Survey of the knowledge and attitude of physicians toward the management of diabetes mellitus during Ramadan

Ramadan fasting has been a major concern among researchers considering the theoretically imposed risk on patients with diabetes mellitus due to prolonged fasting. Studies indicate that the knowledge and practices of physicians do not comply with the proposed recommendations in this regard in many cases. This study aimed to explore the viewpoints and attitudes of physicians toward the management of diabetes mellitus regarding to Ramadan fasting. In addition, we assessed the knowledge and compliance of physicians with available recommendations regarding the management of diabetes mellitus in Ramadan. According to the results, Ninety five present of the physicians (n=862) believed the type of diabetes to be “important” or “very important” in decision-making for Ramadan fasting. Control of diabetes before Ramadan was noted as “important” or “very important” by 95% of the physicians (n=848). Moreover, the majority of respondents emphasized on the pivotal role of self-monitoring of blood glucose in the management of patients receiving insulin or sulphonylureas (SUs), and to a lesser extend in cases treated with other oral hypoglycemic agents than SUs. Among the participants, 63.8% (n=397) confirmed the availability of Ramadan-focused educational programs for their patients, whereas thirty six present (n=225) mentioned the absence of such programs. According to the results of this study, it is crucial to raise the awareness of patients and physicians about the importance of Ramadan fasting through structured educational interventions in order to reduce the health risks associated with fasting in diabetic patients. Therefore, it is recommended that simplified guidelines and educational materials be dispensed for healthcare providers for related training programs before Ramadan

The prevalence and correlates of depression among patients with chronic diseases in the United Arab Emirates.

BackgroundChronic diseases constitute a major public health problem in the United Arab Emirates (UAE) and are the leading cause of mortality and morbidity. Chronic diseases have been found to be associated with an increased prevalence of depression and depressive symptoms. Depression can have detrimental effect on the prognosis of the disease and quality of life in patients.Aims and objectivesThis study aimed to estimate the prevalence and correlates of depression in a sample of patients suffering from chronic disease in Al-Ain city, UAE.Materials and methodsA cross-sectional survey based study was conducted with 417 participants recruited from seven primary health care centers of Al-Ain city. Men and women aged 18 years and above suffering from chronic disease filled the Patient Health Questionnaire (PHQ-9). Univariate and multivariable logistic regressions were performed on the collected data to investigate correlates of different factors with depression. Data was analyzed using SPSS (version 26). The study was approved by Ambulatory Healthcare Services (AHS) Human Ethics Research Committee.ResultsThe majority 62.41% (n = 254) of the sample were females, 57.97% (n = 240) aged above 55 years and with a median (Q25, Q75) duration of chronic disease of 8 (4, 15) years. The prevalence of depression was 21.1% (95% CI: 17.5%-25.3%). With severe depression was in 1.7% and mild-moderate in 34.7% of the participants. Depression severity was statistically significantly associated with increasing age (p = 0.006), low level of education (pConclusionThe prevalence of depression was quite high and the study highlights for health care professionals and policy makers, the importance of mental health support as part of a comprehensive management plan for patients with chronic diseases. A multidisciplinary comprehensive program will improve the long-term outcomes of these patients. Patients with chronic diseases may need more support and counseling at primary health care levels

Prevalence and associated risk factors of overweight and obesity among adult population in Dubai: a population-based cross-sectional survey in Dubai, the United Arab Emirates

Objective To study the prevalence of overweight and obesity and determine the associated risk factors among adults in Dubai.Design and setting A cross-sectional survey with a multistage, stratified random sampling design was conducted in the Emirate of Dubai in 2019.Participants The study included 2142 adults aged 18+ years in the Emirate of Dubai.Results The overall prevalence of obesity, which was defined as body mass index (BMI) ≥30 kg/m2, was 17.8%. The highest obesity rates were reported among women (21.6%) and the United Arab Emirates (UAE)-nationals (39.6%). Moreover, 39.8% of the population was overweight (BMI ≥25–29.9 kg/m2). Multivariate logistic regression showed associations between obesity and age, sex, nationality, hypertension and occupation. Obesity increases with age, with the highest risk at age group 50–59 years (OR 4.30; 95% CI 1.57 to 11.78) compared with the reference group (18–24 years). Females had a higher risk of obesity than males (OR 1.62; 95% CI 1.10 to 2.38). Compared with those in the reference group (Western and others), UAE nationals, other Arabs and Asians were more likely to be obese ((OR 2.08; 95% CI 1.18 to 3.67), (OR 3.61; 95% CI 2.41 to 5.44) and (OR 1.98; 95% CI 1.12 to 3.50), respectively). Clerical and service workers (OR 4.50; 95% CI 2.54 to 8.00) and elementary and unskilled occupation categories (OR 2.57; 95% CI 1.56 to 4.25) had higher risks of obesity than the reference group (professionals), p<0.01). Hypertensive individuals had a higher risk of obesity than normotensive individuals (OR=3.96; p<0.01).Conclusions Obesity and overweight are highly prevalent among adults in Dubai and are remarkably associated with sociodemographic and behavioural risk factors. Comprehensive strategic initiatives are urgently needed to control obesity in the high-risk populations in the Emirate of Dubai

Association of depression severity with demographic and comorbidities characteristics of patients with chronic disease in the UAE (N = 417).

Association of depression severity with demographic and comorbidities characteristics of patients with chronic disease in the UAE (N = 417).</p

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

Simple and multiple logistic regression analysis of factors affecting depression in chronic disease patients in the UAE (N = 417).

Simple and multiple logistic regression analysis of factors affecting depression in chronic disease patients in the UAE (N = 417).</p