Diabetic Saudi Research Articles

Anxiety and Depression Among Patients with Diabetes in Saudi Arabia and Egypt

Background: Mental stress plagued type II diabetes (T2DM) patients. The psychological and emotional issues related to diabetes and its effects include depression, anxiety, poor diet, and hypoglycemia fear. Aim: Compare the impact of diabetes on depression and anxiety in Egyptian and Saudi diabetics. Methods: The diabetes, gastroenterology, and hepatology sections of University of Ha’il Clinic, KSA, and the Theodor Bilharz Research Institute, Egypt, conducted this retrospective study. Everyone gave informed consent before participating. Interviews with male and female outpatients and inpatients were conducted from June 2021 to December 2022. The self-administered validated Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) scale measured sociodemographic characteristics and symptoms of depression and anxiety. Results: In patients with diabetes, the prevalence of depression was higher in KSA [34.8%] than in Egypt [18%], while anxiety was higher in Egypt [40%] than in KSA [29.1%]. Most depressed patients were 31–55 years old (61.2%) from KSA and 97.8% (41–55 years old) from Egypt. Female anxiety was 70.7% in KSA and 51.0% in Egypt, with no significant difference. The duration of diabetes in depressed patients was 5–10 years ([46.9%, Saudis] vs. [57.8%, Egyptians]), while anxious patients (5–10 years [39.0%, Saudis] vs. >20 years [65.0%, Egyptians]) were mainly type-2. Most depressive patients had an HbA1c (59.2%) from 7–10% (Saudis) and 77.8% [>10% Egyptians] compared to anxiety patients (46.3%) and 48.0% [>10% Egyptians]. Depressed and anxious patients from both nations had higher glucose, triglycerides, and cholesterol levels. Saudis and Egyptians with obesity had higher rates of sadness (75.5% vs. 68.9%) and anxiety (82.9% vs. 69.0%). Treatment adherence and serum glucose monitoring were not significantly different from depression in diabetes individuals in both ethnicities. Conclusions: Anxiety was more common among Egyptian patients because of overcrowding, working whole days to fulfill life requirements, and the unavailability of health insurance to all citizens. Meanwhile, in KSA, obesity, unhealthy food, and less exercise reflect the high percentage of depression among patients with diabetes. The detection of depression and anxiety in the context of DM should be critical for the physical health and quality of life of Saudi and Egyptian diabetics. Further investigation is warranted to encompass anxiety and depression within the scope of future research.

Impact of rs599839 Polymorphism on Coronary Artery Disease Risk in Saudi Diabetic Patients.

Coronary artery diseases may be affected by several genetic and nongenetic factors. Single-nucleotide polymorphism (SNP) rs599839 and type 2 diabetes mellitus (T2DM) can affect the occurrence and severity of coronary artery disease (CAD). Our aim was to investigate how T2DM and the rs599839 variant affected serum lipid levels and the degree of CAD patients' coronary artery stenosis. rs599839 polymorphism genotyping was done on Saudi patients with coronary angiography performed previously. Patients enrolled were divided into group A (360 DM patients), group B (225 DM patients with CAD), and group C (190 healthy volunteers as control). Individuals with diabetes and CAD who possessed the GG genotype in rs599839 exhibited markedly reduced means of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG; 224.5, 116.2, and 221.4 versus 251.6, 131.3, and 261.7 mg/dl, p=0.003, 0.007, and 0.025, respectively) than AA genotype. The odds ratio and the confidence interval of 95% for G allele carriers of rs599839 were OR = 0.62, 95% CI: 0.41-0.82, and p=0.003, among diabetic patients with CAD. In patients with diabetic CAD, the locus 1p13.3 polymorphism rs599839 was found to be substantially correlated with serum lipid levels. Furthermore, among Saudi patients with diabetes, the G allele of rs599839 variant lowers the CAD risk.

Saudi Consensus on Medical Nutrition Therapy for Type 2 Diabetes Mellitus

The burden of diabetes mellitus (DM) is a major challenge worldwide. This health problem has drawn attention, especially in Saudi Arabia, which is expected to be among the top five countries in 2030. The socioeconomic changes in KSA in recent decades resulted in changes in eating habits and lifestyle patterns. Diet is a modifiable factor that can prevent or delay the incidence of T2DM. Therefore, the relationship between diet and DM is crucial to deliver recommendations. Treatment of DM can only be effective if adequate attention is given to appropriate nutrition. Therefore, the Saudi Diabetes Clinical Practice Guidelines (SDCPG) (2021) recommended developing a nutrition therapy plan for each patient to achieve the treatment goals registered nutritionists provide for all individuals with DM. That is why a panel of 6 experts, a Saudi task force, gathered to develop an explicit, evidence-based consensus for nutrition therapy for T2DM people. An initial concept proposal was obtained. The proposal was divided into several topics discussed in September 2022. A literature review was carried out. The literature search was completed in March 2023. A drafted report was distributed to the entire panel. Approval of the recommendations required consensus, defined as a majority approval (i.e., above 80%). The recommendations were revised to accommodate any differences of opinion until a consensus was reached. Recommendations were finally formulated in June 2023. Subsequently, the panel reviewed and discussed the supporting rationale of the revised recommendations. This article presents these practical recommendations.

Prevalence of oral lesions and evaluation of the periodontal status among diabetic females attending Princess Nourah Bint Abdulrahman University (PNU).

To evaluate the prevalence of different oral lesions and periodontal status among diabetic Saudi female patients in the College of Dentistry, PNU University. A retrospective study was performed by reviewing the files of all patients who visited the College of Dentistry, PNU University, during the last 5 years. We selected diabetic 20-40-year-old Saudi female patients. Ethical approval was obtained from the Institutional Review Board of PNU University. Data collection sheets were used to gather information on demographics, education, medical and dental history, and extra and intra-oral findings. Data on the duration of diabetes, any major complications, and type of diabetes therapy were retrieved from medical records. The data were entered into an Excel sheet, and descriptive statistics were performed. The analytical phase proceeded to correlate oral lesions with patient age, type of diabetes, and periodontal status. A total of 226 diabetic patients were found after reviewing the records. The most common oral mucosal lesions were traumatic ulcers (10.2%), cheek biting (8.8%), and fissured tongue (8.4%). Furthermore, 81.86% of them had periodontitis, and 18.14% had a healthy periodontal status. The prevalence of periodontitis among diabetic female patients is higher than that of oral lesions. Stage III periodontitis showed the strongest association to oral lesion.

Assessment of Oral Hygiene, Gingival, and Periodontal Health, and Teeth Eruption among Type 1 Diabetic Saudi Children.

To determine the differences between type 1 diabetic children and healthy children regarding oral hygiene, gingival and periodontal health, and permanent teeth eruption.Materials and methods: A case-control study was conducted on 80 children (40 type 1 diabetic children and 40 healthy children) aged 6-12-year-old. The groups were further divided into subgroups (early and late mixed dentition). All study aspects were examined clinically using the simplified oral hygiene index, Löe and Silness gingival index, clinical attachment loss (CAL), and Logan and Kronfeld stages for tooth eruption. The data were analyzed using Fisher's exact test, chi-squared test, and logistic regression models. A p-value of ≤0.05 was the threshold for statistical significance. No significant difference was found between diabetic and healthy children regarding oral hygiene and gingival health. Most children had poor oral hygiene (52.5% in the case group and 60% in the control group), with fair gingival health (70% in the case group and 55% in the control group). Diabetic children had significantly (p = 0.05) more periodontitis than healthy children. Teeth in the advanced stage of the eruption were significantly higher in diabetic than control subjects (p = 0.048 in stage V and p = 0.003 in stage VI). Older diabetic children in late mixed dentition exhibited accelerated eruption. Periodontitis was significantly more common in diabetic than in healthy children. The advanced stage of the eruption was significantly higher in diabetic than in control subjects. Type 1 diabetic children had more periodontal disease and advanced stage of permanent teeth eruption compared to healthy children. Therefore, periodic dental evaluation and a strong preventive plan for diabetic children is crucial. Mandura RA, El Meligy OA, Attar MH, et al. Assessment of Oral Hygiene, Gingival, and Periodontal Health, and Teeth Eruption among Type 1 Diabetic Saudi Children. Int J Clin Pediatr Dent 2022;15(6):711-716.

Effect of nocturnal hypoxemia on glycemic control among diabetic Saudi patients presenting with obstructive sleep apnea.

Obstructive sleep apnea (OSA) is a prevalent disease that is associated with an increased incidence of type II diabetes mellitus (DM) if left untreated. We aimed to determine the association between glycosylated hemoglobin (HbA1c) levels and both nocturnal hypoxemia and apnea-hypopnea index (AHI) among a Saudi patients with OSA. A cross-sectional study that enrolled 103 adult patients diagnosed with DM and confirmed to have OSA by full night attended polysomnography between 2018 and 2021. Those who presented with acute illness, chronic obstructive pulmonary disease (COPD)/restrictive lung diseases causing sleep-related hypoxemia, or no available HbA1c level within 6 months before polysomnography were excluded from the study. Univariate and multivariate linear regression analyses between HbA1c levels and parameters of interest were tested. Sixty-seven (65%) of the studied population had uncontrolled DM (HbA1c ≥7%). In univariate regression analysis, there was a significant positive association between HbA1c, and sleep time spent with an oxygen saturation below 90% (T90), female gender, and body mass index (BMI) (p<0.05) but not AHI, or associated comorbidities (p>0.05). In the multivariate analysis, HbA1c was positively associated with increasing T90 (p<0.05), and ODI (p<0.05), but not with AHI (p>0.05). Nocturnal hypoxemia could be an important factor affecting glycemic control in patients with OSA suffering from DM irrespective of the severity of both diseases.

The Association between Vitamin D Hypovitaminosis and Cardiovascular Disease Risk in Saudi Diabetic Patients Type II.

We evaluated the prevalence and association of Vitamin D deficiency with glycemic control and CVD risk in T2DM patients. Serum 25 (OH)D3, lipid profile, glucose panel, HbA1c, serum insulin, and HOMA-IR were assessed in 93 T2DM patients and 69 controls. 10 years and lifetime ASCVD risk scores were calculated. The levels of 25(OH)D3 were significantly low in T2DM patients compared to the control. T2DM patients with hypovitaminosis D displayed significantly increased FBG, insulin, and HOMA-IR compared to normovitaminosis. Their lifetime and 10-year ASCVD risk scores were significantly higher regardless of vitamin D deficiency levels (P=0.006; P=0.023) in comparison to patients with sufficient levels of vitamin D. Among patients, the lifetime and 10 years of ASCVD risk showed a significant negative correlation with serum 25(OH)D3 and HDLc (P=0.037; 0.018) (P=0.0001), respectively, and significant positive correlation with T2DM duration, serum insulin, and HOMA-IR (P=0.018; 0.0001) (P=0.002; 0.001) (P=0.005; 0.001), respectively. The 10-year ASCVD risk exhibited a significant positive correlation with FBG (P=0.003) and HbA1c (P=0.009). T2DM duration was a predictor of vitamin D deficiency among T2DM patients (β = 0.22; CI = 0.002–0.04). There is a considerable association between lifetime and 10 years of ASCVD risk with hypovitaminosis D in T2DM, regardless of the deficiency levels which could be predicted by the diabetes duration.

Assessment of dental caries and salivary characteristics among type 1 diabetic Saudi children

Background/purposeType 1 diabetes mellitus (DM1) is considered the most common chronic disease in childhood. This study aimed to assess dental caries and salivary characteristics among a group of Saudi children with DM1. Materials and methodsForty children with DM1 and 40 age– and gender–matched healthy controls were enrolled. A saliva sample was obtained to measure flow rate of saliva, buffering capacity, potential of hydrogen (pH), and bacterial counts. Oral examination and dental caries were recorded using Decayed, Missing, and Filled Teeth (dmft/DMFT) indices for primary/permanent teeth. ResultsChildren with DM1 showed higher DMFT scores with a mean of 3.5 compared to 2.8 in healthy children. The differences between both groups were not statistically significant (P = 0.14). Regarding dmft score, children with DM1 showed a significantly lower mean score of 4.5 compared to 6.5 in healthy children (P = 0.019). The flow rate of saliva showed a non–significant reduction in children with DM1 compared to healthy children with a mean of 0.86 and 0.96, respectively (P = 0.24). The mean salivary pH was found to be higher in the healthy group, but this was statistically non–significant (P = 0.118). The buffering capacity was significantly lower in children with DM1 compared to healthy children (P = 0.013). Mutans streptococci (MS) and Lactobacilli counts were found to be not significantly different between both groups (P = 0.422, P = 0.118 respectively). ConclusionChildren with DM1 showed remarkably lower caries experience in primary teeth and lower buffering capacity compared to healthy children.

Self-awareness of HbA1c and its association with glycemic control among patients with type 2 diabetes: A multicenter study.

Objectives:To measure the self-awareness of hemoglobin A1c (HbA1c) prevalence among type 2 diabetic Saudi patients and its association with glycemic control, thereby identifying those factors that might affect their glycemic control.Methods:This multicenter study was carried out in outpatients’ diabetes clinics in tertiary hospitals in Riyadh, Qassim, and Jeddah, Saudi Arabia. The data was collected using questionnaires. The subject’s self-awareness on the HbA1c test was assessed based on the combined score of 4 questions. The latest HbA1c result before the time of data collection was obtained from medical records. Data was analyzed using bivariate and multivariate statistical methods.Results:The prevalence of HbA1c self-awareness was approximately 44.5%. A total of 4 participants characteristics (glycemic control, education level, monthly income and number of follow-up visits) were associated with awareness of HbA1c. Whereas for better glycemic control; type of treatment, duration of diabetes, and self-awareness of HbA1c were independently statistically significantly associated.Conclusion:There is a positive association between HbA1c self-awareness and glycemic control. Glycemic control was good among those who were educated on the meaning of the test, their levels, and their target goal. Awareness among health care providers regarding the role of the patient’s education regarding their condition might help in providing the patient with optimal care. Further studies with different experimental designs are needed to study this association, which will contribute to the development of a structured educational program.

Clinical Practice Guideline for the Management of Overweight and Obesity in Adults in Saudi Arabia

Obesity and overweight are prevalent in Saudi Arabia (24.95% & 31.80%). Also, childhood obesity in the country is a challenge, with 6% - 10% of preschool and school-age children. The burden of being overweight and obese is disastrous. Therefore, the Saudi Diabetes Scientific Society constituted a team to develop a guideline. The team reviewed the local Clinical Practice Guidelines for the Prevention and Management of Obesity in Saudi Arabia; and conducted a rigorous review of relevant evidence-based scientific literature. After a thorough assessment, a consensus was reached to use the Australian guideline as the main guideline to be adapted and localized to be suitable for the Saudi people. To avoid duplication of efforts, the team adopted the grading of evidence used by the Australian guideline. The updated version was presented in a workshop, and the recommendation of the participants was included. The final draft was distributed for review, and comments were included. This document presents the result of such an effort as a local guideline.

Association of Vitamin D Deficiency, Dyslipidemia, and Obesity with the Incidence of Coronary Artery Diseases in Type 2 Diabetic Saudi Patients.

Diabetes mellitus type 2 (T2DM) is a chronic metabolic disease associated with vascular complications. We aimed to evaluate the relationship of vitamin D deficiency, dyslipidemia, and obesity with the incidence of coronary artery disease in type 2 diabetes mellitus. The study included 200 Saudi adult subjects, aged 40 - 60 years, of both genders, attending King Abdulaziz Specialist Hospital in Taif city. Subjects were divided into four groups; 50 subjects each: Control group, type 2 diabetic, type 2 diabetic with coronary artery disease, and type 2 diabetic obese patients having body mass index (BMI) ≥ 30 kg/m2. Serum vitamin D (25-OH-D), fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and glycosylated hemoglobin (HbA1c) levels were estimated. Serum vitamin D and HDL-C in the three diabetic patient groups were significantly decreased (p < 0.001) compared to the control group. Among patient groups, the levels in the diabetic coronary and diabetic obese patients were significantly decreased as compared to the diabetic patient group (p < 0.001). FBG levels, HbA1c%, TC, TG, LDL-C levels, and BMI in all diabetic patient groups were significantly higher (p < 0.001) in comparison to control. Significant negative correlations were observed between serum vitamin D and FBG, HbA1c%, TC, TG, LDL-C levels, and BMI whereas positive correlations with HDL-C in all diabetic patient groups. The deficiency status of 25-OH-D is associated with dyslipidemia in type 2 Saudi diabetic patients, specifically those complicated with obesity and coronary artery diseases.

Association of Vitamin D Deficiency and Vitamin D Receptor Genetic Variants With Coronary Artery Disease in Type 2 Diabetic Saudi Patients.

Vitamin D deficiency accelerates the onset of type 2 diabetes mellitus (T2DM). Polymorphisms in the vitamin D receptor (VDR) have been linked to coronary artery disease (CAD). This study aimed to evaluate the association of vitamin D deficiency and VDR polymorphism with CAD in T2DM. A total of 150 adult male and female subjects, aged from 40 to 60 years, were divided into three groups, each with 50 subjects; control group, T2DM, and T2DM with CAD. Fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), HDL-C, LDL-C, glycosylated hemoglobin (HbA1c), and 25-hydroxyvitamin D (25-OH D) were assessed. VDR genotypes (BsmI, Taq1 and FOK1) were investigated by polymerase chain reaction fragment length polymorphism. There was a significant negative correlation between serum 25-OH D and FBG, TC, TG, and LDL-C levels, and a positive correlation with HDL-C levels in all diabetic patient groups. The risk of CAD was markedly higher in the group of T2DM with CAD in comparison to the control (p<0.0001) and the T2DM group. Regarding Taq1, there was also a significantly higher risk of CAD in Tt+tt genotypes and t allele in the T2DM with CAD group compared to control (p<0.001, 0.031 respectively). In addition, 25-OH D concentrations and the prevalence of VDR polymorphisms (BsmI, Taq1) were correlated with the risk of CAD. Deficiency of vitamin D and the prevalence of VDR polymorphisms (BsmI, Taq1) can serve as important markers for CAD.

The Impact of Aflibercept on Diabetic Macular Edema Patients Refractory to Ranibizumab in a Tertiary Care Eye Specialist Hospital, Saudi Arabia

PTB Reports,2021,7,3,82-85.DOI:10.5530/PTB.2021.7.14Published:December 2021Type:Research ArticleAuthors:Abdullah AlHumaidan, Sitah AlZuman, Muhammad Haris Mazhar, Arwa A AlDahash, Wejdan AlMussalam, Hassan AlDhibi, Marco Mura, Loujain AlAbbasi, and Rajiv Khandekar Author(s) affiliations:Abdullah AlHumaidan*, Pharmacy Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Sitah AlZuman, Pharmacy Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Muhammad Haris Mazhar, Pharmacy Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Arwa A AlDahash, Pharmacy Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Wejdan AlMussalam, Pharmacy Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Hassan AlDhibi, Vitreo-retina Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Marco Mura, Vitreo-retina Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Loujain AlAbbasi, Diagnostic Imaging Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Rajiv Khandekar, Research Department, King Khaled Eye Specialist Hospital, Riyadh, SAUDI ARABIA. Abstract:Aim: The purpose of this study is to see if switching from intravitreal Ranibizumab, an anti–Vascular Endothelial Growth Factor (anti-VEGF), to Aflibercept is evidence-based in the diabetic Saudi population. We compared the efficacy of three injections of the Aflibercept treatment regimen in diabetic macular edema (DME) cases refractory to Ranibizumab. Methods: In 2018, a retrospective single-arm cohort study was carried out. Cases of refractory DME were evaluated before and after three injections of Ranibizumab, as well as three Aflibercept treatment regimens. Optical Coherence Tomography (OCT) was used to investigate changes in Central Macular Thickness (CMT) (anatomic outcome). In addition, changes in the CMT and Best Corrected Visual Acuity (BCVA) (functional outcome) were assessed. Results: The cohort consisted of 74 eyes from 74 DME patients. As an anatomical indicator, the mean CMT decreased from 482±153 μ to 385.6±134.6 μ after three injections of Ranibizumab. In contrast, with Aflibercept treatment, the mean CMT decreased to 370.2±116.9 μ. The decrease in CMT was statistically significant [94.6μ (95% confidence interval (CI): 54.8; 134.3] (P 0.001). In addition, BCVA improved by two or more lines in 17 (23%) of the eyes treated with Aflibercept, remained unchanged in 40 (54%) of the eyes, and decreased in 17 (23%) of the eyes. Conclusion: The anatomic successes of both anti-VEGF (Ranibizumab and Aflibercept) treatment regimens in Saudi patients with DME are promising. The Aflibercept treatment regimen improves success in refractory DME cases, but the visual improvement appears to be limited. Keywords:Aflibercept, Anti Vascular Endothelial Growth Factors (Anti-VEGF), Diabetes., Diabetic Macular Edema (DME), Diabetic retinopathy, RanibizumabView:PDF (242.06 KB) PDF PDF Images The Best-corrected distance visual acuity in eyes with diabetic macular edema before and after anti-vascular growth factor treatment regimen.

AACE2021-A-1078: The Changeable Dynamics Between Glycaemic Control and Neuropathy Risk Across the Lifespan of Saudi Diabetic Patients; a Survey in Diabetes Healthcare Facility

This study aims to evaluate the prevalence of such a common and morbid neuropathy complication in a sample of Saudi diabetic patients. A descriptive questionnaire-based cross-sectional survey was conducted of sample of all diabetic patients who attend the specialist diabetes and endocrine centre in Prince Mansour Military Hospital in Taif, Saudi Arabia. A monofilament test was used to identify peripheral neuropathy cases, whereas its associated factors were identified through generalized linear logistic regression analysis. The study included (n = 343) diabetic patients. The prevalence of peripheral neuropathy was 84.8% affected patients (n = 291). Dyslipidaemia increased the risk for neuropathy by 98.4% (P = 0.04614). An interaction existed between the duration of diabetes and HbA1c levels in terms of their effect on peripheral neuropathy. When the interaction term is included, a positive association between neuropathy and both HbA1c (increased risk by 46.2%, P = 0.03222) and DM duration (increased risk by 19.6%, P = 0.04497). Cardiovascular disease reduced neuropathy risk by 62.1% (P = 0.03516), and retinopathy reduced neuropathy risk by 60.9% (P = 0.00782). over four out of every five patients have peripheral neuropathy. This is because our study was conducted among a high-risk group of attendees at the specialist diabetic centre. Dyslipidaemia, poor glycaemic control, and longer diabetes duration were associated with peripheral neuropathy in our participants, confirming a direct nerve-damaging effect for high levels of lipoproteins, glucose and lipids in the blood.

Oral Health and Patterns of Dental Visits Among Diabetic Patients in the Eastern Province of Saudi Arabia.

PurposeDiabetes is a big public health threat in Saudi Arabia. However, there is limited evidence about dental problems, oral hygiene practices, and dental visits among diabetic patients. The study aimed to evaluate self-perceived oral health status and patterns of dental attendance among diabetic patients in the Eastern province of Saudi Arabia.MethodologyThis cross-sectional study included 486 diabetic patients (mean age 50.14±13.59 years) registered with the Saudi Diabetes Society, Saudi Arabia (October–November 2020). The World Health Organization’s oral health questionnaire for adults was administered to collect information about oral health status, oral hygiene practices, and dental attendance, in addition to sociodemographic data. Descriptive and analytical statistics were performed.ResultsMost participants (66.3%) reported having dental pain or discomfort during the last year. Bad breath (60.50%), tooth cavities (55.10%), difficulty in biting hard food (55.10%), tooth sensitivity (53.30%), and bleeding gums (52.90%) were common oral problems among participants. More than half the sample (55.1%) reported visiting the dental office during the last year. However, pain or trouble with teeth, gums or mouth was the most common (40.5%) reason for the last dental visit. Only 7.8% of participants visited the dentist for a routine dental check-up. Multiple logistic regression analysis showed that Saudi nationality (AOR 2.68, P 0.008), family history of diabetes (AOR 1.88, P 0.022), and having pain during the last year (AOR 4.01, P <0.001) were the significant factors associated with the last dental visit due to pain.ConclusionThis sample of participants demonstrated a high prevalence of dental problems. Few participants performed routine dental visits and most visits were due to pain. Saudis and patients with family history of diabetes and dental pain were more likely to perform pain related dental visits. Multidisciplinary efforts are needed to develop and implement preventive educational and clinical care models for positive oral and general health outcomes.

Xerostomia, Salivary Flow, and Oral Health Status Among Saudi Diabetic Patients: A Comparative Cross-Sectional Study.

PurposeDiabetes mellitus (DM) is associated with numerous oral complications, including frequent oral infections, periodontal diseases, hyposalivation, and xerostomia. The present study aimed to investigate salivary flow rate, xerostomia, and oral health status among a group of Saudi diabetic patients as compared to healthy controls.Patients and MethodsThis comparative cross-sectional study involved 50 diabetic patients (aged between 15 and 70 years) and 53 age- and gender-matched healthy controls. Data collection was carried out using a structured questionnaire and clinical examination of oral health status, which included salivary flow rates, saliva pH, tooth loss, plaque accumulation, and gingival health. Independent t-tests, one-way analysis of variance (ANOVA), and chi-square tests were performed to compare between groups.ResultsThe results revealed a statistically significant lower salivary flow (0.33 ± 0.16 vs 0.59 ± 0.54; p = 0.002) and lower saliva pH (6.36 ± 0.49 vs 6.58 ± 0.39; p = 0.014) in diabetic patients than in the control group. A higher proportion of diabetic subjects (60%) self-reported having xerostomia compared to controls (52%), but the findings were statistically non-significant. Additionally, the results revealed slightly poorer oral health and greater tooth loss among DM patients, although the results did not attain a significant difference (P > 0.05).ConclusionThe findings of the present study demonstrate poor oral health and a high prevalence of xerostomia among Saudi diabetic patients. Oral health education should therefore be promoted in this group of patients.

Saudi Diabetic Patients’ Beliefs and Experiences with Health Related Information from Social Media

Introduction: Social media and acceptance of the information related to health is becoming acceptable to an extent for the public. The use of social media is rapidly growing and it is being used both by healthcare professionals and patients. The aim of this study was to evaluate the use of social networking applications for experience and behaviour towards health information among diabetic patients.&#x0D; Materials and Methods: The present study was a cross sectional study, conducted in spring of 2020 (April to May). The distribution of the survey questionnaire was done online through various social media platforms with a convenience sample of people with diabetes (n=569), Eligibility criteria were aged 18 and above, Saudis with diagnosis of diabetes and willing to give consent were included in the study. Exclusion criteria were less than 18 years old and non-Saudis and non-diabetic.&#x0D; Results: Analysis of online survey data indicated that WhatsApp (89.1%) was the most commonly used social network followed by Snapchat (66.3%), Instagram (40.6%), Twitter (35%), Telegram (19.5%), Tiktok (12.5%) and Facebook (10%). About 25 (4.4%) participants strongly agreed that health information from social media impact life positively. More than half 290(51%) participants agreed to apply information only from the trusted websites. Near about half 275(48.3%) disagreed that social media could invent treatment for diabetes more than believing in health institution and medicinal industries. Nearly one-fourth 141(24.8%) of participants agreed that all health information from social media is right. Almost 264 (46.4%) said that they sometimes face health information in social media. Nearly 265(46.6%) patients mentioned that they never applied themselves any information claiming treating diabetes.&#x0D; Conclusion: This study shows the effect of social media on diabetic patients and various responses of diabetic patients in regard of their beliefs and experience towards health information from social media. Most of the respondents agreed that they apply information obtained from social network and the same could lead to some deleterious effects on health.

Bone and mineral disorders among Saudi diabetics

Increasing bone and mineral changes which caused by both diabetes type 1 and type 2 can raise fracture risks for a period of time during illness and low blood sugar levels. The connection between diabetes and bone fragility is further complicated by the variable effects on the skeleton by various diabetic medications. Diabetic patients are at a higher risk of bone and mineral density alterations, osteoporosis and fragility fractures. Diabetic patients are often susceptible to develop various conditions due to malnutrition, uncontrolled blood sugar and lack of proper follow up regiment. Diabetics should be tested for osteoporosis risk and given effective prevention strategies. Preventing osteoporosis would require interventions such as sufficient vitamin D and calcium intake, physical exercise and exposure to sunlight.

Characteristics of Patients with Charcot's Arthropathy and its Complications in the Saudi Diabetic Population: A Cross-Sectional Study.

Charcot's arthropathy (CA) is a destructive rare complication of diabetes, and its diagnosis remains challenging for foot specialists and surgeons. We aimed to assess the clinical presentation and characteristics of CA and the frequencies of its various types. This cross-sectional study was conducted from January 1, 2007, to December 31, 2016, and included 149 adults with diabetes diagnosed as having CA. Cases of CA were classified based on the Brodsky anatomical classification into five types according to location and involved joints. The mean ± SD age of the studied cohort was 56.7 ± 11 years, with a mean ± SD diabetes duration of 21.2 ± 7.0 years. The CA cohort had poorly controlled diabetes and a high rate of neuropathy and retinopathy. The most frequent type of CA was type 4, with multiple regions involved at a rate of 56.4%, followed by type 1, with midfoot involvement at 34.5%. A total of 47.7% of the patients had bilateral CA. Complications affected 220 limbs, of which 67.7% had foot ulceration. With respect to foot deformity, hammertoe affected all of the patients; hallux valgus, 59.5%; and flatfoot, 21.8%. There is a high rate of bilateral CA, mainly type 4, which could be attributed to cultural habits in Saudi Arabia, including footwear. This finding warrants increasing awareness of the importance of maintaining proper footwear to avoid such complications. Implementation of preventive measures for CA is urgently needed.

Preference of sweeteners among Saudi diabetes patients from a tertiary health care centre in Riyadh, Saudi Arabia.

BackgroundChoice of sweetening options can influence glyceamic control among patients with diabetes. This study aims to investigate the preference of added sweeteners for Saudi patients with diabetes, factors associated with the choice of sweeteners and the attitude of the patients towards the use of artificial sweeteners.MethodsThis was a cross-sectional study conducted at King Saud University Medical City in Riyadh, Saudi Arabia and targeting Saudi patients with type 2 diabetes mellitus. Data was collected via personal interviews accessing medical records of interviewed patients. Patients were asked about consumption of sweeteners and types of consumed soft drinks on daily basis. Bi-variate analysis of the associations between choice of sweeteners and patients characteristics was performed and followed by binary logistic regression to adjust for potential confounders such as age, gender, and education level.ResultsA total of 302 Saudi diabetic patients were recruited in this investigation. Among this sample, frequency of patients reporting weekly consumption of white sugar was the highest (57%), followed by honey (26%) and artificial sweeteners (12% for powder form and 10.5% for tablets). Consumption of white sugar was significantly more frequent among patients with higher level of Body Mass Index (BMI) (P value < 0.05). The frequency of using honey was higher among females while consumption of either sugared or low calorie soft drinks was significantly higher among male patients (P values < 0.05). Upon asking the patients about their attitude towards artificial sweeteners, only 25% of the sample agreed that their use can aid in reduction of caloric intake while 35% of the sample agreed that artificial sweeteners can be harmful to the body.ConclusionsAmong this sample of type 2 diabetes patients, the frequency of white sugar and honey use as a sweetening option is high. These findings generate the need for further research to investigate the effectiveness of health education and nutritional advice among diabetes patients attending similar clinical settings in Saudi Arabia.