Adherence of type-2 diabetic patients to treatment

To determine the percentage of non-adherent patients with type 2 diabetes [T2D] attending primary health care [PHC] settings and to assess related factors Cross sectional case-control study Five primary health care centers [one from each health region in Kuwait] Six hundred and ninety-three T2D patients Comparison between cases and control was conducted using univariate analysis followed by a logistic regression analysis. The collected data included sociodemographic, Clinical, and patients' practice data. Adherence to T2D treatment recommendations Among 693 participants in this study, 181 were diagnosed as non-adherent to treatment recommendations with an overall 26.1% rate. They were compared with 512 adherent patients. Within socio-demographic variables, only education and family income were proved to be significantly associated with adherence to treatment. Among Clinical variables, poor glycemic state [OR = 2.1, 95% CI: 1.2 - 4.7], hypertension [OR = 1.9, 95% CI: 1.2 - 3.2], co-morbid conditions [OR = 3.2, 95% CI: 1.3 - 6.2] were significant determinants of the outcome of interest. Regular follow- up visits, compliance with diet recommendations and mild physical activity were significant protective determinants related to patients' practice [OR = 0.4, 95% CI: 0.1 - 0.9], [OR = 0.3, 95% CI: 0.1- 0.6], [OR = 0.3, 95% CI: 0.2 - 0.8], and [OR 0.5, 95% CI: 0.2 - 0.9] respectively. Many amenable factors were associated with non-adherence. Health education to diabetic patients should be emphasied to improve patients' knowledge, attitude and practice to encourage their adherence. Further studies are needed regarding physicians' practice and their relation with patients

Pre-hypertension and hypertension in college students in Kuwait: a neglected issue

To determine the proportion of pre-hypertension and hypertension in college students in Kuwait and their related risk factors. A total of 803, randomly selected students aged 17 to 23 years [346 male, 457 female] from different colleges in Kuwait, were included in the study between 2009 and 2010. Systolic and diastolic blood pressure measurements were taken by trained personnel. Pre-hypertension was defined as systolic pressure between 120 and 139 mm Hg or diastolic pressure between 80 and 89 mm Hg. Risk factor measurements that were determined, included smoking, body mass index [BMI], and family history of hypertension. Blood samples were collected and impaired glucose tolerance [IGT] and lipid profile levels were determined. There were no hypotensive students. Normotensives constituted 53.5% [n = 430], pre-hypertensives formed 39.5% [n = 317], and hypertensive students comprised of 7% [n = 56]. The overall proportions of hypertension and pre-hypertension were higher among male students [85.7 and 64.4%] than female students [14.3 and 35.6%], respectively. Hypertensive and pre-hypertensive students versus normotensive students had significantly higher levels of BMI-based obesity, smoking, glycated hemoglobin [HbA1c], and IGT. Also, hypertensive and pre-hypertensive, compared to normotensive students, had significantly higher proportions [21.4, 18.3, and 4.0%, respectively] of risky high-density lipoprotein [HDL] level [< 1 mg / dL], cholesterol [7.1, 3.8, and 1.4%, respectively], and triglycerides [TG] [17.9, 9.1, and 7.9%, respectively] where p was< 0.001, 0.016, and 0.051, respectively. Hypertensive and pre-hypertensive students showed elevated levels of lipids and BMI-based obesity more than normotensive students. TG, HDL, HbA1c, and cholesterol appeared to influence pre-hypertension

Association between apolipoprotein E-polymorphism and ischemic heart disease patients with or without type 2 diabetes mellitus: a preliminary study in Kuwait

We investigated the association between apolipoprotein E polymorphism and ischemic heart disease with or without type 2 diabetes in Kuwait and examined the impact of apolipoprotein E polymorphism in diabetic patients. The present study was conducted from January 2005 to June 2006 in the Diabetic Clinic of AI-Amiri and Al-Sabah Hospitals in Kuwait City. Apolipoprotein E polymorphism was assessed in 250 subjects of which 83 were ischemic heart disease patients [41 diabetic and 42 non-diabetic] and 105 were diabetic patients without ischemic heart disease. Results were compared with 62 healthy controls. Apolipoprotein E polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism. Apolipoprotein E3 allele was the most commonly occurring form. The frequency of apolipoprotein E4 was higher in ischemic heart disease patients with type 2 diabetes [39%] and the non-diabetic [31%] group, but lower in the diabetic [20%] and control groups [16%]. Apolipoprotein E4 allele may be related to the development of ischemic heart disease in patients with or without type 2 diabetes in Kuwait. However, future studies with larger population sizes are needed to establish such relationship