Physicians Perspective Towards Impaired Awareness of Hypoglycaemia in Patients With Diabetes: A Forgotten Area

Aim This study aims to assess knowledge, and practices of primary care physician in Saudi Arabia about IAH. Method: A cross-sectional study conducted using a newly designed self-administered questionnaire among 292 primary care physicians at three tertiary hospitals and primary care clinics in Riyadh, Saudi Arabia between December 2018 and June 2019. Results Of the participants, 59.9% of them had acceptable knowledge of IAH while only 40.1% had poor knowledge. Around half (46.2%) of physicians rated their familiarity with IAH as average or above average, and these had higher mean knowledge scores than participants who reported below average familiarity (mean 5.32 versus 4.39) (P = 0.000). Higher mean knowledge scores were found among physicians who have managed IAH patients than those who have not managed IAH patients (5.58 versus 5.01) (P = 0.019). The differences between physicians’ mean knowledge scores and their ages, levels of training, and years in practice were statistically significant. Conclusion: A considerable gap was established in the knowledge, awareness, and practice of IAH among physicians in Saudi Arabia. An effort is needed to implement extensive educational activities about impaired hypoglycemia awareness to be directed to primary care physicians and further research in this area is warranted

Clinical Inertia in the Management of Type 2 Diabetes Mellitus: A Systematic Review

This review seeks to establish, through the recent available literature, the prevalence of therapeutic intensification delay and its sequences in poorly controlled Type 2 Diabetes Mellitus (T2DM) patients. The strategy identified studies exploring the clinical inertia and its associated factors in the treatment of patients with T2DM. A total of 25 studies meeting the pre-established quality criteria were included in this review. These studies were conducted between 2004 and 2021 and represented 575,067 patients diagnosed with T2DM. Trusted electronic bibliographic databases, including Medline, Embase, and the Cochrane Central Register of Controlled Trials, were used to collect studies by utilizing a comprehensive set of search terms to identify Medical Subject Headings (MeSH) terms. Most o the studies included in this review showed clinical inertia rates over 50% of T2DM patients. In the USA, clinical inertia ranged from 35.4% to 85.8%. In the UK, clinical inertia ranged from 22.1% to 69.1%. In Spain, clinical inertia ranged from 18.1% to 60%. In Canada, Brazil, and Thailand, clinical inertia was reported as 65.8%, 68%, and 68.4%, respectively. The highest clinical inertia was reported in the USA (85.8%). A significant number of patients with T2DM suffered from poor glycemic control for quite a long time before treatment intensification with oral antidiabetic drugs (OADs) or insulin. Barriers to treatment intensification exist at the provider, patient, and system levels. There are deficiencies pointed out by this review at specialized centers in terms of clinical inertia in the management of T2DM including in developed countries. This review shows that the earlier intensification in the T2DM treatment is appropriate to address issues around therapeutic inertia

The willingness of Saudi men with type 2 diabetes to discuss erectile dysfunction with their physicians and the factors that influence this.

OBJECTIVES:The study's objectives were to find out the proportion of Saudi men with type 2 diabetes who have been asked by their physicians about erectile dysfunction (ED) in the last year, to determine the willingness of Saudi men with type 2 diabetes to discuss ED, and to explore the factors that may be related to their willingness to discuss ED with their physicians. METHODS:This study employed a cross-sectional survey design using a quantitative self-administered questionnaire among 309 Saudi men with type 2 diabetes. The study was conducted in hospital-based primary care clinics at King Khalid University Hospital, Riyadh, Saudi Arabia during the period from July to September 2015. RESULTS:The mean age of the patients was 60.2 years with the mean duration of diabetes approximately 12.5 years. Few of the patients (9.7%) had been asked by their physicians about ED within the last year of attending the clinics although most patients (84.8%) were willing to discuss this issue. The presence of ED among the respondents was 89%. Two participants' characteristics were associated with a willingness to discuss ED with the physicians. These characteristics were age above 60 (OR = 0.25, 95% CI: 0.11-0.55), and having severe ED (OR = 0.26, 95% CI: 0.08-0.85). The respondents' main barriers to discussing ED with their physicians were embarrassing the doctor, ED is a personal issue, too old or too sick to address ED issues now, no effective treatment available, and the doctor is too young to discuss ED with. CONCLUSIONS:Most patients who have type 2 diabetes are not asked about ED within the last year of attendance even though most are willing to discuss it with their physicians. Being older and suffering more severe ED will result in being less willing to discuss ED with their doctor. Further research is needed to explore the barriers which prevent physicians from discussing ED with their patients who have diabetes

The willingness of Saudi men with type 2 diabetes to discuss erectile dysfunction with their physicians and the factors that influence this

<div><p>Objectives</p><p>The study’s objectives were to find out the proportion of Saudi men with type 2 diabetes who have been asked by their physicians about erectile dysfunction (ED) in the last year, to determine the willingness of Saudi men with type 2 diabetes to discuss ED, and to explore the factors that may be related to their willingness to discuss ED with their physicians.</p><p>Methods</p><p>This study employed a cross-sectional survey design using a quantitative self-administered questionnaire among 309 Saudi men with type 2 diabetes. The study was conducted in hospital-based primary care clinics at King Khalid University Hospital, Riyadh, Saudi Arabia during the period from July to September 2015.</p><p>Results</p><p>The mean age of the patients was 60.2 years with the mean duration of diabetes approximately 12.5 years. Few of the patients (9.7%) had been asked by their physicians about ED within the last year of attending the clinics although most patients (84.8%) were willing to discuss this issue. The presence of ED among the respondents was 89%. Two participants’ characteristics were associated with a willingness to discuss ED with the physicians. These characteristics were age above 60 (OR = 0.25, 95% CI: 0.11–0.55), and having severe ED (OR = 0.26, 95% CI: 0.08–0.85). The respondents’ main barriers to discussing ED with their physicians were embarrassing the doctor, ED is a personal issue, too old or too sick to address ED issues now, no effective treatment available, and the doctor is too young to discuss ED with.</p><p>Conclusions</p><p>Most patients who have type 2 diabetes are not asked about ED within the last year of attendance even though most are willing to discuss it with their physicians. Being older and suffering more severe ED will result in being less willing to discuss ED with their doctor. Further research is needed to explore the barriers which prevent physicians from discussing ED with their patients who have diabetes.</p></div

Association between willingness to discuss erectile dysfunction (ED) with the physician and participants’ socio-demographic and clinical characteristics.

<p>Association between willingness to discuss erectile dysfunction (ED) with the physician and participants’ socio-demographic and clinical characteristics.</p

Participants’ socio-demographic and clinical characteristics (N = 309).

<p>Participants’ socio-demographic and clinical characteristics (N = 309).</p

Comparison between participants’ willingness to discuss ED with the physicians, and identified barriers.

<p>Comparison between participants’ willingness to discuss ED with the physicians, and identified barriers.</p

Predicting participants’ willingness to discuss erectile dysfunction (ED).

<p>Predicting participants’ willingness to discuss erectile dysfunction (ED).</p

Distribution of identified participants’ barriers to discussing ED with their physicians.

<p>Distribution of identified participants’ barriers to discussing ED with their physicians.</p

Factors Associated with an Unhealthy Lifestyle among Adults in Riyadh City, Saudi Arabia

Background: Unhealthy lifestyles are a global concern. This study measured the prevalence and factors associated with an unhealthy lifestyle in Riyadh city, Saudi Arabia. Methods: An interview-based, cross-sectional study was conducted with 968 males and 2029 females, aged 30–75 years, covering 18 primary health care centers in Riyadh. Multivariate logistic regression analyses were conducted to identify the significant determinants associated with an unhealthy lifestyle. Results: Overall, men were 1.49 (1.28, 1.74) times at higher risk of an unhealthy lifestyle compared to women. Men reporting unhealthy lifestyle were 2.1 (1.3, 3.4) and 1.5 (1.0, 2.6) times more likely than men with healthy lifestyle to cite not enjoying physical activity, lack of social support, and not having enough information about a healthy diet [1.5 (1.0, 2.0)], whereas those ≥ 45 years age group were 30 times less likely to report unhealthy lifestyle [0.7 (0.5, 0.9)]. In contrast, in women aged ≥ 45 years [1.3 (1.1, 1.7)], lack of motivation [1.3 (1.1, 1.7)], feeling conscious while exercising [2.0 (1.4, 2.9)], not enjoying healthy food [1.6 (1.3, 2.1)], and no family support to prepare healthy food [1.4 (1.1, 1.8)] were significantly associated with an unhealthy lifestyle. Conclusions: In a Saudi sample, younger men and older women are at higher risk of an unhealthy lifestyle. In addition to self-motivation, combined strategies to promote physical activity and healthy eating are required to improve lifestyle