Prevalence of diabetic retinopathy in the United Arab Emirates: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>Diabetic retinopathy (DR) is one of the leading causes of blindness. The aim of this study was to estimate the prevalence and determinants of retinopathy among diabetics in Al-Ain city, United Arab Emirates (UAE).</p> <p>Methods</p> <p>The study was part of a general cross-sectional survey carried out to assess the prevalence of diabetes (DM) complications including retinopathy among known diabetic patients in Al-Ain District, UAE. Patients were randomly selected during 2003/2004. Patients completed an interviewer-administered questionnaire carried out by treating doctors and underwent a complete medical assessment. All patients were examined for evidence of diabetic retinopathy by ophthalmologist and their fundi were examined using slit lamp examination and fundus photography of each eye through dilated pupils.</p> <p>Results</p> <p>A sample of 513 diabetic patients was selected with a mean age of 53 years (SD ± 13.01). Retinopathy was present in 19% (95% CI: 15.1–23.5%) of the study population. Most patients (74%) were not aware of their condition. The disease was more common among males (24.2 vs. 13.9%; p = 0.016), increased with increasing age (p = 0.004) and disease duration (p = 0.0001). Type I DM was a highly significantly contributing risk factor (38.3% for type 1, vs. 16.4% for type 2; p < 0.0001). Retinopathy was higher among patients with hypertension, microalbuminuria, peripheral vascular disease, coronary artery disease and neuropathy.</p> <p>Conclusion</p> <p>The prevalence of DR in the UAE was (19%) and significantly affected elderly males. Regular screening to detect DR is highly recommended as with the early detection of proliferative retinopathy and timely laser photocoagulation which are known to prevent most of the diabetes related blindness.</p

The prevalence of macrovascular complications among diabetic patients in the United Arab Emirates

<p>Abstract</p> <p>Background</p> <p>Diabetes Mellitus (DM) is a major public health problem in the UAE with a prevalence rate reaching 24% in national citizens and 17.4% in expatriates. The aim of this study was to determine the prevalence and risk factors of macrovascular complications among diabetic patients in the Al-Ain district of the United Arab Emirates (UAE).</p> <p>Methods</p> <p>The study was part of a general cross-sectional survey carried out to assess the prevalence of diabetes (DM) complications among known diabetic patients in Al-Ain District, UAE. Patients were randomly selected during 2003/2004. Patients completed an interviewer-administered questionnaire carried out by treating doctors and underwent a complete medical assessment including measurement of height, weight, blood pressure and examination for evidence of macrovascular complications. A standard ECG was recorded and blood samples were taken to document fasting blood sugar, glycosylated haemoglobin (HbA_1C) and lipid profile.</p> <p>Results</p> <p>A sample of 513 diabetic patients was selected with a mean age of 53 years (SD ± 13.01). Overall, 29.5% of DM patients had evidence of macrovascular complications: 11.6% (95% CI: 8.8–14.4) of patients had peripheral vascular disease (PVD), 14.4% (95% CI: 11.3–17.5) had a history of coronary artery disease (CAD) and 3.5% (95% CI: 1.9–5.1%) had cerebrovascular disease (CVD). Of the total population surveyed 35% (95%CI: 30.8–39) had hypertension. The analysis showed that macrovascular complications in diabetic patients were more common among males, increased with age, were more common among hypertensive patients and its prevalence increased steadily with duration of DM.</p> <p>Conclusion</p> <p>Our data revealed a significant association between hypertension and presence of macrovascular disease among diabetic patients. However, the risk of CAD in the UAE was relatively low compared to that seen in patients in other geographical settings. In addition, a lack of correlation between macrovascular disease and glycemic control among patients with DM was observed.</p

Health literacy among pregnant women in the United Arab Emirates:The Mutaba’ah study

Background: Health literacy is the degree to which individuals can obtain, process, understand, and communicate health-related information. Health literacy among pregnant women, in particular, may have a significant impact on maternal and child health. In the United Arab Emirates, no previous studies have been carried out to investigate the health literacy levels of pregnant women. Objective: This study aimed to investigate antenatal health literacy levels and identify associated factors among pregnant Emirati women in the United Arab Emirates. Design: This analysis was based on the baseline cross-sectional data for pregnant women participating in the prospective cohort Mutaba’ah Study, recruited between May 2017 and August 2022. Methods: Participants completed a self-administered questionnaire during their antenatal visits that collected sociodemographic and pregnancy-related information. Adequacy of health literacy was assessed using the BRIEF health literacy screening tool with adequate health literacy defined as a score ⩾ 17. Regression modeling investigated the association between the pregnant women characteristics with having adequate health literacy level (ability to read and comprehend most patient education materials). Results: A total of 2694 responses to the BRIEF health literacy screening tool were analyzed. Approximately, three-quarters (71.6%) of respondents showed adequate health literacy, followed by marginal (22.8%), and limited (5.6%) health literacy levels, respectively. Higher education levels (adjusted odds ratio (aOR) = 1.74, 95% confidence interval = 1.46–2.08), employment (adjusted odds ratio = 1.35, 95% confidence interval = 1.10–1.65), and adequate social support (adjusted odds ratio = 1.69, 95% confidence interval = 1.26–2.28) were associated with adequate health literacy levels. Participants who expressed worry about birth were less likely to have adequate literacy levels (adjusted odds ratio = 0.70, 95% confidence interval = 0.58–0.85). Conclusion: Nearly three-quarters of pregnant women have adequate health literacy. Nevertheless, measures including policies to sustain and enhance health literacy levels among all expectant mothers are required, with a specific focus on those having limited health literacy.</p

Sociodemographic determinants of prepregnancy body mass index and gestational weight gain:The Mutaba'ah study

Objective: This study examined the associations of sociodemographic and lifestyle factors with prepregnancy body mass index (BMI) and gestational weight gain (GWG). Methods: In the Mutaba'ah Study in the United Arab Emirates, repeated measurements throughout pregnancy from medical records were used to determine prepregnancy BMI and GWG. Associations of sociodemographic and lifestyle factors with prepregnancy BMI and GWG (separately by normal weight, overweight, and obesity status) were tested using multivariable regression models, adjusted for maternal age at delivery. Results: Among 3536 pregnant participants, more than half had prepregnancy overweight (33.2%) or obesity (26.9%), and nearly three-quarters had inadequate (34.2%) or excessive (38.2%) GWG. Higher parity (β for 1–2 to ≥5 children = 0.94 to 1.73 kg/m2), lower maternal education (β for tertiary = −1.42), infertility treatment (β = 0.69), and maternal prepregnancy active smoking (β = 1.95) were independently associated with higher prepregnancy BMI. Higher parity was associated with a lower risk for excessive GWG among women with prepregnancy normal weight (odds ratios (ORs) for 1–2 to ≥5 children = 0.61 to 0.39). Higher maternal education was negatively associated with inadequate GWG among women with normal weight and overweight (ORs for tertiary education = 0.75 and 0.69, respectively). Conclusions: Sociodemographic factors, especially parity and maternal education, were differentially associated with prepregnancy BMI and GWG adequacy across weight status.</p

Incidence of Gestational Diabetes Mellitus in the United Arab Emirates; Comparison of Six Diagnostic Criteria: The Mutaba’ah Study

BACKGROUND: For more than half a century, there has been much research and controversies on how to accurately screen for and diagnose gestational diabetes mellitus (GDM). There is a paucity of updated research among the Emirati population in the United Arab Emirates (UAE). The lack of a uniform GDM diagnostic criteria results in the inability to accurately combine or compare the disease burden worldwide and locally. This study aimed to compare the incidence of GDM in the Emirati population using six diagnostic criteria for GDM. METHODS: The Mutaba’ah study is the largest multi-center mother and child cohort study in the UAE with an 18-year follow-up. We included singleton pregnancies from the Mutaba’ah cohort screened with the oral glucose tolerance test (OGTT) at 24–32 weeks from May 2017 to March 2021. We excluded patients with known diabetes and with newly diagnosed diabetes. GDM cumulative incidence was determined using the six specified criteria. GDM risk factors were compared using chi-square and t-tests. Agreements among the six criteria were assessed using kappa statistics. RESULTS: A total of 2,546 women were included with a mean age of 30.5 ± 6.0 years. Mean gravidity was 3.5 ± 2.1, and mean body mass index (BMI) at booking was 27.7 ± 5.6 kg/m(2). GDM incidence as diagnosed by any of the six criteria collectively was 27.1%. It ranged from 8.4% according to the EASD 1996 criteria to 21.5% according to the NICE 2015 criteria. The two most inclusive criteria were the NICE 2015 and the IADPSG criteria with GDM incidence rates of 21.5% (95% CI: 19.9, 23.1) and 21.3% (95% CI: 19.8, 23.0), respectively. Agreement between the two criteria was moderate (k = 0.66; p < 0.001). The least inclusive was the EASD 1996 criteria [8.4% (95% CI: 7.3, 9.6)]. The locally recommended IADPSG/WHO 2013 criteria had weak to moderate agreement with the other criteria, with Cohen’s kappa coefficient ranging from (k = 0.51; p < 0.001) to (k = 0.71; p < 0.001). Most of the GDM risk factors assessed were significantly higher among those with GDM (p < 0.005) identified by all criteria. CONCLUSIONS: The findings indicate discrepancies among the diagnostic criteria in identifying GDM cases. This emphasizes the need to unify GDM diagnostic criteria in this population to provide accurate and reliable incidence estimates for healthcare planning, especially because the agreement with the recommended criteria was not optimal

Knowledge, Attitude and Practices of Diabetic Patients in the United Arab Emirates

Diabetes self-management education is a cornerstone of diabetes care. However, many diabetics in the United Arab Emirates (UAE) lack sufficient knowledge about their disease due to illiteracy. Thus, before considering any possible intervention it was imperative to assess present knowledge, attitudes, and practices of patients towards the management of diabetes

Associations between Birth Weight and Adult Sleep Characteristics: A Cross-Sectional Analysis from the UAEHFS

Abnormal birth weight, particularly low birth weight (LBW), is known to have long-term adverse health consequences in adulthood, with disrupted sleep being suggested as a mediator or modifier of this link. We thus aimed to assess the associations between birth weight and self-reported adult sleep characteristics: sleep duration, difficulty waking up in the morning, daily nap frequency, sleep problems at night, snoring, daytime tiredness or sleepiness, and ever-stop breathing during sleep. This cross-sectional analysis used the United Arab Emirates Healthy Future Study data collected from February 2016 to March 2023 involving 2124 Emiratis aged 18–61 years. We performed a Poisson regression under unadjusted and age-sex-and-BMI-adjusted models to obtain the risk ratio and its 95% confidence interval for our analysis of the association between birth weight and each adult sleep characteristics, compared to individuals with normal birth weight (≥2.5 kg). Those with LBW had significantly a 17% increased risk of difficulty waking up in the morning, compared to those with normal birth weight. In addition, females with LBW history were also at an increased risk of reporting difficulty waking up in the morning. Studies with objective sleep assessments that include measurements of more confounding factors are recommended to confirm these risks

Types of tobacco consumption and the oral microbiome in the United Arab Emirates Healthy Future (UAEHFS) Pilot Study

© 2018, The Author(s). Cigarette smoking alters the oral microbiome; however, the effect of alternative tobacco products remains unclear. Middle Eastern tobacco products like dokha and shisha, are becoming globally widespread. We tested for the first time in a Middle Eastern population the hypothesis that different tobacco products impact the oral microbiome. The oral microbiome of 330 subjects from the United Arab Emirates Healthy Future Study was assessed by amplifying the bacterial 16S rRNA gene from mouthwash samples. Tobacco consumption was assessed using a structured questionnaire and further validated by urine cotinine levels. Oral microbiome overall structure and specific taxon abundances were compared, using PERMANOVA and DESeq analyses respectively. Our results show that overall microbial composition differs between smokers and nonsmokers (p = 0.0001). Use of cigarettes (p = 0.001) and dokha (p = 0.042) were associated with overall microbiome structure, while shisha use was not (p = 0.62). The abundance of multiple genera were significantly altered (enriched/depleted) in cigarette smokers; however, only Actinobacillus, Porphyromonas, Lautropia and Bifidobacterium abundances were significantly changed in dokha users whereas no genera were significantly altered in shisha smokers. For the first time, we show that smoking dokha is associated to oral microbiome dysbiosis, suggesting that it could have similar effects as smoking cigarettes on oral health

Incense Burning is Associated with Human Oral Microbiota Composition

© 2019, The Author(s). Incense burning is common worldwide and produces environmental toxicants that may influence health; however, biologic effects have been little studied. In 303 Emirati adults, we tested the hypothesis that incense use is linked to compositional changes in the oral microbiota that can be potentially significant for health. The oral microbiota was assessed by amplification of the bacterial 16S rRNA gene from mouthwash samples. Frequency of incense use was ascertained through a questionnaire and examined in relation to overall oral microbiota composition (PERMANOVA analysis), and to specific taxon abundances, by negative binomial generalized linear models. We found that exposure to incense burning was associated with higher microbial diversity (p \u3c 0.013) and overall microbial compositional changes (PERMANOVA, p = 0.003). Our study also revealed that incense use was associated with significant changes in bacterial abundances (i.e. depletion of the dominant taxon Streptococcus), even in occasional users (once/week or less) implying that incense use impacts the oral microbiota even at low exposure levels. In summary, this first study suggests that incense burning alters the oral microbiota, potentially serving as an early biomarker of incense-related toxicities and related health consequences. Although a common indoor air pollutant, guidelines for control of incense use have yet to be developed