Lifestyle intervention in early pregnancy can prevent gestational diabetes in high-risk pregnant women in the UAE: a randomized controlled trial.

PURPOSE: A prevalence of gestational diabetes mellitus (GDM) is approximately three times higher than the global rate in the UAE. However, it has not yet been studied whether a 12-week moderate-intensity lifestyle intervention can prevent gestational diabetes among pregnant women at high risk in this region. PATIENTS AND METHODS: A pragmatic, open-label, randomized clinical trial was conducted. Sixty-three women aged 18 to 45 years, with ≤12 weeks of gestation, singleton pregnancy, and having ≥ two risk factors for GDM were randomly assigned to the Lifestyle Intervention (LI) group (n = 30) or Usual Care (UC) group (n = 33). The women in the LI group received a 12-week, moderate-intensity lifestyle intervention with individualized counseling on a diet, physical activity, and behavior change by a licensed dietitian. The women in the UC group received usual antenatal care. The primary outcome was the incidence of GDM based on the IADPSG criteria at 24-28 weeks of gestation. RESULTS: The incidence of GDM was 33.3% in LI group and 57.5% in UC group. The crude relative risk (RR) for GDM was 0.59 (95% CI, 0.32-1.04, p = 0.05). The multivariable logistic regression model without adjustment showed OR = 0.37 (95% CI, 0.13-1.02, p = 0.05) and after adjusting with Age, BMI and family history of diabetes reported OR = 0.26, 95%CI 0.07, 0.92, p = 0.04. in LI vs UC. The daily dietary intake of calories (- 120 kcal, p = < 0.01), carbohydrates (- 19 g, p < 0.01), and fat (- 5 g, p = 0.03) was reduced, and physical activity time (+ 52 min, p = 0.05) increased in the LI group after the intervention. However, the LI had no significant effect on maternal and neonatal outcomes. CONCLUSION: A 12-week moderate intensity lifestyle intervention in early pregnancy could reduce the relative risk of GDM by 41% among high-risk pregnant women in the UAE. These findings could impact public health outcomes in the region. TRIAL REGISTRATION: Trial registration Retrospectively registered NCT04273412,18/02/2020.

Vitamin D3 supplementation and body composition in persons with obesity and type 2 diabetes in the UAE: A randomized controlled double-blinded clinical trial.

BACKGROUND & AIM: The co-existence of vitamin D deficiency with obesity and type 2 diabetes is highly prevalent in the United Arab Emirates. We do not have studies evaluating the vitamin D dose response and sufficiency, and if sufficient substitution dose during a longer period could decrease obesity or change fat distribution in obese type 2 diabetic vitamin D deficient Emiratis. METHODS: A randomized double-blind clinical trial was conducted for 6 months followed by another 6 months of un-blinded follow up with 87 obese, type 2 diabetic participants. Serum 25-hydroxy vitamin D (S-25(OH)D), anthropometric data, and life-style factors such as diet and sunlight exposure were measured. The study was executed in 3 phases in two arms vitamin D arm (n = 45) and placebo arm (n = 42); in Phase 1 the vitamin D arm received 6000 IU vitamin D3/day (3 months) followed by Phase 2 with 3000 IU vitamin D3/day. During follow up (phase 3) both the arms were un-blinded and supplemented with 2200 IU vitamin D3/day for another 6 months. RESULTS: At the baseline a significant (p < 0.01) positive association between body fat mass and body weight (r = 0.97) muscle mass (r = 0.47), water mass (r = 0.54), waist circumference (r = 0.82) and serum PTH (r = 0.28) was observed. On supplementation no significant changes in anthropometric dimensions was observed. S-25(OH) D peaked in phase 1 (77.2 ± 30.1 vs 28.5 ± 9.2, p = 0.003) followed by a decrease in phase 2 (62.3 ± 20.8, p = 0.006) paralleled by a decrease in parathyroid hormone in phase 2 (5.9 ± 2.4 vs 4.5 ± 1.8, p < 0.01) compared to baseline in vitamin D group. CONCLUSION: This study shows no significant influence of vitamin D supplementation on weight, fat mass or waist circumference in type 2 diabetic obese vitamin D deficient participants of Arab ethnicity after one year. Despite a relatively high daily dose of vitamin D3 we did not achieve target levels of S-25(OH)D above 75 nmol/L in this population. However, supplementation was safe, improved s- 25 (OH)D also reducing the incidence of eucalcemic parathyroid hormone elevation. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov Identifier: NCT02101151.

Observations on self-induced Taenia saginata infection.

Three Cysticercus bovis cysts were ingested voluntarily and the prepatent period was found to be 84 days. Observation on the frequency of proglottid apolysis for 26 days revealed a total of 85 segments with or without faeces. Abdominal pain began one month before the prepatent period. Nausea, headache, and disturbed sleep became apparent only after the end of the prepatent period. During the segment shedding period, a 10.5% increase in eosinophilia and a 13.0% increase in lymphocytes were observed. A count of eggs in 20 gravid segments revealed an average of 89,000 eggs per segment. Treatment using praziquantel a single dosage of 10 mg/kg body weight expelled the worm including the scolex.

Effectiveness of praziquantel against Taenia saginata infections in Ethiopia.

Twenty-six individuals infected with Taenia saginata, 18 males and eight females ranging in age from 19-46 years, were treated successfully by a single oral dose of praziquantel at 10 mg kg-1 body weight. The drug was well tolerated, and no appreciable side effects were observed. Of the 26 patients, eight harboured one worm and the remainder harboured two or more worms; eight worms were obtained from one individual. In all 75 worms were recovered, ranging in length from 1.05-4.55 m, with a mean length of 2.26 +/- 0.36 m. The number of segments per worm ranged from 283-758, with a mean of 450 +/- 57.6. The mean wet and dry weights of the worms were found to be 26.1 +/- 2.7 g and 4.00 +/- 0.32 g respectively. The mean length of the worms, the mean number of segments per worm and the mean wet and dry weights were observed to decrease significantly (P less than 0.01) with an increase in the number of worms harboured by the patient.