Diabetes In Oman Research Articles

Leveraging a 7-Layer Long Short-Term Memory Model for Early Detection and Prevention of Diabetes in Oman: An Innovative Approach.

This study develops a 7-layer Long Short-Term Memory (LSTM) model to enhance early diabetes detection in Oman, aligning with the theme of 'Artificial Intelligence in Healthcare'. The model focuses on addressing the increasing prevalence of Type 2 diabetes, projected to impact 23.8% of Oman's population by 2050. It employs LSTM neural networks to manage factors contributing to this rise, including obesity and genetic predispositions, and aims to bridge the gap in public health awareness and prevention. The model's performance is evaluated through various metrics. It achieves an accuracy of 99.40%, specificity and sensitivity of 100% for positive cases, a recall of 99.34% for negative cases, an F1 score of 96.24%, and an AUC score of 94.51%. These metrics indicate the model's capability in diabetes detection. The implementation of this LSTM model in Oman's healthcare system is proposed to enhance early detection and prevention of diabetes. This approach reflects an application of AI in addressing a significant health concern, with potential implications for similar healthcare challenges relating to globally diagnostic capabilities, representing a significant leap forward in healthcare technology in Oman.

Polypharmacy and Medication Compliance among Patients with Type 2 Diabetes in Oman: A Cross-Sectional Study

The goal of this study was to estimate the prevalence of polypharmacy and medication compliance among patients with T2DM at a primary care clinic in Muscat, Oman, to determine whether various sociodemographic and clinical factors were associated with polypharmacy and to assess relationships between polypharmacy, compliance, and self-related health. It is a cross-sectional study conducted between September and November 2019 and included all adult T2DM patients attending the clinic. Data were coll

Analytical Data Review to Determine the Factors Impacting Risk of Diabetes in North Al-Batinah Region, Oman.

Diabetes is one of the most widespread diseases resulting in an increase in mortality rate, and negatively affecting Oman’s economy. In 2019, an estimated 1.5 million deaths were directly caused by diabetes world health organization (WHO). The total number of diabetes cases among Omanis aged between 20 and 79 in 2015 is about 128,769, which increased in 2020 to 149,195. However, the total forecast number of diabetes cases will double in 2050 to 352,156. The healthcare spend on diabetes is 16.6%, which has triggered the need for the study. This research aims to review and analyze the prevailing situation around diabetes in Oman and its risk factors using multilinear regression tests, ANOVA, and descriptive analysis. Two hundred and fourteen samples were collected through a well-defined questionnaire using the purposive sampling technique. The study’s empirical results reveal that females, who were 79% of the respondents, have at least one of their family members as a diabetes patient; 41% of the respondents were affected by Type-2 (T2-DM) diabetes, and 38% were unaware of their type of diabetes. While, 91% of them were undergoing medication. The study indicates the risk factors that impact the diabetes number and type in North Oman, which include Aage with a rate of (0.595), followed by family history (0.560), smoking habits (0.530), and being overweight (0.435). Age plays an important role in the type of diabetes of the patients, and the types of diabetes impacts medication type. The type of diabetes has influenced the frequency of diabetes patients’ self-testing at home. Overall, 92% were rushed to the hospital or took medication immediately in case of a considerable variation in the readings; and 68% of the respondents complained that visiting the hospital is a costly affair and the health service is deteriorating.

Changes in Self-Efficacy and Social Support after an Intervention to Increase Physical Activity Among Adults with Type 2 Diabetes in Oman: A 12-month follow-up of the MOVEdiabetes trial.

ObjectivesThis study aimed to describe changes in self-efficacy (SE) and social support (SS) 12 months after the MOVEdiabetes trial, an intervention designed to increase physical activity (PA) among adults with type 2 diabetes mellitus in Oman.MethodsThe original MOVEdiabetes trial was conducted between April 2016 and June 2017 in Muscat, Oman. The intervention group (IG) received personalised PA consultations, pedometers and monthly messages using a web-based application, while the comparison group received usual care. Self-reported SE and SS from family and friends were assessed using validated psychosocial scales.ResultsOf the 232 original participants in the trial, a total of 174 completed the 12 months follow-up study period (response rate: 75%). However, based on intention-to-treat analysis with several imputation procedures for missing data at 3 and/or 12 months, there was a significant increase in SE scores in the IG (+10.3, 95% confidence interval [CI]: 7.1–13.5; P <0.001); however, the correlation with PA levels was weak (+4.2, 95% CI: 2.7–5.7; P <0.001). Higher SE scores were noted in those without comorbidities (+12.2, 95% CI: 6.8–17.6; P <0.001) and with high income levels (+9.7, 95% CI: 5.2–14.2; P <0.001). Additionally, SS scores increased significantly among those in the IG who received support from friends (+2.3, 95% CI: 1.1–3.7; P <0.001), but not family (+1.2, 95% CI: −0.4–2.8; P = 0.110). The reliability of the scales was acceptable for SE and SS from family, but poor for SS from friends (Cronbach’s alpha coefficients = 0.82, 0.82 and 0.40, respectively).ConclusionThe PA intervention was associated with positive changes in SE and SS from friends. However, further tools for assessing psychosocial influences on PA are needed in Arab countries.

Development and Pilot Testing of a Diabetes Foot Care and Complications Questionnaire for Adults with Diabetes in Oman: The Diabetic Foot Disease and Foot Care Questionnaire.

ObjectivesDiabetic foot disease causes substantial morbidity and mortality, but it can be prevented. Our study examined the frequency of diabetes-related foot problems and foot self-care practices, as reported by consecutive patients attending primary and secondary diabetes services in Muscat, Oman.MethodsA cross-sectional survey utilizing a newly developed and pre-tested questionnaire was conducted at eight primary health care centers and one polyclinic (secondary care) in A'Seeb, Muscat. A convenience sample of 353 consecutive Omanis, aged 20 years and above, diagnosed with diabetes were invited to participate in this study. We collected data on clinico-demographic characteristics, patient-reported foot complications, and foot self-care practices.ResultsOf the 350 patients who agreed to participate (mean diabetes duration 7.9±7.4 years, response rate: 99.2%), 62.3% were female, 57.4% were unemployed, more than half were illiterate (52.9%), and around three-quarters (71.4%) were unsure of the type of diabetes they had. More than half (55.1%) reported having at least one or more sensory peripheral neuropathy symptoms, almost half (49.1%) reported one or more peripheral vascular disease symptoms in the previous month, and 12.5% a history of foot ulceration. Reported foot self-care practices were overall suboptimal; 54.7% did not examine the bottom of their feet each day.ConclusionsAlthough self-reported diabetes-related foot complications were common in this population, foot self-care practices were inadequate. These findings suggest a need for the provision of regular foot care education to patients with diabetes. Future research should explore barriers to recommended foot self-care practices.

Acceptability of the \u201cMOVEdiabetes\u201d physical activity intervention in diabetes primary care settings in Oman: findings from participants and practitioners

BackgroundAdequate physical activity (PA) is considered essential in diabetes management. However, evidence on the best method of promoting PA within diabetes care is inconclusive. The current work identifies perceptions on the acceptability of Intervention Group Participants (IGP) and Project Officers (POs) about the “MOVEdiabetes” intervention programme aimed at increasing PA in adults with type 2 diabetes in Oman (a retrospectively registered trial).MethodsThe “MOVEdiabetes” programme (PA consultations, pedometers and WhatsApp messages) was delivered by the POs (primary health care practitioners) in four primary care centres within a one-year cluster randomised control trial. Recruitment and retention were measured from trial attendance records. Programme satisfaction, appropriateness, and content suitability were assessed using exit surveys for both the IGP (interview based) and POs (self-administered). Open text questions on perceptions to the study programme were also included.ResultsParticipants were randomised to an intervention group (IG, n = 122) or comparison group (CG, n = 110). The overall retention rate at three and 12 months was 92.7% [110(90.2%) IG vs 105(95.5%) CG] and 75% [82(67.2%) IG vs 92(83.6%) CG] respectively. Most (n = 14, 87.5%) POs and more than half (n = 49, 59.8%) IGP perceived the programme as very appropriate and many reported that they were “quite/ very satisfied” with the programme (n = 16, 100% PO’s and n = 71, 86.6% IGP). Two thirds (n = 55, 66.0%) of IGP were very/quite likely to recommend the programme to others. PA consultations, use of pedometers and Whatsapp messages were well perceived by all. Participants recommended the inclusion of dietary advice and PA promotion for the general public. Exploring PA facilities within the community was suggested by POs.ConclusionsThe “MOVEdiabetes” programme achieved a high retention rate and was perceived as satisfactory and appropriate. Results from this study suggest that it is worthwhile exploring the use of the “MOVEdiabetes” programme in clinical practice and further community links.Trial registrationInternational Standard Randomised Controlled Trials No: ISRCTN14425284. Registered retrospectively on 12th April 2016.

Health professionals’ perceptions about physical activity promotion in diabetes care within primary health care settings in Oman

BackgroundAs part of formative work to inform an interventional design to increase physical activity (PA) in patients with type 2 diabetes in Oman, this qualitative study aimed to determine health professionals’ perception of barriers and opportunities, personnel responsibilities and plausible PA promotional approaches. MethodsFour focus group discussions were carried out with groups of health care professionals (family physicians, dieticians and health educators, managers and general practitioners). All discussions were audio recorded and transcribed. Responses were analysed using a thematic analysis. ResultsBarriers to PA reported by participants (n = 29) were identified at three levels: health care system (e.g. deficient PA guidelines); individual (e.g. obstructive social norms) and community (e.g. lack of facilities). Participants felt that a multilevel approach is needed to address perceived barriers and to widen current opportunities. In the presence of various diabetes primary care providers, the potential for dieticians to include individualised PA consultations as part of their role was highlighted. Participants felt that consultations should be augmented by approaches within the community (volunteer support and/or appropriate facilities). However, despite lack of experience with technology supported approaches and motivational tools, the telephone application “WhatsApp” and use of pedometers were considered potentially suitable. The need for training in behaviour change techniques and clearly communicated intervention guidelines was emphasised. ConclusionsA multi-component approach including PA consultations, possibly led by trained dieticians, technological routes for providing support along with community mapping for resources appear to offer promising approaches for further PA intervention studies within diabetes primary health care.

Correlates of physical activity and sitting time in adults with type 2 diabetes attending primary health care in Oman

BackgroundDespite evidence of the benefits of physical activity in the management of type 2 diabetes, it is poorly addressed in diabetes care. This study aimed to identify the prevalence and correlates of meeting ≥600MET-min/wk. (150 min/wk) of physical activity and sitting time in adults with type 2 diabetes in Oman. Approaches to encourage physical activity in diabetes care were explored.MethodsA cross-sectional study using the Global Physical Activity Questionnaire was conducted in 17 randomly selected primary health centres in Muscat. Clinical data including co-morbidities were extracted from the health information system. Questions on physical activity preferences and approaches were included. Patients were approached if they were ≥18 years, and had been registered in the diabetes clinic for >2 years.ResultsThe questionnaire was completed by 305 people (females 57% and males 43%). Mean age (SD) was 57 (10.8) years and mean BMI (SD) was 31.0 (6.0) kg/m2. Duration of diabetes ranged from 2 to 25 (mean 7.6) years. Hypertension (71%) and dyslipidaemia (62%) were common comorbidities. Most (58.4%) had an HbA1c ≥7% indicating poor glycaemic control (55% in males vs 61% in females).Physical activity recommendations were met by 21.6% of the participants, mainly through leisure activities. Odds of meeting the recommendations were significantly higher in males (OR 4.8, 95% CI 2.5–9.1), individuals ≤57 years (OR 3.0, 95% CI 1.6–5.9), those at active self-reported stages of change for physical activity (OR 2.2, 95% CI 1.2–4.1) and those reporting no barriers to performing physical activity (OR 2.7, 95% CI 1.4–4.9).Median (25th, 75th percentiles) sitting time was 705 (600, 780) min/d. Older age (>57 years) was associated with longer sitting time (>705 min/d) (OR 2.8, 95% CI 1.7–4.6).Preferred methods to support physical activity in routine diabetes care were consultations (38%), structured physical activity sessions (13.4%) and referrals to physical activity facilities (5.6%) delivered by a variety of health care providers.ConclusionsThe results suggest that intervention strategies should take account of gender, age, opportunities within daily life to promote active behaviour and readiness to change. Offering physical activity consultations is of interest to this study population, thus development and evaluation of interventions are warranted.

Care of Patients with Diabetic Foot Disease in Oman

Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002-2013, 47.3% were performed on patients with diabetes. The quality of foot care among patients with diabetes in Oman has not been evaluated and unidentified gaps in care may exist. This article highlights challenges in the provision of adequate foot care to Omani patients with diabetes. It concludes with suggested strategies for an integrated national diabetic foot care programme in Oman.

Preventing the Future Pandemic of Diabetes Mellitus in Oman.

Preventing the Future Pandemic of Diabetes Mellitus in Oman.

Diabetes self-management (DSM) in Omani with type-2 diabetes

ObjectiveThe aim of this study was to assess the status of diabetes self-management (DSM) among Omanis with type-2 diabetes and its relationship with glycemic control and demographic variables. MethodsA correlational descriptive design using questionnaire was conducted with a convenience sample of 266 Omani patients with type-2 diabetes to collect the data. ResultsThe findings indicated that DSM among the study subject is sub-optimal. Only 1% of them were regular on SMBG; 9.5% of them exercise regularly; and 18% of them maintain healthy diet practices. No significant relationship between DSM and glycemic control (p >0.05) was found. DSM was found to be associated with age, gender, level of education, and duration of diabetes. Examining the differences between two regions in Oman (Muscat & Aldhakiliyah) indicated that participants from Muscat differ only in practicing SMBG. ConclusionResults indicated that many Omani patients with type-2 diabetes do not perform DSM consistently. Practice implicationsThe findings of this study set the stage to develop teaching strategies that will improve DSM and subsequently improve diabetes management in patient with type-2 diabetes in Oman.

Evaluation of T2DM related knowledge and practices of Omani patients

BackgroundThe prevalence of diabetes mellitus (DM) has increased alarmingly mainly due to the life style changes and obesity factor. Approximately 10% of the Omani population is suffering from this chronic disease and according to World Health Organization, number of subjects living with diabetes in Oman will rise from 75,000 in 2000 to 217,000 in 2025. It has been well established that data on KP of diabetic patients reveal aspects of education that need to be reinforced and addressed in order to improve diabetes management. ObjectiveThe aim of this cross sectional study was to assess the diabetes mellitus type 2 related knowledge and practices (KP) of Omani adult patients. Materials and methodsDiabetic patients were recruited using the convenient sampling method from Outpatient diabetes clinic of various primary health care centers and private hospitals in Muscat region of Sultanate of Oman. KP of patients who agreed to participate in the study were assessed by administering a self designed questionnaire containing 15 close ended or multiple choice type questions in face-to face interviews. The collected data were analyzed by SPSS software. Results and discussion106 patients with T2DM participated in this study (42 men and 64 women). Majority of them were; married (83%), above 50years (64.2%), on oral hypoglycemic (56.6%), having family history of diabetes (66%). The mean±SD knowledge score of participants was found to be 4.92±1.22 out of maximum possible score of 8. ConclusionOmani patients seemed aware and displayed satisfactory diabetes knowledge and good practices except adherence to regular exercise. We recommend to design and develop diabetes educational programs that could help Omani patients in diabetes management and improvement of quality of life.

Diabetes Self-Management and Education of People Living with Diabetes: A Survey in Primary Health Care in Muscat Oman

BackgroundAlthough the prevalence of type 2 diabetes in Oman is high and rising, information on how people were self-managing their disease has been lacking. The objective of this study was therefore to assess diabetes self-management and education (DSME) among people living with type 2 diabetes in Oman.MethodsA questionnaire survey was conducted in public primary health care centres in Muscat. Diabetes self-management and education was assessed by asking how patients recognized and responded to hypo- and hyperglycaemia, and if they had developed strategies to maintain stable blood glucose levels. Patients' demographic information, self-treatment behaviours, awareness of potential long-term complications, and attitudes concerning diabetes management were also recorded. Associations between these factors and diabetes self-management and education were analysed.ResultsIn total, 309 patients were surveyed. A quarter (26%, n = 83) were unaware how to recognize hypoglycaemia or respond to it (26%, n = 81). Around half (49%, n = 151), could not recognize hyperglycaemia and more than half could not respond to it (60%, n = 184). Twelve percent (n = 37) of the patients did not have any strategies to stabilize their blood glucose levels. Patients with formal education generally had more diabetes self-management and education than those without (p<0.001), as had patients with longer durations of diabetes (p<0.01). Self-monitoring of blood glucose was practiced by 38% (n = 117) of the patients, and insulin was used by 22% (n = 67), of which about one third independently adjusted dosages. Patients were most often aware of complications concerning loss of vision, renal failure and cardiac problems. Many patients desired further health education.ConclusionsMany patients displayed dangerous diabetes self-management and education knowledge gaps. The findings suggest a need for improving knowledge transfer to people living with diabetes in the Omani clinical setting.

Effectiveness of medical nutrition treatment delivered by dietitians on glycaemic outcomes and lipid profiles of Arab, Omani patients with Type 2 diabetes

In this randomized controlled trial we evaluated the effectiveness of medical nutritional therapy on Arab patients with Type 2 diabetes in Oman delivered by a dietitian. Patients with Type 2 diabetes (n = 170) were randomly assigned to a group receiving usual nutritional care (n = 85) or a group receiving practice guidelines nutritional care (n = 85). Anthropometric (weight, height, BMI and waist circumference) and biochemical (fasting blood glucose, HbA1c ) variables were measured at baseline and after each appointment. Patients were given 1-3 appointments with a dietitian over 6 months. Those in the group receiving practice guidelines nutritional care (n = 85) had significant changes in HbA(1c) (-0.8%, P = 0.001), fasting plasma glucose (-1.3 mmol\l, P = 0.003) and weight (-5.1 kg, P = 0.05), whereas the patients in the usual nutritional care group (n = 85) had no significant improvements in either HbA(1c) (-0.4%, P = 0.248) or fasting plasma glucose (-0.2 mmol/l, P = 0.638) during the same period. We also found a significant difference between the group receiving practice guidelines nutritional care and the usual nutritional care group, respectively, in waist circumference (96.9 ± 7.9 vs. 100.0 ± 8.7 cm, P = 0.019), triglycerides levels (1.42 ± 0.58 vs. 1.98 ± 0.96 mmol\l, P = 0.001), cholesterol levels (5.1 ± 1.0 vs. 5.5 ± 0.9 mmol/l, P = 0.009) and LDL cholesterol levels (3.58 ± 0.98 vs. 3.89 ± 0.98 mmol/l, P = 0.046). Medical nutrition therapy provided by dietitians to Arab patients with Type 2 diabetes in Oman resulted in significant improvements in anthropometric and biochemical outcomes in both the usual nutritional care group and the group receiving practice guidelines nutritional care. Subjects with Type 2 diabetes tended to do better with practice guidelines nutritional care than with usual nutritional care. Ongoing medical counselling in nutrition by a trained dietitian is important for better long-term metabolic control.

Mood dysfunction and health-related quality of life among type 2 diabetic patients in Oman: Preliminary study

Aim: A temporal relationship exists between the presence of affective disturbance, poor glycaemic control and complications in people with type-2 diabetes. The objective of this study is to compare the performance of patients diagnosed with type-2 diabetes and normoactive group on indices of mood functioning and indices of health-related quality of life. Materials and Methods: In 2006-2007, for a six-month period, diabetics from Oman were screened for the presence of propensity towards psychiatric distress using Self-Reporting Questionnaire during their routine consultation at the diabetic clinic at a tertiary care hospital in an urban area of Oman. Those who fulfilled presently operationalised criteria for subclinical propensity towards affective disorders were further screened for affective functioning (Hospital Anxiety and Depression Scale) and indices of general well-being or health-related quality of life (Nottingham Health Profile). The age- and sex-matched controls group (n=40) underwent the same procedure. Results: Both measurement scales used in the present study indicated that the diabetic group had significantly poorer quality of life and higher distress level than the non-diabetic group, with the exception of emotional reaction for which the non-diabetics showed poorer health than the diabetics. Additionally, no difference between groups was found when compared for social isolation. Conclusions: In agreement with previous studies from different populations, people with diabetes in Oman appear to have marked affective functioning and impairment based on the indices of quality of life. The present finding is discussed within a sociocultural context that has a direct bearing on the situation in Oman.

Type 2 Diabetes in Oman: Can we learn from the Lancet editorial.

more than 75% of the disease burden in Oman is attributable to non-communicable diseases (NCDs) with the distribution of chronic diseases and related risk factors among the general population being similar to that of industrialized nations; 12% of the population have diabetes, 30% are overweight, 20% are obese, 41% have high cholesterol, and 21% have the metabolic syndrome. The findings related to diabetes from the above recent review article, 2 does not paint a good picture regarding diabetes control, since Omanis have high rates of diabetes-related complications; more than 14% were found to have diabetic retinopathy, 27% had microalbuminuria, and more than 50% of amputations are attributed to diabetes mellitus. Another review also noted that as Oman continues through the epidemiological transition and socioeconomic development, the burden of NCDs, particularly cardiovascular diseases and diabetes, can only be expected to increase. 3 Higher prevalence rates of diabetes have been identified in more urbanized areas of the country (18%) relative to more rural areas (11%). 4 An earlier study found that only one-third of people with diabetes knew that they had the condition. 5 There are concerns about the financial implications of diabetes in the Arab countries. A recent conference on health economics proposed to issue the ‘Riyadh Declaration’ as a guiding framework to address the challenges of diabetes particularly from an economic standpoint. 6 Some of the objectives of the conference were in fact in tune with what the Lancet editorial is now proposing. These include shedding light on all aspects of economics of diabetes including the medical and social issues at the international, regional and gulf level; illuminate the immense challenges imposed by diabetes on the heath systems and healthcare costs (whether direct or indirect); propose and present responses to confront these challenges, with presentation of effectiveness models; involve key stakeholders in the management of Diabetes and impart significance to their role in combating diabetes; increase the knowledge of governmental officials and others concerned with and interested in the economic aspects of diabetes; and present outstanding international

Knowledge, attitude and practice regarding eye complications and care among Omani persons with diabetes - A cross sectional study

Purpose:We present the level of Knowledge, Attitude and Practice (KAP) among diabetic patients regarding eye complications and their care.Materials and Methods:A cross sectional study was conducted in 2008 at seven regions of Oman. Arabic speaking nurses interviewed diabetics at clinics. They used a closed ended questionnaire with 15 questions. The responses were analyzed and the KAP were grouped into excellent (>80%), good (60 to 79%), average (40 to 59%), poor (20 to 39%) and very poor (<20%). They were also compared among epidemiologic variants.Result:Of the 750 participants, ‘Excellent’, grade of knowledge about diagnosis and eye care was present in 547 (72.9%) and 135 (18%) persons respectively. The ‘excellent’ grade of attitude about eye involvement and eye care was found in 135 (18%) and 224 (29.9%) participants. The practice for undergoing eye check up and accepting treatment was of ’excellent’ grade in 390 (52%) and 594 (79.2%) respectively. Age (OR = 0.98), Sharqiya region (OR = 25) and ‘5 to 9’ duration of DM (OR = 2.1) were associated with the knowledge. ‘<1 year’ duration (OR = 0.3) and Dhakhiliya region (OR = 39) were associated with the attitude while ‘5 to 9 year’ duration (OR = 3.4) was associated with better practices.Conclusions:Knowledge about eye complications and care is satisfactory among persons with diabetes. However, levels of attitude and practice were less than desired and should be improved. This could strengthen program approach for early detection and care of eye complications of diabetes in Oman.

Carbohydrate -Food knowledge of Emirati and Omani Adults with Diabetes:Results of a pilot study

There is limited research on nutrition knowledge related to diabetes management in persons with diabetes in the United Arab Emirates and other Arabian Gulf countries. Carbohydrate – containing foods have the greatest impact on post-meal blood glucose levels. The purpose of this exploratory study was to determine nutrition knowledge related to carbohydrate- containing foods of adults with diabetes in Oman and the United Arab Emirates. A culturally-appropriate questionnaire was used to assess carbohydrate - food knowledge in a convenience sample of 94 Emirati and Omani men and women with diabetes (age (mean± s.d.): 50 ± 13.5 years) residing in the cities of Al Ain and Al Bureimi. Carbohydrate-food knowledge score (mean± s.d.) was 6.3 ± 2 (maximum 14), reflecting low knowledge of food sources of carbohydrate. Ninety-three percent of the study participants believed that whole wheat bread does not increase their blood glucose levels and 88% of them did not think that unsweetened fruit juices can increase blood glucose levels. Further, scores for the Omani citizens were significantly lower than those of Emirati counterparts, mean difference 2.3 (95% confidence interval:1.5-3.1). Significant (p<0.05) differences in carbohydrate food knowledge scores between the 2 groups were found for 5 of the 14 food items assessed. The results of this study underscore the importance of nutrition education programs for persons with diabetes in these 2 communities.

Quality of interaction between primary health-care providers and patients with type 2 diabetes in Muscat, Oman: an observational study

BackgroundA good patient-physician interaction is particularly important in chronic diseases like diabetes. There are so far no published data regarding the interaction between the primary health-care providers and patients with type 2 diabetes in Oman, where diabetes is a major and growing health problem. This study aimed at exploring how health-care providers interact with patients with type 2 diabetes at primary health-care level in Muscat, Oman, focusing on the consultation environment, and some aspects of care and information.MethodsDirect observations of 90 consultations between 23 doctors and 13 diabetes nurses concerned with diabetes management during their consultations with type 2 diabetes patients in six primary health-care centres in the Muscat region, using checklists developed from the National Diabetes Guidelines. Consultations were assessed as optimal if more than 75% of observed aspects were fulfilled and sub-optimal if less than 50% were fulfilled.ResultsOverall 52% of the doctors' consultations were not optimal. Some important aspects for a positive consultation environment were fulfilled in only about half of the doctors' consultations: ensuring privacy of consultation (49%), eye contact (49%), good attention (52%), encouraging asking questions (47%), and emphasizing on the patients' understanding of the provided information (52%). The doctors enquired about adverse effects of anti-diabetes drugs in less than 10% of consultations. The quality of the nurses' consultations was sub-optimal in about 75% of 85 consultations regarding aspects of consultation environment, care and information.ConclusionThe performance of the primary health-care doctors and diabetes nurses needs to be improved. The role of the diabetes nurses and the teamwork should be enhanced. We suggest a multidisciplinary team approach, training and education to the providers to upgrade their skills regarding communication and care. Barriers to compliance with the guidelines need to be further explored. Improving the work situation mainly for the diabetes nurses and further improvement in the organizational efficiency of diabetes services such as lowering the number of patients in diabetes clinic, are suggested.

Diabetes and urbanization in the Omani population: an analysis of national survey data

BackgroundThe prevalence of type 2 diabetes in Oman is high and appears to be rising. Rising rates of diabetes and associated risk factors have been observed in populations undergoing epidemiological transition and urbanization. A previous study in Oman indicated that urban-dwellers were not significantly more likely to have diabetes. This study was undertaken to determine if a more accurate urban and rural categorization would reveal different findings.MethodsThis study included 7179 individuals aged 20 years or above who participated in a cross-sectional interviewer-administered survey in Oman including blood and anthropomorphic tests. Multiple logistic regression analyses were conducted to analyze the factors associated with diabetes, first in the whole population and then stratified according to region.ResultsThe prevalence of diabetes (fasting blood glucose ≥ 7 mmol/l) in the capital region of Muscat was 17.7% compared to 10.5% in rural areas. The prevalence of self-reported diabetes was 4.3%. Urban residence was significantly associated with diabetes (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4–2.1), as was age (OR = 1.2, 95% CI: 1.1- 1.2), obesity (abnormal waist circumference) (OR = 1.8, 95% CI: 1.5–2.1), and systolic blood pressure (SBP) 120–139 (OR = 1.4, 95% CI:1.04–1.8), SBP 140–159 (OR = 1.9, 95% CI: 1.4–2.6), SBP ≥ 160 (OR = 1.7, 95% CI: 1.2–2.5). Stratified analyses revealed higher education was associated with reduced likelihood of diabetes in rural areas (OR = 0.6, 95% CI: 0.4–0.9).ConclusionA high prevalence of diabetes, obesity, hypertension and high cholesterol exist in the Omani population, particularly among urban-dwellers and older individuals. It is vital to continue monitoring chronic disease in Oman and to direct public health policy towards preventing an epidemic.