Prevalence and Correlates of Diabetic Peripheral Neuropathy in a Saudi Arabic Population: A Cross-Sectional Study

The purpose of this cross-sectional study was to investigate the prevalence and correlates of diabetic peripheral neuropathy (DPN) in a Saudi population. The study population consisted of 552 diabetic participants with an average age of 53.4 years. Among this population, 62.7% were male and 94.9% had type 2 diabetes. The average body mass index was 31.1 kg/m2. DPN was diagnosed based on a combination of reduced vibration perception measured by neurothesiometer and/or reduced light touch perception evaluated by the 10-g Semmes-Weinstein monofilament, as well as neurological symptoms. Information on socio-demographic variables, smoking status, duration of diabetes, and medications was obtained through interviews by physicians. Body weight, height, waist circumference, blood pressure and clinical markers were assessed following standard procedures. The prevalence of DPN in this population was 19.9% (95% CI, 16.7%-23.5%). In the multivariable analyses, longer duration of diabetes [odds ratio (OR) for every 5-year increase, 2.49, 95% CI, 1.75-3.53], abdominal obesity (OR, 2.53, 95% CI, 1.41-4.55), and higher levels of fasting blood glucose (OR for every 1 mmol/L increase, 1.05, 95% CI, 0.99-1.12), creatinine (OR for every 10 µmol/L increase, 1.07, 95% CI, 0.99-1.14) and white blood cell count (OR for every 106/L increase, 1.08, 95% CI, 1.01-1.16) were associated with higher odds of DPN, while oral hypoglycemic medication use was associated with a lower odds of DPN (OR, 0.47, 95% CI, 0.26-0.85). In this large Saudi population, several correlates for DPN, in addition to glycemic control and diabetes duration, were identified, including abdominal obesity, creatinine and white blood cell count

The puzzle of self-reported weight gain in a month of fasting (Ramadan) among a cohort of Saudi families in Jeddah, Western Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>During Ramadan fast, approximately one billion Muslims abstain from food and fluid between the hours of sunrise to sunset, and usually eat a large meal after sunset and another meal before sunrise. Many studies reported good health-related outcomes of fasting including weight loss. The objective of this study is to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a group of families in Jeddah, Western Saudi Arabia.</p> <p>Methods</p> <p>A Cross-section study using a pre-designed questionnaire to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a representative cohort of Saudis living in Jeddah. It was piloted on 173 nutrition students and administered by them to their families.</p> <p>Results</p> <p>A total of 173 Saudi families were interviewed. One out of 5 indicated that their expenditure increases during Ramadan. Approximately two thirds of the respondents (59.5%) reported weight gain after Ramadan. When asked about their perspective explanations for that: 40% attributed that to types of foods being rich in fat and carbohydrates particularly date in (Sunset meal) 97.7% and rice in (Dawn meal) 80.9%. One third (31.2%) indicated that it was due to relative lack of physical exercise in Ramadan and 14.5% referred that to increase in food consumption. Two thirds (65.2%) of those with increased expenditure reported weight gain.</p> <p>Conclusion</p> <p>Surprisingly weight gain and not weight loss was reported after Ramadan by Saudis which indicates timely needed life-style and dietary modification programs for a population which reports one of the highest prevalence rates of diabetes.</p

Self-reported use of complementary and alternative medicine (CAM) products in topical treatment of diabetic foot disorders by diabetic patients in Jeddah, Western Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>There is little published on current Saudi diabetic patients' practices when they are exposed to foot disorders such as open wound, ulcer, and skin cracks. These factors are usually influenced by local culture and communities beliefs. The aim of the current study was to identify the pattern of patients' use of CAM products in dealing with diabetic foot disorders topically in a group of diabetic patients.</p> <p>Findings</p> <p>A Cross-sectional descriptive study of a representative cohort of diabetic patients living in Jeddah, Saudi Arabia was designed. A pre-designed questionnaire to identify local diabetics' practices in dealing topically with foot disorders including open wound, chronic ulcer, and skin cracks was designed. Questionnaire was administered by a group of trained nutrition female students to diabetics face to face living in their neighborhood. A total of 1634 Saudi diabetics were interviewed. Foot disorders occurred in approximately two thirds of the respondents 1006 (61.6%). Out of the 1006 patients who had foot disorders, 653 reported trying some sort of treatment as 307 patients (47.1%) used conventional topical medical treatment alone, 142 (21.7%) used CAM products alone, and 204 (31.2%) used both treatments. The most commonly used CAM product by the patients was Honey (56.6%) followed by Commiphora Molmol (Myrrh) in (37.4%) and Nigellia Sativa (Black seed) in (35.1%). The least to be used was Lawsonia inermis (Henna) in (12.1%). Ten common natural preparations used topically to treat diabetic foot disorders were also identified.</p> <p>Conclusions</p> <p>The use of CAM products in topical treatment of diabetic foot disorders is fairly common among Saudi diabetic patients. Honey headed the list as a solo topical preparation or in combination with other herbs namely black seeds and myrrh. The efficacy of the most common products needs further research.</p

Antibacterial and Antioxidant Potency of Floral Honeys from Different Botanical and Geographical Origins

In order to assess their physicochemical and antioxidant properties as well as their antimicrobial potency, four varieties of honey from different botanical and geographical origins were used. The agar incorporation method was used to determine the antimicrobial potency of honeys. The total phenol content was determined by a modified Folin–Ciocalteu method and the free radical scavenging activity by the Fe3+ reducing power (FRAP) assay. Manuka honey was the most effective against Staphylococcus aureus Oxa R and S. aureus Oxa S with a Minimum Inhibitory Concentration (MIC) of 6% and 7%, respectively, whereas wild carrot honey was the most effective against Pseudomonas aeruginosa, with a MIC of 12%. Lavender honey was the least effective against all tested strains, even though was found to have the lowest pH and water content. Manuka honey had the highest content of polyphenols, with 899.09 ± 11.75 mg gallic acid/kg, whereas lavender honey had the lowest, with 111.42 ± 3.54 mg gallic acid/kg. A very significant correlation (r value was 0.9079 at P < 0.05) was observed between the total polyphenolic content and the Fe2+ content formed in the presence of the honey antioxidants. The differences between honey samples in terms of antibacterial and antioxidant activity could be attributed to the natural variations in floral sources of nectar and the different locations

Antibacterial and Antioxidant Potency of Floral Honeys from Different Botanical and Geographical Origins

In order to assess their physicochemical and antioxidant properties as well as their antimicrobial potency, four varieties of honey from different botanical and geographical origins were used. The agar incorporation method was used to determine the antimicrobial potency of honeys. The total phenol content was determined by a modified Folin–Ciocalteu method and the free radical scavenging activity by the Fe&lt;sup&gt;3+&lt;/sup&gt; reducing power (FRAP) assay. Manuka honey was the most effective against &lt;em&gt;Staphylococcus aureus &lt;/em&gt;Oxa R and &lt;em&gt;S. aureus &lt;/em&gt;Oxa S with a Minimum Inhibitory Concentration (MIC) of 6% and 7%, respectively, whereas wild carrot honey was the most effective against &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt;,&lt;em&gt; &lt;/em&gt;with a MIC of 12%. Lavender honey was the least effective against all tested strains, even though was found to have the lowest pH and water content. Manuka honey had the highest content of polyphenols, with 899.09 ± 11.75 mg gallic acid/kg, whereas lavender honey had the lowest, with 111.42 ± 3.54 mg gallic acid/kg. A very significant correlation (&lt;em&gt;r&lt;/em&gt; value was 0.9079 at &lt;em&gt;P&lt;/em&gt; &lt; 0.05) was observed between the total polyphenolic content and the Fe&lt;sup&gt;2+&lt;/sup&gt; content formed in the presence of the honey antioxidants. The differences between honey samples in terms of antibacterial and antioxidant activity could be attributed to the natural variations in floral sources of nectar and the different locations

Association between risk factors and prevalence of diabetic peripheral neuropathy among individuals with diabetes. ^†

<p>Abbreviations: SR, Saudi riyal (currency unit of Saudi Arabia); HbA1c, glycated hemoglobin; HDL, high-density lipoprotein cholesterol; LDL, low-density lipoprotein cholesterol; CRP, C-reactive protein.</p>†<p>Logistic regression model adjusted for sex, age (continuous) and nationality (Saudi, non-Saudi).</p>‡<p>For ordinal variables, <i>P</i>-value was estimated from the linear trend test.</p><p>Association between risk factors and prevalence of diabetic peripheral neuropathy among individuals with diabetes. ^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0106935#nt106" target="_blank">†</a>}</p

Backward multivariate logistic regression of risk factors associated with diabetic peripheral neuropathy. ^†

†<p>Logistic regression model adjusted for sex, age (continuous), nationality (Saudi Arabia, non-Saudi Arabia), abdominal obesity (case, non-case), Oral hypoglycemic (user, non-user), duration of DM (every 5 years), fasting blood glucose (every 1 mmol/L), creatinine (every 10 ìmol/L), and White blood cell (every 10⁶/L).</p>‡<p>For ordinal variables, <i>P</i>-value was estimated from the linear trend test.</p><p>Backward multivariate logistic regression of risk factors associated with diabetic peripheral neuropathy. ^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0106935#nt108" target="_blank">†</a>}</p

Molecular Mechanism Underlying Anti-Inflammatory and Anti-Allergic Activities of Phytochemicals: An Update

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Characteristics of participants according to diabetic peripheral neuropathy status.

<p>Abbreviations: DPN, diabetic peripheral neuropathy; SR, Saudi riyal (currency unit of Saudi Arabia); HbA1c, glycated hemoglobin; HDL, high-density lipoprotein cholesterol; LDL, low-density lipoprotein cholesterol; CRP, C-reactive protein.</p>†<p><i>P</i>-values were calculated from logistic regression models for categorical variables or quantile regression for continuous variables adjusted for age, sex and nationality when applicable.</p>‡<p>n (%) for all such values</p>§<p>median (25% percentile – 75% percentile) for all such values</p><p>Characteristics of participants according to diabetic peripheral neuropathy status.</p