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Alsheikh A, Alshehri A, Alzahrani S, Jammah AA, Alqahtani F, Alotaibi M, Aldahash R, Alhozali AM, Alsabaan F, Almehthel M, Aljuhani N, Aldabeis A, Alamri M, Maghawry W, Alzaman N, Alshaikh A, M Alnozha O, Issak ER, Alsifri S. Evaluating the Clinical Effectiveness and Safety of Semaglutide in Individuals with Uncontrolled Type 2 Diabetes. Real-World Evidence from Saudi Arabia: The Observational, Multicenter, 15-Month EVOLUTION Study. Diabetes Ther 2024; 15:473-485. [PMID: 38110660 PMCID: PMC10838866 DOI: 10.1007/s13300-023-01516-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/23/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION This study aimed to assess the safety and effectiveness of semaglutide, administered either by weekly subcutaneous (SC) injection or orally, in real-life practice in Saudi Arabia in individuals with type 2 diabetes mellitus (T2DM). METHODS A retrospective chart review study was conducted at 18 Saudi Arabia centers. An accredited centralized institutional review board approved the study. Medical records were included for individuals of any age ≥ 18 years with uncontrolled T2DM. The primary outcome measure was the laboratory glycated hemoglobin (HbA1c) level. Secondary measures included fasting blood glucose (FBG), weight, and hypoglycemia. All variables were checked after 6 and 12 months of semaglutide initiation. RESULTS The analysis of this study included 1223 patients with uncontrolled T2DM (HbA1c > 7%). The mean (SD) baseline HbA1c was 10.02% (1.17). HbA1c was reduced by an average of 3.02% (0.84) and 3.17% (0.84) at 6 and 12 months, respectively. Results of a repeated measure analysis of variance (ANOVA) indicated significant differences in HbA1c (p value < 0.001). HbA1c levels at 6 and 12 months were significantly lower, 7.00% (0.70) and 6.85% (0.69), than at baseline, 10.02% (1.17). About 193 patients (56.4%) of the 295 patients having HbA1c < 9% achieved HbA1c of 5.7% or less. The frequency of hypoglycemia events was 4.60 (1.10) in the 3 months before semaglutide was initiated. The frequency of hypoglycemia events in the last 3 months was 2.30 (0.80) events and 0.80 (0.50) events at 6-month and 12-month follow-up visits, respectively. The percent reduction in body mass index (BMI) was an average of 13.07% (1.53) and 19.89% (4.07) at 6 and 12 months, respectively. Lipid profile and blood pressure were improved at 6 and 12 months. CONCLUSION Semaglutide, administered either by SC injection or orally, provided substantial glycemic and weight-loss benefits in adults with T2DM.
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Affiliation(s)
- Abdulrahman Alsheikh
- King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Dr. Suliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | | | | | - Anwar A Jammah
- King Saud University Medical City, Riyadh, Saudi Arabia
- Alhammadi Hospital, Riyadh, Saudi Arabia
| | | | - Metib Alotaibi
- Alhammadi Hospital, Riyadh, Saudi Arabia
- Dr Suliman Alhabeeb Hospital, Alolya, Riyadh, Saudi Arabia
| | - Raed Aldahash
- Dr Suliman Alhabeeb Hospital, Alolya, Riyadh, Saudi Arabia
- King Abdallah Medical City, National Guard, Riyadh, Saudi Arabia
| | - Amani M Alhozali
- King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- International Medical Center, Jeddah, Saudi Arabia
| | | | | | | | | | - Moneer Alamri
- Southern Armed Forces Hospital, Khamis Mushait, Saudi Arabia
| | | | - Naweed Alzaman
- Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
- Madina Medical Center, Madinah, Saudi Arabia
| | | | - Omar M Alnozha
- Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
- Saudi German Hospital, Madinah, Saudi Arabia
| | - Emad R Issak
- Department of Internal Medicine, Ain Shams University, Cairo, Egypt.
| | - Saud Alsifri
- Alhada Armed Forces Hospital, Taif, Saudi Arabia
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Al Sifri S, Aldahash R, de Luis Roman DA, Amin A, Camprubi-Robles M, Kerr KW, Juusti-Hawkes A, Beresniak A. Optimizing Diabetes Management Using a Low-Calorie Diet in Saudi Arabia: A Cost-Benefit Analysis. Diabetes Ther 2024; 15:155-164. [PMID: 37889472 PMCID: PMC10786763 DOI: 10.1007/s13300-023-01495-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Low-calorie diets, high in protein and low in carbohydrates, are commonly recommended for patients with pre-diabetes and type 2 diabetes. The objective of this study was to carry out a cost-benefit analysis (CBA) of a low-calorie versus a standard diet from the perspective of the Saudi Arabian health system. METHODS The CBA compares costs and benefits of the two diet strategies over a 1-year time horizon. Costs included diet and diabetes treatment-related resources while benefits were measured in terms of the costs of diabetes complications avoided. Data on costs and benefits were collected from published literature and subject matter experts. Incremental costs were estimated as the cost difference between low-calorie and standard diet. Incremental benefits were estimated as cost difference from medical complications when following a low-calorie or standard diet. The incremental absolute cost-benefit ratio was calculated to show the difference between the costs and benefits of the low-calorie diet. Incremental relative cost-benefit ratio was calculated to show the cost per dollar of benefit obtained. Monte Carlo simulation modeled variability in outcomes due to variation in costs and uncertainty of diabetes complications. RESULTS The 1 year cost of standard diet was US$2515 ± 156 compared to US$2469 ± 107 per patient for a low-calorie diet. Incremental benefit is estimated at US$21,438 ± 7367 per patient. The estimated incremental absolute cost-benefit ratio was US$ - 21,360 establishing that benefits are greater than costs, while the estimated incremental relative cost-benefit ratio is 0.0037, establishing that benefits are 270 times greater than costs. CONCLUSION The low-calorie diet was the dominant strategy compared to the standard diet in modeled scenarios. These findings highlight the importance of a low-calorie diet as part of diabetes management programs for outpatients with type 2 diabetes.
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Affiliation(s)
- Saud Al Sifri
- Department of Endocrinology and Diabetes, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Raed Aldahash
- Department of Medicine, Ministry of National Guard-Heath Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz for Health Science, Riyadh, Saudi Arabia
| | - Daniel-Antonio de Luis Roman
- Servicio Endocrinología y Nutrición Hospital Clínico Universitario Valladolid, Valladolid, Spain
- Centro de Investigación de Endocrinologia y Nutrición. Facultad de Medicina, Valladolid, Spain
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Ghannam N, Alahmed S, Aldahash R, Aljohani N, Alshammary A, Amir A, Kamal A, Khader S, Salah M, Shalabi H, Abdallah A, Elboghdady A. Addressing the Continuum of Dysglycaemia and Vascular Complications in Prediabetes and Type 2 Diabetes: Need for Early and Intensive Treatment. Diabetes Metab Syndr Obes 2023; 16:105-115. [PMID: 36760588 PMCID: PMC9844108 DOI: 10.2147/dmso.s396621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
The onset of type 2 diabetes increases the risk of vascular complications and death. We know now that that this risk begins long before the diabetes diagnosis. Prediabetes and type 2 diabetes are not separate entities in practice and exist within a continuum of dysglycaemia and vascular risk that increases in severity over time. This excess risk requires early intervention with lifestyle therapy supported with pharmacologic antidiabetic therapy, intensified promptly where necessary throughout the duration of the diabetes continuum. Metformin is an evidence-based treatment for preventing prediabetes and improves cardiovascular outcomes in people with type 2 diabetes from diagnosis onwards. Newer agents (SGLT2 inhibitors and GLP-1 agonists) are appropriate for people presenting with type 2 diabetes and significant cardiovascular comorbidity. Additional therapies should be used without delay to achieve patients' individualised HbA1c goals and to minimise cardiovascular risk.
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Affiliation(s)
- Nadia Ghannam
- Ghannam Clinic, Jeddah, Saudi Arabia
- Correspondence: Nadia Ghannam, Ghannam Clinic, King Abdulaziz Road, Jeddah, 21411, Saudi Arabia, Email
| | | | - Raed Aldahash
- Ministry of National Guard (Health Affairs) and King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Afaf Alshammary
- Ministry of National Guard (Health Affairs), King Abdulaziz Medical City, Riyadh and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ashraf Amir
- Family Medicine International Medical Center, Jeddah, Saudi Arabia
| | | | - Said Khader
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Mohammed Salah
- Cairo University, Cairo, Egypt and GNP Hospital, Jeddah, Saudi Arabia
| | - Hani Shalabi
- University of Jeddah, Jeddah, Saudi Arabia
- Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
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Aldossari KK, Shubair MM, Al-Ghamdi SH, Alduraywish AA, Almeshari AA, Alrasheed AA, Aldahash R, Angawi K, Gaissi A, Alhumud HA, El-Metwally A. Psychological Wellbeing of Diabetic Individuals, Prediabetics, and Non-diabetics: A Population-Based Study in Saudi Arabia. Front Psychol 2022; 13:863861. [PMID: 35769727 PMCID: PMC9236127 DOI: 10.3389/fpsyg.2022.863861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe increased burden of diabetes affects the quality of life, including psychosocial problems. The study aims to compare the psychological well-being of individuals who are prediabetic, diabetic, or non-diabetic.MethodsA cross-sectional exploratory study was conducted from January to June 2016 (n = 1,019) in Al Kharj, Saudi Arabia. After consent and questionnaires were filled out, trained staff took blood samples followed by anthropometry. Chi-squared tests, one-way ANOVA, and multiple linear regression analyses were conducted to examine the association between diabetes classes defined by HbA1c cut-off levels set by the American Diabetes Association (three categories), individual items, and total score in general health questionnaire (GHQ). An ROC curve was plotted for the total GHQ-12 score against HbA1c.FindingsThe mean GHQ score for psychological distress was significantly higher (F = 6.569, P = 0.038) in the diabetics (mean = 14.7) and the prediabetics (12.4) than in the non-diabetics (10.71). Four out of six positive GHQ items and three out of six negative GHQ items significantly differed among the three classes of diabetes. The adjusted multivariate analysis revealed that people with diabetes were most likely to report psychological distress compared to non-diabetics (unstandardized beta = 2.414; P = 0.037). The AUC examining the relationship between HBA1c and GHQ scores showed a moderate but statistically insignificant sensitivity/specificity of 0.643 (P = 0.23).ConclusionThis study demonstrates that psychological wellbeing is substantially poorer among diabetic or prediabetic individuals than non-diabetic individuals. Future longitudinal studies are required to examine a plausible causal relationship between diabetes/prediabetes and psychological distress.
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Affiliation(s)
- Khaled K. Aldossari
- Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- *Correspondence: Khaled K. Aldossari ; orcid.org/0000-0003-3265-8651
| | - Mamdouh M. Shubair
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Sameer H. Al-Ghamdi
- Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | | | - Abdullah A. Alrasheed
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Raed Aldahash
- Department of Medicine, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz for Health Science, Riyadh, Saudi Arabia
| | - Khadijah Angawi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anood Gaissi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hana Abdullah Alhumud
- Research and Education Department, Saudi National Institute for Health Research, Riyadh, Saudi Arabia
| | - Ashraf El-Metwally
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Al-Ghamdi S, Shubair MM, Angawi K, Al-Zahrani J, Khormi AAM, Alshammari RF, Alshammari NS, Aldahash R, Otayf BY, Al-Zahrani HS, Aleshaiwi MS, Aldossari KK. Combined' Neck/Back Pain and Psychological Distress/Morbidity Among the Saudi Population: A Cross-Sectional Study. Front Psychol 2022; 13:870600. [PMID: 35519627 PMCID: PMC9066093 DOI: 10.3389/fpsyg.2022.870600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022] Open
Abstract
Background Psychological distress/morbidity is amongst the primary reason for the cause of pain at multiple sites, its progression, and recovery. Though still not very clear if physical pain in the neck or the back may predict psychological morbidities or not. Thus, we investigated the association between combined neck or back pain and psychological distress/morbidity. Methods A cross-sectional study was conducted in Al-Kharj, Saudi Arabia, including 1,003 individuals. The questionnaire comprised of General Health Questionnaire-12 (GHQ-12) and some questions about neck and back pain. Data analysis was done using statistical software SPSS version 26.0. Results The results of the multivariate analysis revealed a significant positive association between neck/back pain status and total GHQ score (unstandardized Beta = 2.442, P ≤ 0.0001). Having neck/back pain had almost a 2.5 times greater risk of psychological distress/morbidity. Further, females were more likely to have a higher risk of psychological distress/morbidity (unstandardized Beta = 1.334, P = 0.007) than males while adjusting for sociodemographic and clinical characteristics. Conclusion The combination of neck and back pain was significantly associated with the Saudi population’s psychological problems. Therefore, the Saudi government needs to devise high-risk strategies and allocate adequate resources to the cause so that at-risk people can be shielded from the adverse complications arising from this condition in the long run.
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Affiliation(s)
- Sameer Al-Ghamdi
- Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mamdouh M Shubair
- School of Health Sciences, University of Northern British Columbia (UNBC), Prince George, BC, Canada
| | - Khadijah Angawi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jamaan Al-Zahrani
- Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Abdulrahman Ali M Khormi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Reem Falah Alshammari
- Family and Community Medicine Department, University of Hail (UOH), Hail, Saudi Arabia
| | | | - Raed Aldahash
- King Abdullah International Medical Research Center (KAIMRC), Department of Medicine, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | | | - Hayat Saleh Al-Zahrani
- Family Medicine and Medical Education, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Khaled K Aldossari
- Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Gaikwad A, Mehta V, Shah C, Agrawal M, Shaik RA, Alharbi MB, Alrouji M, Alhajlah S, Alomeir O, Kumar Ahmad R, Ahmad MS, Alanazi FH, Alharbi A, Tawakul A, Hemdi MT, Aldossari KK, Aldahash R. Retrospective Analysis of Neutralizing Antibody Cocktail (Casirivimab and Imdevimab): A Game Changer in Treating Mild COVID-19 Patients. Indian J Pharm Sci 2022. [DOI: 10.36468/pharmaceutical-sciences.spl.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Aldahash R. Rare Presentation of Hypoglycemia in a Patient with Anaplastic Large-Cell Lymphoma. Case Rep Endocrinol 2021; 2021:6843103. [PMID: 34900354 PMCID: PMC8660226 DOI: 10.1155/2021/6843103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
Anaplastic large-cell lymphoma is a rare type of aggressive non-Hodgkin's lymphoma, and arriving at a final diagnosis for this tumor is a challenge for the healthcare providers. Usually, it involves the lymph nodes and extranodal tissues such as the lungs, skin, and other soft tissues. Its presentation by extending into different organs such as the liver, lungs, bones, spleen, and thyroid is rare. Thus, involvement of other organs is very rare as we found in a 54-year-old male patient, a known case of hypertension and end-stage renal disease who was on hemodialysis, who presented to the emergency department with a history of generalized weakness and weight loss of about 20 kg for two months. The tumor cells are positive for CD45, CD30, CD15, MUMi, and Ki-67 (80%) and negative for CD20, PAX-5, CD79a, CD3, CD5, CD10, BCL6, BCL2, EMA, ALK-1, and CD138. The patient was hypoglycemic and hypercalcemic and was managed accordingly. The patient was evaluated, and the third assessment showed that hypoglycemia was resolved due to dexamethasone. The patient's glucose storage was depleted most likely due to liver involvement plus poor general condition. It was asserted that the patient's hypoglycemia could be related to his underlying malignancy. Also, the patient was advised to start tablet diazoxide 45 mg three times a day (3 mg/kg/day TID) in addition to levothyroxine tablet 50 mcg once a day. Tablet diazoxide was stopped, and nutritional support was recommended. This case reveals a rare systematic ALK-1-negative anaplastic large-cell lymphoma that involves multiple organs. The main learning point from this report is that these tumors can present atypically even in adults and can be ALK-1 negative, which is contrary to the typical systematic anaplastic large-cell lymphomas that are positive for ALK.
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Affiliation(s)
- Raed Aldahash
- Department of Medicine, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz for Health Science, Riyadh, Saudi Arabia
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Aldahash R. Efficacy of Glucagon-Like Peptide-1 Receptor Agonists in the Weight Loss Among Obese Individuals: A Systematic Review. J Endocrinol Metab 2021. [DOI: 10.14740/jem745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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