An update on the current characteristics and status of care for Muslims with type 2 diabetes fasting during Ramadan: the DAR global survey 2022.

BACKGROUND: Managing diabetes during Ramadan fasting is a challenge due lifestyle changes. We described the characteristics and patterns of care for type 2 diabetes mellitus (T2DM) during Ramadan 2020 and 2022. METHODS: Our study included multinational Muslims with T2DM who were during routine consultation. We collected data on demographics, fasting characteristics, and complications. Descriptive statistics, chi-square test, and multiple testing were performed. RESULTS: 12,529 patients participated. Mean age was 55.2 ± 11.8 years; 52.4% were females. Mean diabetes duration was 9.9 ± 7.4 years; 27.7% were with HbA1c >9% (75 mmol/mol) and 70% had complications. Metformin was the most used medication followed by insulin. 85.1% fasted ≥1 day; fasting mean duration was 27.6 ± 5.6 days. Hypoglycemia occurred in 15.5% of whom 11.7% attended emergency department or were hospitalized; this was significantly associated with age and/or duration of diabetes. Hyperglycemia occurred in 14.9% of whom 6.1% attended emergency department or were hospitalized and was also associated with age or duration of diabetes. 74.2% performed SMBG during fasting. 59.2% were educated on Ramadan fasting, with 89.7% receiving it during routine consultation. CONCLUSIONS: Ramadan fasting in T2DM is high. Multidisciplinary approach is required to mitigate complications. Our findings support current recommendations for safe fasting.

The goal of this survey was to describe the characteristics and current ways of care for Muslim patients with type 2 diabetes mellitus fasting during and after Ramadan 2020 and 2022. Most of the participants fasted a minimum of one day during Ramadan (85.1%). Overall, 15.5 and 14.9% reported low blood sugar levels or high blood sugar levels during fasting, respectively. Low blood sugar level was more reported in patients with older age, patients with longer diabetes duration, and women. High blood sugar level was more reported in patients with longer diabetes duration. Educational programs focusing on the risks occurring with fasting and practices that improve control of the disease will raise knowledge and awareness among patients with diabetes. Improving blood sugar control during Ramadan fasting remains a major need for both patients and healthcare providers who should collaborate to reduce the risk of diabetes-related problems.

Transcriptome Changes and Metabolic Outcomes After Bariatric Surgery in Adults With Obesity and Type 2 Diabetes.

Context: Bariatric surgery has been shown to be effective in inducing complete remission of type 2 diabetes in adults with obesity. However, its efficacy in achieving complete diabetes remission remains variable and difficult to predict before surgery. Objective: We aimed to characterize bariatric surgery-induced transcriptome changes associated with diabetes remission and the predictive role of the baseline transcriptome. Methods: We performed a whole-genome microarray in peripheral mononuclear cells at baseline (before surgery) and 2 and 12 months after bariatric surgery in a prospective cohort of 26 adults with obesity and type 2 diabetes. We applied machine learning to the baseline transcriptome to identify genes that predict metabolic outcomes. We validated the microarray expression profile using a real-time polymerase chain reaction. Results: Sixteen patients entered diabetes remission at 12 months and 10 did not. The gene-expression analysis showed similarities and differences between responders and nonresponders. The difference included the expression of critical genes (SKT4, SIRT1, and TNF superfamily), metabolic and signaling pathways (Hippo, Sirtuin, ARE-mediated messenger RNA degradation, MSP-RON, and Huntington), and predicted biological functions (ß-cell growth and proliferation, insulin and glucose metabolism, energy balance, inflammation, and neurodegeneration). Modeling the baseline transcriptome identified 10 genes that could hypothetically predict the metabolic outcome before bariatric surgery. Conclusion: The changes in the transcriptome after bariatric surgery distinguish patients in whom diabetes enters complete remission from those who do not. The baseline transcriptome can contribute to the prediction of bariatric surgery-induced diabetes remission preoperatively.

Association of Four Missense SNPs with Preeclampsia in Saudi Women.

OBJECTIVE: The objective of this study was to investigate the association of rs1051740, rs2234922 (in microsomal epoxide hydrolase 1; EPHX1), rs268 (in lipoprotein lipase; LPL) and rs6025 (in Factor V Leiden; F5) genetic variants with the risk of preeclampsia development in Saudi women. MATERIALS AND METHODS: This case-control study recruited 233 Saudi women (94 preeclampsia cases and 139 healthy controls) who visited the Gynecology and Obstetrics Departments of two hospitals in Jeddah, Saudi Arabia, for routine postpregnancy clinical follow-ups. All the women underwent thorough clinical and biochemical investigations conducted according to the standard clinical guidelines. Genotyping of the study participants was done using real-time polymerase chain reaction-based TaqMan allelic discrimination assay. The strength of the association between genetic variants and disease development was assessed using chi-square, odds ratio, 95% confidence interval and multifactor dimensionality reduction tests. RESULT: The minor alleles "G" in rs268 (LPL) and "A" in rs6025 (F5) were absent in Saudi women. The frequencies of rs1051740 and rs2234922 of EPHX1, both in the homozygous and allelic forms, were not significantly different between preeclampsia patients and healthy controls (for all tests, P > 0.05). The multifactor dimensionality reduction analysis also indicated that the interaction between the four studied single-nucleotide polymorphisms (SNPs) had no significant association with preeclampsia risk. CONCLUSION: This study found that none of the studied genetic variants (neither the single SNP nor the SNP-SNP interactions) explain the development of preeclampsia in the Saudi population. These findings not only underscore the disease heterogeneity but also highlight the need to develop population-specific diagnostic genetic biomarkers for preeclampsia.