ABSTRACT
A growing number of reports suggest a connection between hepatitis C virus [HCV] infection and type 2 diabetes [T2D]. However, the association of HCV infection with diabetes-related complications has not yet been clarified. The aim of this study was to determine the prevalence of HCV infection in T2D-patients in Kuwait which has a high incidence of type 2 diabetes, and to investigate the association between HCV viremia and diabetes-related complications. A total of 438 patients with T2D [325 Kuwaitis and 113 Egyptians], and 440 control subjects, were enrolled for this study. HCV infection was assessed by testing for serum HCV-specific antibodies, and by detection of HCV RNA. HCV viral load and hemoglobin A1c [HbA1c] levels were assessed in patients with and without diabetes complications. Thirty one [7%] out of 438 T2D-patients had evidence of HCV infection compared to 4 [1%] out of 440 control adults [p < 0.0001]. The prevalence of HCV infection in Kuwaiti and Egyptian T2D-patients was 3% and 18%, respectively. Most of the HCV sequences detected in T2D patients and control subjects were of genotype 4. The HbA1c levels in T2D-patients with HCV viremia were significantly higher than those in HCV-negative patients. HCV viremia, female sex, age, family history of diabetes were found to be independent risk factors for diabetes complications. The results suggest that T2D-patients in Kuwait have higher prevalence of HCV infection than controls, and that HCV viremia is associated with diabetes-related complications
ABSTRACT
Diabetes education is effective for improving clinical outcomes and quality of life. The barriers to patient education in the Arab World include: Attitude of the administration and policy makers, the negative view of health professionals and patients towards education, lack of curriculum / programs, lack of trained/certified personnel in the field of Therapeutic Patient Education [TPE], economic barriers, misconcepts, environmental and ecological barriers, lack of legislation for food labels, lack of premises for TPE, the absence of a positive role for the patients in their therapeutic choices, unawareness of patients about their rights, lack of time for both the patient and health care providers and high prevalence of illiteracy. Strategic plans should address all these barriers. Content areas that need to be addressed are determined in collaboration with the patient. Any health care professional can provide diabetes education. The lack of trained personnel in the domain of TPE in our region dictates the need to fill this gap by adopting a strategic plan, implemented in successive steps, starting by the formation of a number of Health Care Professionals [HCPs] in short term training. This document is a call for action, inviting all who are concerned with diabetes to establish national diabetes programs in the Arab World, and to start to undertake educational initiatives
Subject(s)
Humans , Arabs , Quality of Life , Patient Education as Topic , Patient Rights , Awareness , Curriculum , Educational StatusABSTRACT
To study the prevalence of uncontrolled hypertension in the diabetic Kuwaiti patients and to assess factors related to this condition. A population based study of a total of 251 diabetic patients [T1DM and T2DM] followed up in diabetes out patient clinic at Al Amiri hospital in Kuwait. Patients were evaluated basically for the blood pressure control, and in addition to the routine biophysical data, we measured the glycated hemoglobin, lipid, renal profile, and urinary protein excretion. 142 patients [56.6%] found to have uncontrolled hypertension. Factors associated with uncontrolled hypertension were old age [54.4 +/- 11.2 vs. 43.8 +/- 16.6 years in normotensives, p = 0.0], being T2DM rather than T1DM [62.1% vs. 24.3%, p = 0.0], longer duration of DM [14.5 +/- 8.2 vs. 10.7 +/- 6.9 years in normotensives, p = 0.001], obesity [BMI 30.9 +/- 5.6 vs. 27.6 +/- 5.3, p = 0.00], having past history of hypertension [78.2% vs. 31.2%, p = 0.0], the presence of proteinuria [52.8% vs. 32.1%, p = 0.01] and the presence of diabetic retinopathy [43% vs. 29.4%, p = 0.027]. The number of antihypertensive medication used by the hypertensive group was higher [1.6 +/- 1.0 vs. 0.71 +/- 0.9, p =0.00]. Uncontrolled hypertension was not significantly related to the degree of diabetes control, the presence of dyslipidemia, coronary heart disease and the type of antidiabetic treatment. We conclude that the majority of the diabetic patients are having uncontrolled hypertension. Beside tight blood pressure control, other factors related to uncontrolled hypertension namely obesity and proteinuria should be managed and tightly treated as this may have positive impact on hypertension control