United Arab Research Articles (Page 1)

The rate of work-related musculoskeletal disorders (WRMDs) among hospital workers is approximately twice as high as that in other service industries, making it a significant cause of absenteeism and reduced productivity. The study aimed to determine the severity and extent of WRMDs among physiotherapists in United Arab Emirates (UAE) last 2 years and to specify the specialty area, task, and the most common risk factors for these injuries. Also, to identify the different coping mechanisms the physiotherapist in UAE use to deal with WRMDs. The research was conducted as a descriptive cross-sectional design between March and June 2024. A self-reported questionnaire was distributed among 202 physiotherapists in the UAE who are members of the Emirates physiotherapy society via email. The questionnaire consisted of 17 questions that includes personal and occupational history. The statistically significant was set at a p-value less than 0.05 and 95% confidence interval. 69% of physiotherapists had a WRMDs in one or more area of the body most of the injuries have been occurred in the lower back (38.6%), followed by the neck and shoulders with an equal percentage (28.7%). The highest risk factors in causing the injury were performing repetitive tasks (28.2%) and maintaining a position for a prolonged period (26.2%). With regards to coping, 32% reported utilizing their professional expertise, 40% seek medical assistance to manage their injuries. Approximately 15% preferred to take rest and 13% to do exercise. Based on the findings of this study, physiotherapists in UAE have a high rate of WRMDs attributed to their profession. Survey respondents expressed the need for a change in work habits to reduce the risk of further injuries.

Introduction High-dose methotrexate (HDMTX) therapy is a cornerstone in treating pediatric and adult cancers, namely, acute lymphoblastic leukemia, non-Hodgkin lymphoma, and osteosarcoma, due to its capability to penetrate the blood–brain barrier. Despite its therapeutic benefits, HDMTX poses significant risks of delayed methotrexate elimination (DME) and associated toxicities such as acute kidney injury (AKI). These risks necessitate individualized dosing and preventive strategies, including hyperhydration, urine alkalinization, and leucovorin rescue. Methods To address these challenges, a modified Delphi method with two rounds was used to develop consensus statements to guide clinicians in mitigating HDMTX-associated toxicities and optimizing management strategies. A panel of 13 experts from Saudi Arabia, United Arab Emirates (UAE), Kuwait, Oman, Jordan, and Egypt formulated 54 initial statements focusing on HDMTX regimens, risk factors, preventive care, and monitoring strategies. Results Consensus (≥75%) was reached on 50 statements covering HDMTX regimens, preventive care, and toxicity management. Recommendations emphasized standardized methotrexate monitoring intervals, structured risk assessment for DME and AKI, supportive care measures (hyperhydration, urine alkalinization), pharmacokinetically adjusted leucovorin rescue, and the role of glucarpidase in severe toxicity or AKI. Conclusions This consensus provides concrete clinical strategies for the safe and effective use of HDMTX, including structured risk stratification for DME, standardized monitoring intervals, pharmacokinetically guided leucovorin adjustments, and early glucarpidase intervention in patients with AKI or severe toxicity. These recommendations are particularly relevant for optimizing HDMTX administration in regions with limited access to advanced interventions.

Human Papillomavirus Infection and Vaccine Uptake Among Males in the United Arab Emirates and the Wider Middle East and North Africa Region: A Narrative Review

Objectives Dupilumab has demonstrated strong efficacy and safety in clinical trials for atopic dermatitis (AD), but real-world data from the Greater Gulf region remain limited. This study aimed to evaluate the real-world effectiveness and safety of dupilumab in adolescents and adults with moderate-to-severe AD in Saudi Arabia and the United Arab Emirates. Methods A retrospective observational study was conducted in adolescents and adults (≥12 years) with moderate-to-severe AD, who had received dupilumab for one to three years. Clinical outcomes were assessed using SCORing Atopic Dermatitis (SCORAD) and the Dermatology Life Quality Index (DLQI), while safety was evaluated through reported adverse events (AEs). Results Ninety-five patients were eligible, with a mean age of 29.3 years, and 52.6% were males. The mean baseline SCORAD score was 49.9, which decreased markedly to 21.5 after one month, 12.7 after three months, and 14.1 at six months. At six months, data were available for 71 patients, of whom 76% achieved SCORAD-50 and 52.1% achieved SCORAD-75. Reported AEs were generally mild, the most frequent being dry eyes (14.7%), dry eyes with pruritus (8.4%), and facial erythema (6.3%). No serious AEs or treatment discontinuations were recorded. Conclusion Dupilumab demonstrated sustained clinical improvements and favorable safety. These findings reinforce the results of previous real-world studies and Randomized Controlled Trials.

ABSTRACT Comparative evidence of how two Gulf Cooperation Council (GCC) states translate artificial intelligence (AI) ambitions into post–New Public Management (post‐NPM) outcomes are scarce because most studies focus on Western democracies. To fill this gap, we examine constitutional, collective choice, and operational rules that shape AI uptake in two contrasting GCC members, the United Arab Emirates (UAE) and Kuwait, and whether they foster citizen centricity, collaborative governance, and public value creation. Anchored in Ostrom's Institutional Analysis and Development framework, the study integrates a most similar/most different systems design with multiple sources: 62 public documents issued between 2018 and 2025, embedded UAE cases (Smart Dubai and MBZUAI), and 39 interviews with officials conducted from Aug 2024 to May 2025. Dual coding and process tracing connect rule configurations to AI performance. Our cross‐case analysis identifies four mutually reinforcing mechanisms behind divergent trajectories. In the UAE, concentrated authority, credible sanctions, pro‐innovation narratives, and flexible reinvestment rules transform pilots into hundreds of operating services and significant recycled savings. Kuwait's dispersed veto points, exhortative sanctions, cautious discourse, and lapsed AI budgets, by contrast, confine initiatives to pilot mode despite equivalent fiscal resources. These findings refine institutional theory by showing that vertical rule coherence, not wealth, determines AI's public value yield, and temper post‐NPM optimism by revealing that efficiency metrics advance societal goals only when backed by enforceable safeguards. To curb ethics washing and test the transferability of these mechanisms beyond the GCC, future research should track rule diffusion over time, experiment with blended legitimacy‐efficiency scorecards, and investigate how narrative framing shapes citizen consent for data sharing. Related Articles Robles, P. and D. J. Mallinson 2023. “Catching up With AI: Pushing Toward a Cohesive Governance Framework.” Politics & Policy , 51, no. 3: 355–372. https://doi.org/10.1111/polp.12529 . Veloso Meireles, A. 2024. “Digital Rights in Perspective: The Evolution of the Debate in the Internet Governance Forum.” Politics & Policy 52, no. 1: 12–32. https://doi.org/10.1111/polp.12571 . Zeng, J., T. Stevens, and Y. Chen. 2017. “China's Solution to Global Cyber Governance: Unpacking the Domestic Discourse of ‘Internet Sovereignty.’” Politics & Policy 45 no. 3: 432–64. https://doi.org/10.1111/polp.12202 .

Gulf Cooperation Council (GCC) countries are undergoing a critical transformation in their healthcare systems. This empowers them to address the rising burden of complex diseases, including rare diseases, cancer, neurological disorders, and immunological illnesses, which involve a high cost of therapy. A strategic shift from volume- to value-based healthcare (VBH) emphasizes sustainability, enhanced accessibility, and improved health outcomes through innovation. GCC’s healthcare is marked by universal coverage and a shifting landscape of public-private partnerships. Rising pharmaceutical costs, especially for specialty drugs, continue to challenge budget sustainability. VBH offers a strategy to align healthcare expenditure with patient outcomes. This framework is supported by global and regional models such as managed entry agreements (MEAs), multi-criteria decision analysis, and real-world evidence (RWE). These models provide guidance for reimbursement strategies and support decision-making regarding high-value treatments. The GCC nations are also progressing towards policy discussion, but face challenges related to infrastructure, regulation, and workforce capacity. The Department of Health (DOH) in Abu Dhabi, which is a governmental health authority in the United Arab Emirates, has officially established a dedicated HTA unit to evaluate and assess new health technologies for evidence-informed decision making. This review highlights specialty care priorities and proposes target strategies such as expanding genetic databases, implementing screening programs, and establishing risk-sharing agreements to improve affordability, particularly for rare diseases. A consensus-driven phased roadmap for GCC-wide VBH adoption is recommended. This includes a focus on MEAs and patient-reported outcome measures, mid-term harmonization of health technology assessments (HTA) and RWE development as well as long-term establishment of digital ecosystems and value-based pricing platforms. Equitable and collaborative policies will be essential to achieving sustainable and inclusive healthcare systems across the GCC.

Employees are the fundamental source of a sustainable competitive advantage. Without the high quality of human capital, organisations cannot attain a competitive advantage that can be sustained over time. Employer branding is a strategy that focuses on engaging and attracting the best talent from the job market, which is crucial for sectors known for high employee turnover rates. In recent years, digital platforms and information technology systems have revolutionised employer branding by helping organisations connect with talent in more personal and innovative ways. In this study, we sought to explore and understand the role of LinkedIn in employer branding efforts and evaluate the benefits of using LinkedIn to brand an employer as the first choice for prospective employees. Additionally, the research proposes a LinkedIn-Integrated Employer Branding Model (LIEBM) that incorporates LinkedIn strategies. Qualitative data were collated from the recruiting heads of the leading four- and five-star hotels in Al Ain, United Arab Emirates. The findings indicate that LinkedIn is widely used to improve an organisation’s employer brand image through various strategies. The results also demonstrate that employing LinkedIn strategies enhances the benefits of employer branding, contributing to actionable insights in the hotel industry to make excellent decisions at pre-recruitment, recruitment and selection stages.

The research investigated the effect of AI-powered chatbots on crisis communication efficiency and trust-building in government public relations in the United Arab Emirates. It also explored the role of message customization in mediating this effect. The research relied on the descriptive analytical approach. A questionnaire was distributed to 360 public relations professionals in government institutions responsible for managing corporate communication during crises. The results revealed the need for incorporating AI-powered chatbots into corporate communication strategies. The data analysis indicated that the synergy of technology and communication efficiency can improve a corporation's performance and guarantee increased efficiency in managing a crisis. The research paper proposes the development of communication systems that incorporate chatbots in a strategic approach. This will help improve interactions with the citizens and provide precise and timely information in case of an emergency. The research also recommends greater investments in training public relations organizations to adopt AI technologies efficiently to ensure they are maximally exploited in governmental contexts.

BackgroundSince January 2022, Sharjah in the United Arab Emirates has implemented the 4-day work week model for the first time in the public and private sectors, including universities. While this framework may enhance productivity and work-life balance for many professionals, the current study specifically explores the perceptions of students in medicine, dentistry, and health sciences programs regarding the impact of transitioning from a 5-day to a 4-day work week on their academic performance.ObjectiveThe objective of this study was to explore and analyze the perceptions of students in medicine, dentistry, and health sciences regarding the implementation of a 4-day academic week in the Emirate of Sharjah, United Arab Emirates.MethodsTwenty-four university students (mean age 20.95, SD 1.30 years; 12 men) studying in medicine, dentistry, physiotherapy, nursing, or medical diagnostic imaging programs, who experienced a transition from a 5-day week to a 4-day week, participated in semistructured interviews lasting approximately 20‐30 minutes. All interviews were recorded and transcribed verbatim. The Braun and Clarke 6-phase framework of thematic analysis was used.ResultsWe identified 5 themes: academic journey, academic work-life balance, support systems, classroom dynamics, and common stressors of the 4-day academic week. Overall, most students reported increased motivation, engagement, and academic achievement following the transition from a 5-day to a 4-day week. In addition, participants described a positive academic work-life balance, improved physical and mental well-being, optimal use of time for both academic and personal commitments, favorable support from faculty and family members, and maintained or even improved attendance levels. Nevertheless, some students expressed concerns about condensed schedules and longer days, increased stress, disrupted work-life balance, and inadequate support systems to cope with this new framework.ConclusionsOverall, the 4-day academic week enhanced motivation, academic performance, work-life balance, and the physical and mental well-being of medicine, dental, and health science students. However, some students experienced challenges related to condensed schedules and increased stress. These mixed outcomes highlight that while the 4-day work week offers notable advantages, careful planning and support are essential to mitigate the potential drawbacks and ensure all students can succeed within this new academic framework. Future research could explore strategies to address these challenges and further improve the 4-day week experience for all students.

Leadership and innovation have been two key areas of research over the last decade. Innovation is crucial in organisational survival and growth, and it is a force of change in today’s competitive market. To be competitive in the global market, especially in the public sector, organisations must adopt innovative approaches to service delivery, governance and operational efficiency. Innovation is identified as a critical element for the success of an organisation. Effective leadership is essential in driving innovation within organisations, still the role of leadership style to foster innovation and encourage experimentation are still not fully understood. While considerable research has been conducted globally, studies examining the association between leadership style and innovation in the United Arab Emirates, particularly Dubai government organisations, is still rare. Accordingly, this study seeks to address the following research question: How do leadership styles foster a culture of innovation within Dubai government organisations? As a conceptual paper, this study adopts a synthesis approach, drawing on existing regional and global literature to develop a theoretical foundation, identify research gaps, and propose directions for future empirical study. The research aims to shed light on the vital role of leadership style in fostering a culture of innovation in Dubai government organisations, with specific focus on how leadership styles foster a culture that support experimentation, innovation, and continuous improvement. The research highlights innovation initiatives implemented by Dubai government organisations, examining how leadership has driven initiatives, for example the Mohammed Bin Rashid Centre for Government Innovation, and the Dubai Future Accelerators to promote digital transformation, agile governance, and promote a culture of experimentation. The research addresses the persistent barriers to innovation commonly faced by Dubai government organisations, including bureaucratic inertia, rigid hierarchies, and resistance to change. In addition, the study offers practical recommendations to the public sector to help overcome the challenges through strategic leadership practises, capability building, and supportive policy frameworks. Finally, the underlying mechanisms and determinants of effective leadership style and its impact on innovation are critical to understand, as the existing literature tends to focus on leadership style practices, rather than its drivers. This research offers practical guidance for leaders to create a culture of innovation within the Dubai government organisations.

Occupational hazards facing nurses in the United Arab Emirates: a cross-sectional study

Background Colorectal cancer (CRC) is a leading global health burden, contributing significantly to disability-adjusted life years and economic burden. The BRICS nations—spanning diverse and rapidly evolving socio-economic contexts—are undergoing critical epidemiological transitions. Understanding CRC trends in these countries is essential to inform targeted control strategies. Methods Data from the Global Burden of Disease (GBD) 2021 database were used to assess trends in CRC incidence across BRICS countries from 1990 to 2021. An age-period-cohort (APC) model with the intrinsic estimator (IE) algorithm was employed to disentangle the independent effects of age, period, and cohort on incidence rates. Data were stratified into 5-year age groups, and 95% uncertainty intervals (UIs) were calculated to reflect variability and estimation precision. Results From 1990 to 2021, the global CRC cases increased by 139.38%, with the age-standardized incidence rate (ASIR) rising by 6.52%. Among BRICS nations, Saudi Arabia had the largest increase in cases (111.02%), while United Arab Emirates showed a decline (-23.04%). Globally, most age groups exhibited positive local drift values, indicating rising incidence rates, except for individuals under 20 years. This pattern was also observed in India and South Africa, whereas Ethiopia showed a distinct trend. Brazil, China, Egypt, Iran, and Saudi Arabia experienced consistent increases across nearly all age groups. The age effect revealed a low CRC risk before age 35–39, with risk rising steadily and peaking at age 90–94, a pattern consistent across all countries. Period effects were relatively stable globally, with increasing trends in all BRICS nations except Ethiopia. Cohort effects generally increased over time, stabilizing in recent birth cohorts, with a steeper rise among males. However, India and Ethiopia showed declining cohort risks. Conclusion This study highlights a substantial global increase in CRC incidence, with notable variations across BRICS nations over the past three decades. The observed age, period, and cohort effects underscore the need for age-specific and gender-sensitive health policies. Ongoing surveillance, research, and targeted public health interventions are critical to mitigating the rising CRC burden and improving health outcomes in these rapidly evolving regions.

BackgroundPremarital screening is a preventive public health measure to identify genetic, infectious, and chronic conditions affecting the health of couples and their future offspring. It plays a crucial role in reducing the prevalence of common hereditary disorders, particularly in regions with high consanguinity rates, like the Middle East. In the United Arab Emirates, where approximately half of the marriages are consanguineous, premarital screening has become a cornerstone of genetic healthcare, helping to mitigate the increased risk of genetic disorders. Despite its importance, gaps remain in healthcare professionals’ awareness and training regarding the implementation of premarital genetic screening, highlighting the need for educational interventions to ensure its effective integration into routine practice. This study evaluates the knowledge enhancement and attitude shift among physicians participating in health education workshops on expanded premarital screening, addressing gaps in their awareness, training, and perspectives on its implementation and ethical considerations.ResultsA cross-sectional study was conducted between May 2023 and June 2024 among physicians participating in three premarital genetic screening workshops. Differences in knowledge scores before and after the training were assessed using paired t-tests. The study surveyed 60 physicians, predominantly females (85%) and Emiratis (67%). Only 25% received formal training or education on premarital genetic screening. The study observed a significant increase in knowledge scores after the workshop, with overall scores rising from a mean of 45% (SD = 15) to 77% (SD = 12), showing a mean difference of 32% (p < 0.001). This improvement was significant across different age groups, genders, and regardless of prior formal training. While the belief that expanded premarital screening should be obligatory decreased (90% to 76%), the proportion of physicians who strongly disagreed that it breaks personal privacy increased significantly (10% to 42%).ConclusionThese findings suggest that targeted educational interventions can significantly enhance healthcare professionals’ knowledge and attitudes regarding genetic screening practices. To maximize impact, these interventions should be sustainable and reinforced through regular refresher courses. Continuous education ensures that physicians remain updated on the latest guidelines, advancements in genetic screening, and best practices, ultimately improving the quality of patient care and counseling services.

The Sustainable Development Goals (SDGs), announced by the United Nations (UN) in 2015, consist of 17 goals. Today, the rapid increase in population and industrialization necessitates the efficient and effective use of resources. Furthermore, climate change and global warming highlight the importance of a sustainable world. From this perspective, the performance of OPEC (Organization of the Petroleum Exporting Countries) member countries—which hold over two-thirds of the world's oil reserves—in achieving the SDGs is of significant interest. This study uses Gray Relational Analysis (GRA) to examine the performance of 13 OPEC countries using social, environmental, and economic indicators. The results indicate that the countries with the best performance are the United Arab Emirates (UAE), Saudi Arabia, and Kuwait, while those with the lowest performance are Nigeria, Equatorial Guinea, and Angola, respectively. The primary factors contributing to the low performance of certain countries include shortcomings in gender inequality, education, and mortality rate indicators.

The study aims to identify the trends of scientific research (master’s and PhD theses) at Al Wasl University by analysing and tracking the following elements and indicators: Degree awarded, Gender of the researcher, Nationality of the researcher, Gender of the research supervisor, Nationality of the research supervisor, Annual distribution of research, Research specialization, Type of research. Considering the above, there is a clear need to conduct a statistical analytical study to answer the following main question: What are the trends of scientific research (master’s and PhD theses) at Al Wasl University,Dubai, United Arab Emirates? A systematic bibliometric analysis was conducted using the Theses and Dissertations Approved in The University of Alwasl published between 1999 and August 2025. A total of 425 Theses and Dissertations were identified, involving 364 authors. The study recorded the theses approved at the master's and doctoral levels since the establishment of graduate studies at the university up to August 2025. showing a consistent growth in the number of master's and doctoral degrees and an increased approval rate in recent years, the languages thesis to master's and doctoral research. It is evident that the percentage of Arabic language is higher than that of other languages completed (99.07%), while other languages for (0.93%). The specializations of Master's and Doctoral theses at Al Wasl University, varied across five main areas. Leading these was the field of Emirati culture and society studies, with 203 theses, making up 46.99%, which is logically consistent with the university's context.

Background/Objectives: Takotsubo syndrome (TS) is an acute, reversible cardiac condition that represents an increasingly recognized acute heart failure syndrome affecting 2–3% of patients presenting with suspected acute coronary syndrome (ACS), with significant morbidity and mortality comparable to myocardial infarction. The InterTAK Diagnostic Score was developed to differentiate TS from ACS at initial presentation. However, its performance characteristics and optimal cutoff values in Middle Eastern populations have not been established, despite potential ethnic and cultural variations in the clinical presentation and trigger patterns. Methods: We conducted a retrospective, case–control, diagnostic accuracy study of patients admitted to Tawam Hospital, Al Ain, United Arab Emirates, between June 2012 and June 2022. Power analysis indicated 80% power to detect an AUC difference of 0.15 with our sample size. Results: Eleven patients with confirmed TS (mean age 53.4 ± 14.1 years, 72.7% female) were compared with 26 age-matched patients with ACS (mean age 54.6 ± 11.0 years, 23.1% female). TS diagnosis was based on modified Mayo Clinic criteria with independent adjudication by two cardiologists (κ = 0.92). The InterTAK score was calculated for each patient based on seven clinical variables. The mean InterTAK score was significantly higher in TS patients (49.1 ± 14.8) compared with ACS patients (13.0 ± 9.3; p &lt; 0.001). The receiver operating characteristic curve analysis yielded an area under the curve (AUC) of 0.974 (95% confidence interval, 0.92–1.00), exceeding the original validation cohort’s performance (AUC 0.971). An InterTAK score ≥ 40 identified TS with 81.8% sensitivity and 100% specificity. Remarkably, when the cutoff was lowered to ≥36, sensitivity improved to 90.9% while maintaining 100% specificity. Conclusions: The InterTAK Diagnostic Score demonstrated exceptional discriminatory ability (AUC 0.974, 95% CI 0.92–1.00) in differentiating TS from ACS in our Middle Eastern cohort, surpassing the original validation study’s performance. A regionally optimized cutoff of ≥36 points achieved 90.9% sensitivity with 100% specificity, compared to the original ≥40 cutoff (81.8% sensitivity, 100% specificity). These findings establish the score’s trans-ethnic validity while highlighting the importance of regional calibration. Larger prospective studies are warranted to validate these findings and establish region-specific cutoff values.

Abstract Objectives We aimed to gather insights from physicians regarding feeding practices for premature infants in the Middle East and North Africa. Methods An online survey was distributed among physicians who managed premature infants. Descriptive analyses were used to evaluate the responses. Results In total, 1000 out of 1300 participants from Egypt, Iraq, Kuwait, Qatar, Saudi Arabia, Syria, and the United Arab Emirates completed the survey. As reported, the participants included neonatologists ( n = 678), general pediatricians ( n = 258), and pediatric gastroenterologists ( n = 14). Nearly half the participants ( n = 466; 49.2%) had over 10 years of experience. Overall, 53.4% of participants followed available feeding protocols, 16.8% inconsistently adhered to available protocols, and 14.8% reported unavailability of feeding protocols in their practice. Some participants (36%) had concerns about feeding‐related complications with early initiation of enteral feeding. We observed variations in feeding practices as well as the management and monitoring of feeding‐related complications in preterm infants among the participants. Additionally, awareness of human milk fortifiers was variable and correlated with clinical experience. Conclusion There is a need for training healthcare professionals, standardizing feeding protocols, and optimizing care for preterm infants across the region to reduce feeding‐related complications and improve long‐term health outcomes.

Background/Objectives: Antibiotic resistance is a growing global health threat, requiring comprehensive investigations into the occurrence, distribution, and diversity of antibiotics across environmental systems. This study aimed to examine the distribution and prevalence of commonly used antibiotics in various wastewater sources across the United Arab Emirates (UAE), providing insights into potential environmental reservoirs contributing to antimicrobial resistance dissemination. Methods: Wastewater samples were collected from the outlets of three hospitals, three residential communities, and the influent and return activated sludge of two wastewater treatment plants. Samples were prepared using solid-phase extraction (SPE) and analyzed via liquid chromatography–mass spectrometry (LC–MS/MS) to quantify antibiotic concentrations and compare their distribution among sources. Results: Significant variations were observed in antibiotic concentrations across the different wastewater sources. Ciprofloxacin concentrations were highest in hospital wastewater, reaching up to 247.9 ng/mL, while cefuroxime and vancomycin ranged between 0.2 and 10.9 ng/mL across samples. Clindamycin was notably prevalent in wastewater treatment plant samples (up to 10.9 ng/mL), whereas vancomycin and cefuroxime were dominant in residential community samples, reflecting diverse antibiotic usage patterns and persistence in treatment systems. Conclusions: The findings reveal substantial antibiotic contamination in United Arab Emirates wastewater systems, underscoring the need for ongoing surveillance and regulatory measures. Continuous monitoring, coupled with effective wastewater treatment and antibiotic stewardship strategies, is critical to mitigating the environmental spread of antimicrobial resistance and safeguarding public and environmental health.

Cost Analysis of Diabetes Mellitus Treatment in the Public Sector in Dubai, The United Arab Emirates: Analysis Based on a Global Perspective Model.

Diabetic ketoacidosis (DKA) is a potentially fatal diabetes complication marked by hyperglycemia, ketonemia, and acidosis that remains a major global healthcare burden despite advances in diabetes management. The aim of this study was to quantify the healthcare costs of DKA admissions at a tertiary hospital in the United Arab Emirates (UAE), and evaluate cost-effective preventative strategies. A retrospective electronic record analysis of all DKA admissions from 2019 to 2023 at Tawam Hospital, Al Ain, was conducted after ethical approval from Tawam Human Research Ethics Committee, approval number MF2058-2023-916. Clinical characteristics, precipitating factors, length of stay, insurance status, and total inpatient costs were analyzed for all consecutive adult (≥ 16years) DKA admissions over this period. The cost of DKA-related admission was compared to the price of insulin therapy in underinsured patients who are unable to afford insulin. There were 134 patients admitted with DKA (157 admissions) over 5years (one DKA admission every 11.6days). The mean hospitalization cost per DKA admission was 12,274 ± 10,213 USD (45,461 ± 37,826 AED), with an average length of stay of 10.2 ± 11.7days (1203 USD [4,457 AED] per day). Insulin unaffordability, a preventable factor, led to 13.4% (21 cases) of admissions, incurring a total cost of 257,765 USD (954,686 AED). Underinsured patients demonstrated significantly higher ICU utilization (76.8% vs 52.5%, p < 0.01) and mean costs (14,269 USD [52,847 AED] vs 11,133 USD [41,235 AED], p = 0.07) compared to adequately insured patients. In comparison, the average cost of insulin is 38 USD (139.5 AED) per patient/month, indicating that the cost of one preventable DKA admission equals 27years of insulin therapy. The overall mortality rate of DKA admissions was 4.5%. DKA imposes a substantial economic and clinical burden in the UAE, with mean hospitalization costs of 12,274 USD per admission. While insulin unaffordability accounts for 13.4% of admissions (costing 257,765 over 5years), infections represent the largest precipitating factor at 49.0%. Comprehensive DKA prevention requires a multifaceted approach: infection management education, ensuring insulin access for underinsured patients, and structured diabetes education. Our analysis suggests that addressing insulin affordability could be economically favorable, as preventing one DKA admission would offset 27years of insulin costs. However, optimal resource allocation requires addressing all major precipitating factors to achieve meaningful reductions in DKA burden. Graphical abstract available for this article.