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Background: Diabetes Mellitus, a global health challenge, affects 537 million individuals. Traditional management relies on periodic clinic visits, but technological advancements, including remote monitoring, offer transformative changes. Telemedicine enhances access, convenience, adherence, and glycemic control. Challenges include trust-building and limitations in face-to-face interactions. Integrating remote monitoring with in-person healthcare creates a hybrid approach. This study evaluates the impact on Type 2 Diabetes patients over 3 months. Methods: A retrospective case-control observational study. Inclusion criteria involved previous Type 2 Diabetes diagnosis and a minimum 3-month GluCare model period with two physical visits. Patients in the case group had in-clinic visits, bi-weekly app engagement, and monthly body weight readings. Control group had in-clinic visits only. Outcomes measured included HbA1c, lipid profile, CV risk, eGFR, urine Albumin/Creatinine Ratio, Uric Acid, and CRP. Results: Case group showed significant HbA1c improvements (-2.19%), especially in higher baseline levels. Weight, BMI, LDL, total cholesterol, and CVD risk also improved. Controls showed smaller improvements. Higher digital interactions correlated with better outcomes. Patients with ≥11 interactions showed significant reductions in HbA1c (-2.38%) and weight (-6.00 kg). Conclusion: The GluCare.Health hybrid model demonstrates promising outcomes in Type 2 diabetes management. The integration of in-clinic consultations with continuous remote monitoring leads to substantial improvements in glycemic control and clinical parameters. The study highlights the importance of patient engagement in achieving positive outcomes, with higher digital interactions associated with greater reductions in HbA1c and weight. The hybrid approach proves more effective than digital-only interventions, emphasizing the need for comprehensive, end-to-end solutions in diabetes care.
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Automonitorização da Glicemia , Diabetes Mellitus Tipo 2 , Telemedicina , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/sangue , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estudos de Casos e Controles , Automonitorização da Glicemia/métodos , Glicemia/análise , Glicemia/metabolismo , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Idoso , AdultoRESUMO
Aim: Emerging anti-obesity pharmacotherapy provides an option to correct maladaptive physiological and hormonal changes associated with obesity. One of the widely used medications in this context is glucagon-like peptide 1 (GLP-1) agonists. However, the misuse of these medications without any guidance and monitoring of lifestyle modifications can lead to unfavorable outcomes. The study aims to evaluate the effectiveness of a hybrid care model, incorporating GLP-1 and GLP-1/GIP agonist therapies, in managing obese patients with/without pre-diabetes. This study showcases the midway results of a 6-month program, which includes a multidisciplinary care team and digital technology for continuous engagement and monitoring of patients, both in-clinic and remotely. Methods: In a retrospective observational study, 115 participants were treated with GLP-1s (semaglutide, tirzepatide, and liraglutide). Physicians, dietitians, and coaches worked together to support behavioral changes using a dedicated app provided to patients. At the care team end, an integrated portal enabled continuous data flow allowing for the care team to provide personalized care via chat at regular intervals. Data collected included food logs, continuous glucose monitoring (CGM), and digital biomarkers such as sleep and activity. Results: At the midpoint of the program, participants exhibited statistically significant improvements in various metabolic parameters. Mean weight reduction was 8 %, with significant reductions in BMI, fat mass, and cholesterol levels. 24 (20.9 %) of patients lost ≥5 % of body weight, 55 (47.8 %) patients lost ≥10 % weight, and 36 (31.3 %) patients lost ≥15 % weight. Sub-analysis of pre-diabetic patients (n=36) demonstrated substantial improvements, including control of pre-diabetes in 80.6 % of cases and reduced HbA1c levels back to normoglycemia (5.39 ± 0.27). Conclusion: The Zone.Health's program, which combines pharmacotherapy with continuous engagement and monitoring to enable sustainable lifestyle modifications, demonstrated significant improvements in weight, body composition, and metabolic markers. Pre-diabetes was also effectively addressed. It is necessary to conduct further research to assess the long-term sustainability and optimal adoption of such care models into clinical practice.
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BACKGROUND: Gestational Diabetes Mellitus (GDM) is responsible for the development of 30-50% of type 2 diabetes mellitus that predisposes later to adverse consequences among affected mothers and their offspring. Several studies have suggested that GDM increases the risk of developing perinatal depression (PND); however, factors that are involved in this association are yet to be determined. This study aims to identify factors that interrelate GDM and PND among pregnant and postnatal women in the United Arab Emirates (UAE). METHODS: A total of 186 women between 18 and 45 years old attending the obstetrics clinic during their 3rd trimester or up to 6 months postnatal were recruited between October 2021 and April 2022. Women who were known to have pre-existing diabetes mellitus (type 1 or type 2), kidney disease, liver disease, and those receiving hormonal therapy were excluded. Participants completed a structured questionnaire including sociodemographic data and the Edinburgh Postnatal Depression Scale (EPDS). Based on their EPDS scores, study participants were categorized into three groups: no depression (> 9), possible depression (9-11), and high possibility/strong positive depression (≥ 12). SPSS 26 was used for data analysis. RESULTS: Among the 186 participants, 81% (n = 151) were Emirati, 41% (n = 76) had no GDM, and 58% (n = 110) had GDM. Of the study participants, 34.4% had a high possibility of strong positive depression, 40.9% had possible depression, and only 6.5% had no depression. The association between GDM and PND was clinically and statistically insignificant, with a calculated odds ratio (OR) of 1.574 (p value = 0.204) and a 95% confidence interval (0.781-3.172). However, age, personal history of depression, and BMI were found to be strong predictors of depression among pregnant/postpartum women in the UAE. CONCLUSIONS: The study findings propose that age, personal history of depression, and obesity are strong predictors of depression during pregnancy. The strong correlation between obesity (which is a known strong predictor of GDM) and PND suggests that further studies with longitudinal designs and longer observational periods might better reveal the relationship between GDM and PND. TRIAL REGISTRATION: Retrospectively registered study by Research Ethics Committees of the University Hospital Sharjah and the University of Sharjah (Ref. No.: UHS-HERC- 025-17122019) December 17, 2019.
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Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Adulto Jovem , Estudos Transversais , Depressão/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Gestacional/epidemiologia , Obesidade , Fatores de Risco , Emirados Árabes Unidos/epidemiologiaRESUMO
Aims: Diabetes is a pressing global health issue, demanding innovative strategies for improved treatment. However, traditional care often falls short of patient goals. To address this, digital health solutions, including smartphone apps and remote monitoring, have emerged as crucial in diabetes management. This study aims to assess a comprehensive intervention, combining remote continuous data monitoring (RCDM) with in-clinic care, for enhancing diabetes-related outcomes. Additionally, it seeks to evaluate the effectiveness of the digital RCDM component by comparing adherent and non-adherent patients. Methods: Conducted in the United Arab Emirates, a retrospective study involved 89 patients primarily on anti-diabetic medications. They were split into two groups based on adherence to RCDM. Over time, significant improvements were observed across various parameters. Results: Notably, patients exhibited weight loss (-4.0 ± 5.3, p < 0.001), reduced waist circumference (-4.74 ± 7.8, p < 0.001), lowered HbA1c levels (-1.00 ± 1.3, p < 0.001), decreased systolic BP (-3.1 ± 13.1, p = 0.035), and diminished diastolic BP (-3.4 ± 9.9, p = 0.002) annually. Furthermore, patients adhering to the GluCare model demonstrated substantial HbA1c reductions (-1.53 ± 1.5, p < 0.001), improved lipid profiles, notably decreased total Cholesterol (-16.6 ± 50.3, p = 0.034), and lowered LDL levels (-18.65 ± 42.6, p = 0.006). Conclusions: The intervention model effectively managed T2D patients through a comprehensive approach, yielding notable improvements in HbA1c levels and other outcomes within a year. The study underscores the limitations of traditional care and reliance simply on pharmacotherapy, and emphasizes the need for a hyper-personalized, and continuous approach for T2D management.
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Gestational diabetes mellitus (GDM) is one of the most common pregnancy-related endocrinopathies, affecting up to 25% of pregnancies globally. GDM increases the risk of perinatal and delivery complications, and the chance of developing type 2 diabetes mellitus and its complications, including cardiovascular diseases. This elevated risk is then passed on to the next generation, creating a cycle of metabolic dysfunction across generations. For many years, GDM preventive measures have had inconsistent results, but recent systematic reviews and meta-analyses have identified promising new preventative routes. This review aims to summarize the evidence investigating the efficacy of lifestyle treatments for the prevention of GDM and to summarize the effects of two lifestyle interventions, including physical activity and dietary interventions. Based on the present research, future studies should be conducted to investigate whether initiating lifestyle interventions during the preconception period is more beneficial in preventing GDM. In addition, research targeting pregnancy should be designed with a personalized approach. Therefore, studies should customize intervention approaches depending on the presence of modifiable and non-modifiable risk factors at the individual level.
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Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Gravidez , Feminino , Humanos , Diabetes Gestacional/prevenção & controle , Exercício Físico , Estilo de VidaRESUMO
Camel milk has been consumed for centuries due to its medicinal and healing properties. The present study aims to investigate the consumption patterns of camel milk and perceived benefits and risks among adults in the United Arab Emirates. A self-administered online questionnaire was developed in English and Arabic languages and was completed online by 852 adults. Socio-demographic characteristics, camel milk consumption patterns and perceived knowledge of the benefits and risks of camel milk were investigated. About 60 % of the participants have tried drinking camel milk, but only a quarter (25â 1 %) were regular consumers. The most consumed camel milk products after fresh milk were yoghurt and flavoured milk. The most popular additions to camel milk were honey, turmeric and sugar. Most consumers had less than one cup of camel milk per day (57â 0 %). Camel milk consumers preferred it over other types of milk due to its nutritional value (66â 4 %) and medicinal properties (39â 3 %). Among consumers, 58â 4 % reported consuming unpasteurised camel milk. Reasons included the belief that it is fresher (87â 2 %), better for the immune system (41â 6 %), and higher in nutrients (39â 2 %). Overall, participants had inadequate knowledge about the health benefits of camel milk (7â 11 ± 5â 3 out of 25). Males and camel milk consumers had a significantly higher knowledge about the health benefits of camel milk compared to females and non-consumers (P < 0â 05). Although positive perceptions were common, misperceptions appear to be prevalent among non-consumers. Consuming unpasteurised camel milk is a major public health concern, thus national regulations are essential.
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Camelus , Leite , Animais , Estudos Transversais , Feminino , Humanos , Masculino , Valor Nutritivo , PaladarRESUMO
OBJECTIVE: To investigate into the prevalence of the SP complex elongation among patients attending RAK Dental College Clinic. MATERIAL AND METHODS: A 3234 radiographic images of patients aged ≥18 years were examined. The O'Carroll (1984) classification of stylohyoid complex was used. Age, gender, ethnicity and patterns of calcification were recorded and analyzed. Chi-squared and ANOVA tests were used to detect potential differences. RESULTS: Male to female ratio was 1.9:1. There were 1150 (35.6%) subjects in age group-I (18-39) and 2084 (64.4%) subjects in the age group-II (≥40). The mean age was 38.12 (±13.2). Fifty seven % (1836) of the subjects were eastern Asians, 671 (21%) Africans, 325 (10%) Middle east, 254 (8%) Europe, and 148 (4%) other ethnicities. A normal SP was found in 1601 (49.51%) of the images, elongated in 903 (27.92%), calcified in 406 (12.55) and undetected in 324 (10.2%). The elongated and the calcified styloid processes were more common in males (p=0.0078). The elongated and the calcified SP were more frequent in group II subjects (p=0.0004). Eastern Asians had higher percentage of elongated and calcified SP p= 0.00567. CONCLUSION: Although 1601 (49.51%) of subjects had normal SP, the study revealed a high prevalence of SP elongation among eastern Asians. There is a strong association between the age and the SP elongation. It is crucial to include the head and neck symptoms of non-odontogenic origin in the differential diagnosis of Eagle's syndrome. The study recommends further investigation using some advanced imaging techniques.