Translation, psychometric evaluation and validation of the “diabetes health profile-18” questionnaire in Arabic

Introduction: measuring quality of life requires an instrument validated in the population language. The purpose of our study was to translate and analyze the psychometric properties of the literary Arabic version of the “diabetes health profile (DHP)-18”. Methods: we conducted a methodological study for psychometric evaluation and validation of the DHP-18, following the steps of the cross-cultural validation described by Vallerand. A convenience sample of people with diabetes was collected for this purpose. The developed questionnaire included participants‘ demographic characteristics, diabetes data and the experimental version of the DHP-18 questionnaire. Validity, reliability and questionnaire standards establishment were carried out. Results: a sample of 333 diabetics was recruited. Test-retest correlation coefficient (r = 0.985; p<0.01) and Cronbach's alpha coefficient (alpha = 0.840) showed that the experimental version was accurate in terms of temporal stability and internal consistency. The content validity index was 0.84 and showed that the questionnaire statements accurately measured the concepts under study. The exploratory principal axis factoring, using the orthogonal varimax rotation, allowed the extraction of a factorial solution with four independent factors, grouping the 18 items of the questionnaire. Correlation coefficients between the three corresponding dimensions of the theoretical model of the questionnaire were low and positive, between 0.431 and 0.535, confirming that each dimension measured a unique content. Conclusion: the literary Arabic version of the DHP-18 has proven to be valid, reliable and ready for use in clinical practice in Tunisian people with diabetes

Benzylthiouracil-Induced Glomerulonephritis

Vasculitis is a rare complication of antithyroid drugs (ATDs). It was first described with Propylthiouracil (PTU). We report a new case of antineutrophil cytoplasmic antibody (ANCA) vasculitis with glomerulonephritis induced by Benzylthiouracile (BTU). A 50-year-old man with Graves disease treated with BTU developed general malaise and haematuria without skin rash or respiratory involvement. Laboratory data revealed acute renal failure with proteinuria and haematuria. An indirect immunofluorescence test for ANCA was positive, showing a perinuclear pattern with specificity antimyeloperoxidase (MPO). A renal biopsy was performed and revealed pauci-immune extracapillary glomerular nephropathy and necrotic vasculitis lesions. Based on these findings we concluded to the diagnosis of rapidly progressive glomerulonephritis associated with ANCA induced by BTU therapy. The drug was therefore discontinued and the patient was treated with steroids and immunosuppressive treatment during 3 months. Renal failure, proteinuria and haematuria significantly improved within 2 months. However, P-ANCA remained positive until 10 months after drug withdrawal. Thyroid function was kept within normal range using iodine solution. We demonstrated clearly that BTU may induce severe forms of vasculitis with glomerulonephritis. Thus, the ANCA must be measured when confronted to systemic manifestation during treatment

Monogenic diabetes characteristics in a transnational multicenter study from Mediterranean countries

International audienceBackground: Diagnosis of monogenic diabetes has important clinical implications for treatment and health expenditure. However, its prevalence remains to be specified in many countries, particularly from South Europe, North Africa and Middle-East, where non-autoimmune diabetes in young adults is increasing dramatically.Aims: To identify cases of monogenic diabetes in young adults from Mediterranean countries and assess the specificities between countries.Methods: We conducted a transnational multicenter study based on exome sequencing in 204 unrelated patients with diabetes (age-at-diagnosis: 26.1 ± 9.1 years). Rare coding variants in 35 targeted genes were evaluated for pathogenicity. Data were analyzed using one-way ANOVA, chi-squared test and factor analysis of mixed data.Results: Forty pathogenic or likely pathogenic variants, 14 of which novel, were identified in 36 patients yielding a genetic diagnosis rate of 17.6%. The majority of cases were due to GCK, HNF1A, ABCC8 and HNF4A variants. We observed highly variable diagnosis rates according to countries, with association to genetic ancestry. Lower body mass index and HbA1c at study inclusion, and less frequent insulin treatment were hallmarks of pathogenic variant carriers. Treatment changes following genetic diagnosis have been made in several patients.Conclusions: Our data from patients in several Mediterranean countries highlight a broad clinical and genetic spectrum of diabetes, showing the relevance of wide genetic testing for personalized care of early-onset diabetes