Highlights of the Twelfth Emirates Diabetes and Endocrine (Virtual) Congress, 24–26 February 2022

Backgrounds: The Twelfth Diabetes and Endocrine Virtual Congress (EDEC 2022) was held on 24–26 February 2022 due to the COVID pandemic. Objectives: We aimed to present highlights of the congress proceeding. Methods: Three rapporteurs prepared this congress report. They prepared assigned sections, reviewed the rest of the manuscript, and approved its final version. Conference Highlights: The conference contents over 3 days included a wide range of lectures by world-class experts and key opinion leaders on various topical subjects, endocrinology, diabetes care, and metabolism, in addition to original data from submitted abstracts. The virtual EDEC 2022 provided a comprehensive review of topical issues concerning clinical practice and research in diabetes, endocrinology, and metabolism. The clinical approach to managing a pituitary mass, contemporary management of acromegaly, and the challenging prolactin disorders, thyroid nodules, hyperparathyroidism, polycystic ovary, and premature ovarian failure were also discussed. On the diabetes side, emphasis on the cardiovascular outcomes, using newer agents when compelling indications exist, hypoglycemia, hypertension, and halting of chronic kidney disease progression were discussed. Other presentations considered type 1 diabetes care, the latest guidelines, role of technology in diabetes care, including telemedicine and some regional experiences. Use and abuse of testosterone were reviewed. The newer and future lipid-modifying therapies in adults and children were discussed. Conclusions: This EDEC 2022 session provided a comprehensive review of topical issues in clinical practice and research in diabetes, endocrinology, and metabolism

Pattern of Clinical Presentation and Management of Inflammatory Bowel Disease

Background: Inflammatory bowel disease (IBD) is characterized by non-specific chronic relapsing inflammation of the gastrointestinal tract and extra-intestinal manifestations. It includes Crohn’s disease (CD) ulcerative colitis (UC) and unclassified colitis.Objective: To assess the clinical presentations and management of inflammatory bowel disease in Sudanese patients.Methodology: Prospective, cross-section hospital-based study was conducted at Soba University Hospital (SUH) and Ibn Sina Hospital, in a period from December 2016 to March 2017. Data was entered and analyzed with SPSS, an interview questionnaire containing demographic, clinical, type of IBD, treatment, and complications.Results: A total of 64 IBD patients were included, 50% were diagnosed with UC, 28.1% with CD and 21.9% unclassified type. The most frequent age in UC patients was 41 – 50 years 34.4%, in CD was 31- 40 years 38.9% and for the unclassified type was 51 – 70 years 57.2%. The female was higher in CD while males were higher in Ulcerative colitis disease, symptoms were diarrhea, rectal bleeding, abdominal pain, rectal pain, tenesmus and fatigue. Study participants received 5 amino salicylic acid, and steroids, especially in the oral formulation. Minimal usage of topical forms, azathioprine, and biological agents. Conclusion: The study concluded UC is more common than CD. This should be taken into account as an important update for internal medicine professionals to adjust their expectations and lines of diagnosis, and management. The emergence of the unclassified type in Sudan requires good communication between the pathologists and the physicians and MDT meetings in every patient with suspicion of IBD

Safety of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2-I) During the Month of Ramadan in Muslim Patients with Type 2 Diabetes

Objectives: Sodium-glucose cotransporter 2 inhibitors (SGLT2-I) are a new class of antidiabetic drugs that might increase the risk of dehydration and hypoglycemia, particularly during the month of Ramadan in which Muslims abstain from eating and drinking for 14–16 hours daily. We aimed to provide real-life evidence about the safety of SGLT2-I during Ramadan. Methods: All patients over the age of 18 years on SGLT2-I before Ramadan 2016 who would be fasting during Ramadan were included. Demographic data, detailed medical history including comorbidities and medication profile, and laboratory results were collected before and after Ramadan. We also conducted a phone interview to evaluate the frequency and severity of hypoglycemia and dehydration. Results: Of the total of 417 patients, 113 (27.0%) experienced hypoglycemic events, and 93 of these (82.3%) checked their blood glucose using a glucometer. Confirmed hypoglycemia (< 70 mg/dL) was observed in 78 (83.8%). The hypoglycemic events were significantly more frequent in the SGLT2-I plus insulin-treated group than in those treated with SGLT2-I plus oral hypoglycemic agents group (p < 0.001). Confirmed hypoglycemic events were more frequent in those using SGLT2-I plus intensive insulin compared to those using SGLT2-I plus basal insulin (p = 0.020). Symptoms of dehydration were seen in 9.3% (n = 39) of the total population. We observed statistically significant reductions in glycated hemoglobin and weight by the end of Ramadan (p < 0.001). There were no significant changes in lipid profile and creatinine levels by the end of the study. Conclusions: The use of insulin in combination with SGLT2-I increases the risk of hypoglycemia during Ramadan. Hypoglycemic events were mild and did not require hospital admission. However, careful monitoring during prolonged fasting is warranted. No significant harmful effects on renal function result from treatment with SGLT2-I during Ramadan