Sleeping duration, napping and snoring in association with diabetes control among patients with diabetes in Qatar

Background: Poor glycemic control is associated with chronic life-threatening compli-cations. Several studies have revealed that sleep status is associated with glycemic control. Aim: to examine the association between sleep duration, quality and glycemic control among adults with diabetes. Methods: Data on 2500 participants aged 18-60 years were collected from the Qatar Biobank (QBB). Sleep duration and quality were assessed by a self-completed health and lifestyle questionnaire, and glycemic control was assessed using HbA1c. Logistic regression was used to assess the association between sleep duration, napping, snoring and poor glycemic control. Results: After adjusting for age and gender, sleep duration was not associated with poor glycemic control. Lack of association persisted after controlling for smoking, physical activity, education, BMI, fruit and vegetable intake, insulin and medication use. However, sleeping for long hours at night (?8 h) had a trend in increasing the risk of poor glycemic control (OR = 1.28; 95% CI: 0.94-1.74). Napping was positively associated with poor glycemic control. After adjusting for age and gender, patients who reported "sometimes, frequently, or always" napping had more than 30% increased risk of poor control as compared to patients who reported "never/rarely" napping. Snoring was not associated with poor glycemic control among the study sample when adjusted for age and gender (p = 0.61). Other factors were found to be associated with a better glycemic control such as female, high educational and high physical activity level. Conclusions: our results suggest that napping may be an independent risk factor for a poor glycemic control in diabetes; further investigations are required. 2021 by the authors. Licensee MDPI, Basel, Switzerland.Funding: This research was funded by Qatar University, grant number QUST-1-CHS-2021-6.Scopu

Impact of COVID-19 lockdown on smoking (waterpipe and cigarette) and participants' BMI across various sociodemographic groups in Arab countries in the Mediterranean Region

INTRODUCTION: Tobacco smokers are at high risk of developing severe COVID-19. Lockdown was a chosen strategy to deal with the spread of infectious diseases; nonetheless, it influenced people's eating and smoking behaviors. The main objective of this study is to determine the impact of the COVID-19 lockdown on smoking (waterpipe and cigarette) behavior and its associations with sociodemographic characteristics and body mass index. METHODS: The data were derived from a large-scale retrospective cross-sectional study using a validated online international survey from 38 countries (n=37207) conducted between 17 April and 25 June 2020. The Eastern Mediterranean Region (WHO-EMR countries) data related to 10 Arabic countries that participated in this survey have been selected for analysis in this study. A total of 12433 participants were included in the analysis of this study, reporting their smoking behavior and their BMI before and during the COVID-19 lockdown. Descriptive and regression analyses were conducted to examine the association between smoking practices and the participant's country of origin, sociodemographic characteristics, and BMI (kg/m2). RESULTS: Overall, the prevalence rate of smoking decreased significantly during the lockdown from 29.8% to 23.5% (p<0.05). The percentage of females who smoke was higher than males among the studied population. The highest smoking prevalence was found in Lebanon (33.2%), and the lowest was in Oman (7.9%). In Egypt, Kuwait, Lebanon, and Saudi Arabia, the data showed a significant difference in the education level of smokers before and during the lockdown (p<0.05). Smokers in Lebanon had lower education levels than those in other countries, where the majority of smokers had a Bachelor's degree. The findings show that the BMI rates in Jordan, Lebanon, Oman, and Saudi Arabia significantly increased during the lockdown (p<0.05). The highest percentages of obesity among smokers before the lockdown were in Oman (33.3%), followed by Bahrain (28.4%) and Qatar (26.4%), whereas, during the lockdown, the percentage of obese smokers was highest in Bahrain (32.1%) followed by Qatar (31.3%) and Oman (25%). According to the logistic regression model, the odds ratio of smoking increased during the pandemic, whereas the odds ratio of TV watching decreased. This finding was statistically significant by age, gender, education level, country of residence, and work status. CONCLUSIONS: Although the overall rates of smoking among the studied countries decreased during the lockdown period, we cannot attribute this change in smoking behavior to the lockdown. Smoking cessation services need to anticipate that unexpected disruptions, such as pandemic lockdowns, may be associated with changes in daily tobacco consumption. Public health authorities should promote the adoption of healthy lifestyles to reduce the long-term negative effects of the lockdown

Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar

Background: Poor glycemic control is associated with chronic life-threatening complications. Several studies have revealed that sleep status is associated with glycemic control. Aim: to examine the association between sleep duration, quality and glycemic control among adults with diabetes. Methods: Data on 2500 participants aged 18-60 years were collected from the Qatar Biobank (QBB). Sleep duration and quality were assessed by a self-completed health and lifestyle questionnaire, and glycemic control was assessed using HbA1c. Logistic regression was used to assess the association between sleep duration, napping, snoring and poor glycemic control. Results: After adjusting for age and gender, sleep duration was not associated with poor glycemic control. Lack of association persisted after controlling for smoking, physical activity, education, BMI, fruit and vegetable intake, insulin and medication use. However, sleeping for long hours at night (8 h) had a trend in increasing the risk of poor glycemic control (OR = 1.28; 95% CI: 0.94-1.74). Napping was positively associated with poor glycemic control. After adjusting for age and gender, patients who reported "sometimes, frequently, or always" napping had more than 30% increased risk of poor control as compared to patients who reported "never/rarely" napping. Snoring was not associated with poor glycemic control among the study sample when adjusted for age and gender (p = 0.61). Other factors were found to be associated with a better glycemic control such as female, high educational and high physical activity level. Conclusions: our results suggest that napping may be an independent risk factor for a poor glycemic control in diabetes. Further research is needed to establish the causal link between sleep and impaired glucose metabolism. These findings may open up new strategies for targeted intervention to improve the duration and quality of sleep

Diphenylcyclopropenone-Induced Vitiligo in a Patient with Alopecia Universalis

Alopecia areata and vitiligo are autoimmune diseases, both associated with multiple autoimmune comorbidities. Many studies show colocalization of these diseases at the same anatomical site. Here, we have a case where both disorders were reported to present in the same patient. Diphenylcyclopropenone (diphencyprone, DCP) is used in the treatment of alopecia areata and may induce vitiligo in some patients. We report on one case of vitiligo that was induced by DCP during therapy for alopecia universalis. Alopecia areata and vitiligo share many susceptibility genes. Follicular melanocyte destruction may represent the link between the two diseases

Pruritic Vesicular Eruption on the Lower Legs in a Diabetic Female

A 50-year-old diabetic female presented with highly pruritic vesicles and excoriated lesions over the anterior aspect of both lower legs. The lesions were recurrent over the last two years. She received a lot of medications with partial response. Hb A1c was 10.8% (normal up to 7%). CBC showed microcytic, hypochromic anemia. Serum zinc, folate, IgE, TSH and T4 were all within normal ranges. Biopsy showed epidermal separation secondary to keratinocyte necrosis and minimal monocytic, perivascular infiltrate. Direct immunofluorescence was negative for intraepidermal and subepidremal deposition of immunoglobulin. The dermis was positive for mucin deposition stainable by both PAS and Alcian blue while it was negative for Congo red and APC immunoperoxidase staining for amyloid material. In conclusion, the case was diagnosed as bullosis diabeticorum by distinctive clinical and pathological features and after exclusion of other possible differentials. Pruritus was partially controlled by topical potent steroid and the case was resolved spontaneously after eight months