved CR, while PR was found in 36 (23.8%). CR was significantly associated with younger age, shorter duration of DM (p < 0.001, for both), higher C-peptide and GLP-1 levels (p < 0.001 and p = 0.002, respectively), and bypass surgery (p = 0.027). On multivariate analysis, shorter duration of DM, lower BMI, and higher C-peptide levels were the independent factors predicting CR. CONCLUSION Complete remission of T2DM can be achieved in nearly half of the patients two years after SG or SAGB. The duration of diabetes and preoperative BMI and C-peptide levels are the independent factors predicting complete remissions.
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Affiliation(s)
| | - Ahmed Rabiee
- Internal Medicine Department, Kasralainy School of Medicine, Cairo University, Egypt.
| | - Ahmed Salman
- Internal Medicine Department, Kasralainy School of Medicine, Cairo University, Egypt.
| | - Ahmed Elewa
- General Surgery Department, National Hepatology and Tropical Medicine Research Institute, Egypt.
| | - Mohamed Tourky
- General Surgery Department, Great Western Hospital, NHS Foundation Trust, UK.
| | | | - Ahmed Moustafa
- Endemic Medicine and Hepatology Department, Kasralainy School of Medicine, Cairo University, Egypt.
| | - Hossam El-Din Shaaban
- Gastroenterology and Hepatology Department, National Hepatology and Tropical Medicine Research Institute, Egypt.
| | - Ahmed Abdelaziz Ismail
- Lecturer of Anesthesia and Pain Management, Kasralainy School of Medicine, Cairo University, Egypt.
| | - Khaled Noureldin
- General Surgery Department, Kasralainy School of Medicine, Cairo University, Egypt.
| | - Mohamed Issa
- Speciality Doctor in Colorectal and General Surgery Prince Charles Hospital Myrthyer Tydfil, Cardiff, UK.
| | | | - Hesham Barbary
- General and Laparoscopic Surgery Specialist at Alzytoun Specialized Hospital, Egypt.
| | | | - Haitham S E Omar
- General Surgery Department, Kasralainy School of Medicine, Cairo University, Egypt.
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Muacevic A, Adler JR. Prevalence of Obesity and Cardiovascular Risk Factors Among Type 2 Diabetes Mellitus Patients in Al-Khobar, Saudi Arabia. Cureus 2022; 14:e30539. [PMID: 36415391 PMCID: PMC9675942 DOI: 10.7759/cureus.30539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The prevalence of obesity has grown significantly worldwide. It is considered a major cardiovascular risk factor among type II diabetes mellitus (T2DM) patients. OBJECTIVES The main objective of this study is to determine the prevalence of obesity in patients with T2DM at King Fahd University Hospital (KFUH), Al-Khobar, and to assess the relationship between T2DM and cardiovascular risk factors with body mass index (BMI) and waist to hip ratio (WHR). METHODS A retrospective, cross-sectional study, included T2DM patients from the Internal Medicine department at KFHU. The investigators recorded patient demographics (age and gender), weight (kg), height (cm), body mass index (Kg/m2), waist and hip circumference (cm), smoking status, physical activity, blood pressure measurements (mmHg) and laboratory results of fasting blood glucose (FBG), glycated haemoglobin (HbA1c) and lipid profile. RESULTS Among 346 patients, the prevalence of obesity and overweight was 62.4% and 27.2%, respectively. The relationship between BMI and demographic data including age and gender was statistically significant (P<0.05). The correlation between the BMI with cardiovascular risk factors including smoking, physical activity and WHR found to be statistically significant (P<0.05). CONCLUSION Our study showed that obesity and overweight affect 89.6% of patients with T2DM. Therefore, it is important to take into consideration weight control strategies to effectively manage diabetic patients.
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Mphasha MH, Skaal L, Mothiba TM. Prevalence of overweight and obesity amongst patients with diabetes and their non-diabetic family members in Senwabarwana, Limpopo province, South Africa. S Afr Fam Pract (2004) 2022; 64:e1-e7. [PMID: 35695450 PMCID: PMC9210144 DOI: 10.4102/safp.v64i1.5409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background Diabetes remains a public health concern and the second cause of mortality in South Africa. Family history of diabetes increases risk of developing diabetes. Obesity amongst patients is associated with comorbidity, whilst amongst non-diabetic family members it is associated with developing diabetes. This study aimed at determining prevalence of overweight and obesity amongst patients with diabetes and non-diabetic family members. Methods A quantitative, cross-sectional descriptive study was conducted on 200 patients and 200 non-diabetic family members were selected using systematic random sampling from rural clinics of Senwabarwana. Data were collected using close-ended questionnaires and anthropometric measurements. Body mass index (BMI) and waist circumference were measured and interpreted according to World Health Organization guidelines. Data were analysed using Statistical Package for Social Sciences, using both descriptive and inferential statistics. Chi-square test was used to calculate associations at 95% confidence interval where a p-value of < 0.05 was considered statistically significant. Results Most patients (75.5%) had comorbidities and hypertension was most prevalent (89.0%). Over half of the patients (57.0%) and 38.0% of family members were obese. Most patients (75.0%) and 58.0% of family members had abdominal obesity. Conclusion Patients with diabetes suffer from comorbidities are overweight and obese whilst evidence from various studies suggest that non-diabetic family members are at added risk of developing diabetes because of higher BMI and abdominal obesity. There is an urgent need to create a conducive environment that discourages sedentary behaviours through lifestyle modifications using the family centred approach, and involve family members in the care of patients.
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Affiliation(s)
- Mabitsela H Mphasha
- Department of Public Health, Faculty of Healthcare Sciences, University of Limpopo, Polokwane.
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13
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Li Y, Jiang Y, Lin J, Wang D, Wang C, Wang F. Prevalence and associated factors of diabetes mellitus among individuals aged 18 years and above in Xiaoshan District, China, 2018: a community-based cross-sectional study. BMJ Open 2022; 12:e049754. [PMID: 35296469 PMCID: PMC8928303 DOI: 10.1136/bmjopen-2021-049754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 02/17/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE With the rapid development of the Chinese economy, Xiaoshan District, Zhejiang Province has experienced urbanisation, population ageing and significant lifestyle changes, so diabetes mellitus (DM) has attracted more attention. This study aimed to evaluate the prevalence of DM and its risk factors among individuals aged 18 years and above in the district. STUDY DESIGN AND METHODS A community-based cross-sectional study was carried out in Xiaoshan, China from 1 March to 31 August 2018. A multistage sampling method was used. Sociodemographic and behavioural characteristics were collected using a combination of centralised surveys and household surveys. Anthropometric parameters were measured with standardised techniques and calibrated equipment. Venous blood samples were obtained after at least 8 hours of fasting to determine the level of fasting blood glucose (FBG) and blood lipids. A standard 2-hour 75 g oral glucose tolerance test was also given if 6.1 mmol/L≤FBG<7.0 mmol/L. Univariate and multivariate logistic regression analyses were used to assess the associated factors of DM. RESULTS The overall prevalence of DM was 12.47%, and the proportion of previously undiagnosed DM (UDM) was 48.66%. The prevalence of pre-diabetes was 10.92%. Age, family history of DM (FHDM), obesity, abdominal obesity, systolic blood pressure (SBP), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) were significantly associated with DM. CONCLUSIONS This study found a high prevalence of DM and pre-diabetes, especially a high prevalence of UDM among adults. The associated risk factors identified for DM were age, FHDM, obesity, abdominal obesity, SBP, TG and HDL-C.
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Affiliation(s)
- Yurong Li
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuanyuan Jiang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Junying Lin
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Dongfei Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Chunli Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Fenjuan Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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14
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Salman AA, Salman MA, Marie MA, Rabiee A, Helmy MY, Tourky MS, Qassem MG, Shaaban HED, Sarhan MD. Factors associated with resolution of type-2 diabetes mellitus after sleeve gastrectomy in obese adults. Sci Rep 2021; 11:6002. [PMID: 33727637 PMCID: PMC7966796 DOI: 10.1038/s41598-021-85450-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/01/2021] [Indexed: 02/06/2023] Open
Abstract
Many bariatric procedures are more effective for improving type-2 diabetes mellitus (T2DM) than conventional pharmacotherapy. The current research evaluated factors linked to complete and partial remission or improvement of T2DM after laparoscopic sleeve gastrectomy (LSG). The current prospective study included all diabetic patients who were submitted LSG between January 2015 and June 2018 and completed a 2-year follow-up period. Patients were assessed at baseline and 2 years after LSG. This work comprised of 226 diabetic cases. Two years after LSG, 86 patients (38.1%) achieved complete remission of DM, and 24 (10.6%) reached partial remission. Only 14 patients (6.2%) showed no change in their diabetic status. On univariate analysis, age ≤ 45 years, duration of diabetes ≤ 5 years, use of a single oral antidiabetic, HbA1c ≤ 6.5%, HOMA-IR ≤ 4.6, C-peptide > 2.72 ng/mL, and BMI ≤ 40 kg/m2 predicted complete remission. The independent predictors of complete remission were age ≤ 45 years, duration of diabetes ≤ 5 years, use of a single oral antidiabetic, HOMA-IR ≤ 4.6, and C-peptide > 2.72 ng/mL. A combined marker of young age, short duration of DM, and low HOMA-IR predicted complete remission with sensitivity 93% and specificity 82%. Independent predictors of complete remission of T2DM after LSG were younger age, shorter duration, single oral antidiabetic, lower HOMA-IR, and higher C-peptide.
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Affiliation(s)
| | | | - Mohamed A Marie
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Rabiee
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona Youssry Helmy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Sabry Tourky
- Department of Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Mohamed Gamal Qassem
- Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hossam El-Din Shaaban
- Gastroenterology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Mohamed D Sarhan
- General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Iradukunda A, Kembabazi S, Ssewante N, Kazibwe A, Kabakambira JD. Diabetic Complications and Associated Factors: A 5-Year Facility-Based Retrospective Study at a Tertiary Hospital in Rwanda. Diabetes Metab Syndr Obes 2021; 14:4801-4810. [PMID: 34984012 PMCID: PMC8703046 DOI: 10.2147/dmso.s343974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/02/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from defects in insulin production, insulin action, or both. Despite advances in DM diagnosis and management, the incidence of DM-related complications remains high. This study aimed to determine patterns of common complications and associated factors among hospitalized patients in Rwanda. METHODS A cross-sectional study, with retrospective chart review, was conducted at CHUK from July to August, 2021. Charts for DM patients admitted from January 2016 to December 2020 were considered while those inaccessible at the time of data collection were excluded. Linear regression model was used to assess the relationship between dependent and independent variables with a p < 0.05 considered statistically significant. RESULTS A total of 246 charts were reviewed. The median age was 56 years (IQR: 14-90). More than half of participants (n = 135; 54.9%) were females; majority from the Central region (n = 138; 56.7%). Recorded DM risk factors included alcohol intake (n = 81; 48.5%); smoking (n = 40; 24.2%), obesity (n = 43; 52.4%), and family history of DM (n = 27; 56.3%). Majority (n = 153; 84.5%) had type 2 DM and (n = 147; 69%) had known their diagnosis for at least 6 years. Hypertension (n = 124, 50.4%), acute hyperglycemic state (n = 59, 24%), nephropathy (n = 58, 23.6%), and stroke (n = 38, 15.4%) were frequently reported complications. Nearly all participants (n = 81, 95.2%) with complications had poor glycemic control. Alcohol intake, age ≥45 years, and T1DM were associated with higher odds of DM complications (aOR = 8, 95% CI = 2-32.6, p = 0.003, aOR = 6.2, 95% CI = 1.4-27.6, p = 0.016 and aOR = 14.1, 95% CI = 1.2-161.5, p = 0.034, respectively). Duration of DM (p = 0.001) was significant at bivariate analysis. CONCLUSION DM complications were prevalent among the studied population with poor glycemic control mainly influenced by alcohol consumption and duration of DM. Expansion of integrated DM and hypertension screening services to lower-level centers is needed to reduce the associated morbidity and mortality.
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Affiliation(s)
- Angelique Iradukunda
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Correspondence: Angelique Iradukunda School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda Email
| | - Shallon Kembabazi
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nelson Ssewante
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Andrew Kazibwe
- Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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