Dietary assessment of type 2 diabetic patients using healthful plant-based diet score in the Eastern Province of Saudi Arabia.

BACKGROUND: Diabetes mellitus is a chronic disease characterized by a wide range of metabolic problems. The current study sought to assess nutritional habits of Saudi patients with type 2 diabetes (T2D) and to propose recommendations to improve these patients' dietary habits and delay possible disease complications. METHODS: Over a period of three years, (2017-2019) 577 patients with T2D attending the outpatient's diabetic clinics at King Fahd Hospital of the University, Al Khobar, Saudi Arabia were invited to participate in this study. Data of dietary intake were collected by trained nurses using a pretested structured validated semi quantitative food frequency questionnaire. The dietary data were collected using 7-day dietary recall questionnaire. A modified score system that associates dietary habits with glycemic control and lipid profile was used. RESULTS: Overall, a high healthful plant-based diet score was associated with a significant (P = 0.018) reduction in triglycerides (TG) level (mean difference - 3.78%; 95% CI, -0.65% to -6.81%) and a statistically non-significant (P = 0.06) increase in high density lipoprotein (HDL) levels (mean difference 1.87%; 95% CI -0.06-3.84%) in T2D patients from the Eastern Province of Saudi Arabia. Additionally, in our patient group, the prevalence of coronary artery disease, stroke, peripheral artery disease, and chronic kidney disease in T2D patients was 11.3%, 6.2%, 3.3%, and 8.4%, respectively and were higher when compared to the prevalence in the general population. CONCLUSION: The present study showed that adherence to a healthful plant-based diet, when compared to high glycemic index diet, is associated with a favorable outcome in glycemic control and lipid profile in T2D patients. Prior assessment of total diet quality may be beneficial when giving nutritional advice to T2D patients with the possibility of improving glycemic control and lipid profile.

Fenugreek and Its Effects on Muscle Performance: A Systematic Review.

Fenugreek extracts possess promising physiological and pharmacological properties in human and animal models. This review aims to provide a scientific and comprehensive analysis of the literature on the effects of fenugreek extracts on muscle performance. An extensive online search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. The main medical and scientific engines were searched for articles from May 1981 to May 2021 to capture all scientific studies focused on the effect of fenugreek on muscle and exercise or sport. Out of 81 studies acquired, six eligible randomized controlled trials (RCTs) were included in the qualitative analysis. Four RCTs observed that fenugreek supplementation had significantly improved muscle strength, repetitions to failure (muscle endurance), submaximal performance index, lean body mass, and reduced body fat. Among the remaining two trials, one reported the significant effect of fenugreek extracts on the rate of muscle glycogen resynthesis during post-exercise recovery; however, the other failed to do so. Those two trials were weak, with a minimal sample size (<10). Further, fenugreek glycoside supplementation with sapogenins and saponins reported substantial anabolic and androgenic activity, influencing testosterone levels and muscle performance. It was useful during eight weeks of resistance training without any clinical side effects. Fenugreek with creatine supplementation improved creatine uptake without the necessity of high carbohydrate intake. Hence, fenugreek extracts can be a helpful natural supplement and ergogenic aid for athletes. However, it is better to be aware of doping and liver and kidney damage before using the fenugreek supplement.

Gut microbiota analyses of Saudi populations for type 2 diabetes-related phenotypes reveals significant association.

BACKGROUND: Large-scale gut microbiome sequencing has revealed key links between microbiome dysfunction and metabolic diseases such as type 2 diabetes (T2D). To date, these efforts have largely focused on Western populations, with few studies assessing T2D microbiota associations in Middle Eastern communities where T2D prevalence is now over 20%. We analyzed the composition of stool 16S rRNA from 461 T2D and 119 non-T2D participants from the Eastern Province of Saudi Arabia. We quantified the abundance of microbial communities to examine any significant differences between subpopulations of samples based on diabetes status and glucose level. RESULTS: In this study we performed the largest microbiome study ever conducted in Saudi Arabia, as well as the first-ever characterization of gut microbiota T2D versus non-T2D in this population. We observed overall positive enrichment within diabetics compared to healthy individuals and amongst diabetic participants; those with high glucose levels exhibited slightly more positive enrichment compared to those at lower risk of fasting hyperglycemia. In particular, the genus Firmicutes was upregulated in diabetic individuals compared to non-diabetic individuals, and T2D was associated with an elevated Firmicutes/Bacteroidetes ratio, consistent with previous findings. CONCLUSION: Based on diabetes status and glucose levels of Saudi participants, relatively stable differences in stool composition were perceived by differential abundance and alpha diversity measures. However, community level differences are evident in the Saudi population between T2D and non-T2D individuals, and diversity patterns appear to vary from well-characterized microbiota from Western cohorts. Comparing overlapping and varying patterns in gut microbiota with other studies is critical to assessing novel treatment options in light of a rapidly growing T2D health epidemic in the region. As a rapidly emerging chronic condition in Saudi Arabia and the Middle East, T2D burdens have grown more quickly and affect larger proportions of the population than any other global region, making a regional reference T2D-microbiome dataset critical to understanding the nuances of disease development on a global scale.

Beneficial effects of adding magnesium to desalinated drinking water on metabolic and insulin resistance parameters among patients with type 2 diabetes mellitus: a randomized controlled clinical trial.

There is evidence that increasing the consumption of water containing magnesium can improve glucose metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). This trial was undertaken with the objective of evaluating the effect of adding different concentrations of magnesium chloride to the desalinated drinking water on the glycemic, metabolic, and insulin resistance parameters among patients with T2DM. A randomized cross-sectional controlled clinical trial was conducted to evaluate the effects of adding magnesium chloride supplement to desalinated drinking water consumed by patients with T2DM on the glycemic and metabolic parameters and indicators of insulin sensitivity. The total number of patients with T2DM who successfully completed the trial is 102. Patients were randomly allocated into three groups: the first group received bottled water without added magnesium (0 mg/L) (Group A, n = 37); the second group received bottled water with a low level of magnesium (20 mg/L) (Group B, n = 33); and the third group received drinking water with a high level of magnesium (50 mg/L) (Group C, n = 32). The daily consumption of elemental magnesium for a period of 3 months resulted in significant improvement in HbA1C (8.0 vs 8.2%, p = 0.04), insulin level (7.5 vs 9.9 µIU/mL, p = 0.03), and homeostasis model assessment-estimated insulin resistance (HOMA.IR) (2.5 vs 2.9, p = 0.002) in group C. However, there was no significant improvement in fasting blood glucose (FBS) level or lipid profile. The results of this study suggest that oral magnesium supplementation at the given dose of 50 mg/L daily added to drinking water could improve long-term glycemic control indicators and reduce insulin resistance in patients with T2DM.

Determinants of misconceptions about diabetes among Saudi diabetic patients attending diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia.

OBJECTIVE: To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia. MATERIALS AND METHODS: This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculated and categorized into low (0-12), moderate (13-24) and high (25-36) scores. The association of misconception score with various potential determinants was calculated using Chi-square test. Step-wise logistic regression was applied to the variables showing significant association with the misconception score in order to identify the determinants of misconceptions. RESULTS: The mean age was 39.62 ± 16.7 and 112 (56%) subjects were females. Type 1 diabetics were 78 (39%), while 122 (61%) had Type 2 diabetes. Insulin was being used by 105 (52.5%), 124 (62%) were self-monitoring blood glucose and 112 (56%) were using diet control. Formal education on diabetes awareness had been received by 167 (83.5%) before the interview. The mean misconception score was 10.29 ± 4.92 with 115 (57.5%) subjects had low misconception scores (<12/36). On the Chi-square test, female gender, rural area of residence, little or no education, <5 or >15 years since diagnosis, no self-monitoring, no dietary control and no diabetes education were all significantly (P < 0.05) associated with higher misconception scores. Step-wise logistic regression suggested that diabetes education, gender, education and time since diagnosis were significant (P < 0.05) predictors of misconception scores. CONCLUSIONS: The strongest determinants of misconceptions about diabetes in our study population were female gender, rural area of residence, illiteracy or little education, <5 or >15 years since diagnosis, no self-monitoring, no diet control and no education about diabetes.

Hyercalcemia induced by interferon therapy in chronic hepatitis C.

Interferon is being increasingly used in the treatment of chronic hepatitis C. Several case reports have suggested an association between interferon therapy and sarcoidosis with hypercalcemia. We report a case of severe hypercalcemic crisis with bilateral hilar lymphadenopathy in a male patient who was receiving interferon therapy for hepatitis C. Gastroenterologists should be aware of this unusual but clinically important complication of interferon therapy.

Helicobacter pylori infection and its relationship to metabolic syndrome: is it a myth or fact?

Metabolic syndrome is one of the most prevalent global health problems that predisposes to Type 2 diabetes. It is strongly linked to insulin resistance, which results in hyperglycemia. Over the past few years, lot of studies have been carried out on Helicobacter pylori infection and found a possible causal relationship through releasing some of the interleukins factors, which result in endothelial dysfunction. However, some studies attributed that due to coincidence were not able to establish any causal relationship. In this review, the literature has been reviewed to check this possible association.