Interventional program for teenagers' obesity

The increasing rates of overweight and obesity in children and adolescents have been accompanied by an increase in cardiovascular disease and diabetes. There is a need for evidence-based interventions that could be used by primary care providers to address this issue. Teen obesity increases the risk for adult obesity and is associated with negative health consequences. To evaluate obesity management through interventional multidisciplinary program for teenagers. An Interventional Multidisciplinary Program. A'Ali Health Center, Kingdom of Bahrain. An interventional multidisciplinary program for six months from October 2012 to March 2013 was designed for thirteen teenagers. The mean age was 16.2 years. The height, weight and Body Mass Index [BMI] were measured before and after enrollment in the program. Behavioral parameters were also assessed before and after enrollment in the program. Data entry was analyzed with SPSS version 19. The mean BMI during the initial visit was 44.5 [SD +/- 4.42] and at the end of the interventional program, the mean BMI decreased to 42.9 [SD +/- 4.87]. The teen participants showed 77% decrease in screen time to 2 hours/day, 12 [92.3%] had no sugar sweetened beverages, 11 [84.6%] consumed 5 serving of fruits and vegetables daily and 13 [100%] ate breakfast daily. A group of teenagers enrolled in interventional program showed small but noticeable declines in obesity. Continued prevention efforts are needed to sustain and expand the implementation and evaluation of population-level interventions to prevent teenagers' obesity

Eight years incidence of diabetes mellitus in gestational diabetic patients

To evaluate eight years incidence of Gestational Diabetes Mellitus [GDM]. A retrospective study. Primary Healthcare, Bahrain. Five hundred sixty-two patients suffering from GDM were identified in 2002 and were traced in 2010 for laboratory diagnosis of diabetes. Two hundred one [36%] patients were found to be diabetic. One hundred one [18%] were normal, 33 [5.8%] had impaired glucose tolerance [IGT] and 227 [40.4%] were of undetermined status. There is a statistically significant relation between the development of diabetes and the age at diagnosis of GDM. The long-term rate development of diabetes after GDM is high. Age and level of screening test at diagnosis are strong predictive factors

Coronary risk assessment in diabetic population in primary care setting in Bahrain using the UKPDS risk engine

Cardiovascular morbidity and mortality are more prevalent in the diabetic population. To estimate the 10-year risk rate for cardiovascular mortality and morbidity in a diabetic population. Primary Health Center, Bahrain. Cross sectional study. Two hundred thirty patients were recruited. Cross sectional study measuring the cardiovascular morbidity and mortality in a diabetic population using the UKPDS risk engine software. Two hundred thirty patients were enrolled in the study. The cardiovascular risk rate calculated by the UKPDS risk engine was comparable to other risk rates. Association of risk rates with majority of risk factors was significant though total cholesterol and HbA1c showed selective significance. Dividing the population into low and high risk yielded a significant relation of all risk factors to risk rates. Risk rates for cardiovascular endpoint events in our diabetic population are comparable to other diabetic populations. Risk factors for fatal and non-fatal cardiovascular and stroke are either non-modifiable, such as age, sex and genetics or modifiable such as hypertension, hypercholesterolemia, diabetes mellitus and smoking. Reduction of the modifiable risk factors would reduce cardiovascular and stroke risks. Coronary risk assessment is an essential part in the assessment of diabetic population showed

Hypoglycemia in diabetic - The role of new technologies

One common obstacle in the treatment of diabetics is hypoglycemia. Hypoglycemia in diabetic is unpredictable and life threatening. It is a consequence of either treatment or part of the natural history of diabetes. Therefore, many dietary and therapeutic maneuvers have been initiated to tackle such obstacle. Twenty-eight years old Bahraini male known diabetic since birth was suffering from frequent attacks of hypoglycemia mandating visits to the Accident and Emergency Department. His blood biochemistry parameters were normal except for the high HbA1c. His general examination was normal. Several treatment regimens were initiated to combat his hypoglycemia with little success. New insulin analogue was prescribed for the patient to reduce the magnitude and frequency of hypoglycemic attacks and improve the blood sugar control. This method of treatment combined with dietary interventions proved effective in reducing the hypoglycemic attacks in clinical trials

use of glucose screen test alone in diagnosing gestational diabetes mellitus in Bahrain-preliminary report

To establish a cutoff point where gestational diabetes mellitus [GDM] can be diagnosed based on the one-hour glucose challenge test [GCT] alone without doing the Oral Glucose Challenge test [OGTT]. Ministry of Health, Bahrain. Design: Retrospective. All pregnant ladies with positive screen test of at least 7.8 mmol/1 in 2002 were identified and their subsequent oral glucose challenge test [OGTT] evaluated. Two thousand six hundred and forty-eight ladies with a positive screen test were identified. Five Hundred and sixty-two had GDM and 537 had impaired glucose tolerance test [IGT]. The ROC curve yielded a cutoff value of 11.05 mmol/L with high specificity and low false positive results. GDM can be diagnosed from the GCT using a value of 11.05 mmol/L

Diabetes disabilities

Diabetes is a notorious epidemic affecting different age groups and ethnicities. The absolute increase in incidence of diabetes among the elderly is alarming. This increase in incidence adds to the traditional diabetes complications.Disability affects about 20-50% of the diabetic population. Persons with diabetes are 2-3 times more likely to be disabled than non-diabetics. This difference appears more vividly in the most severe forms of diabetes. Estimates of disability prevalence in diabetics are variant due to the diversity in disability measures.In this overview, certain areas of disability will be discussed including definition of disability, spectrum of disability, definition of diabetic disability, factors related to diabetic disabilities, interventions to decrease cognitive and functional decline in diabetics and barriers to management and future needs.Disability is defined in relation to its impact on the individual either functionally, medically, anatomically or emotionally. The environment and the family situation in turn augment or decrement the effects of these factors. In general, disability can be defined as limitation in performing socially defined roles such as self-care and work [Saad Nagi and Philip Wood].The spectrum of disability depends on many determinants including environmental, social and family factors. It in turn may affect the utilization of health care facilities, self-care, income levels and work dysfunction.Diabetes is associated with disability through a number of processes. Acute complications including acute hyperglycemia and hypoglycemia may lead to temporary impairment that is associated with physical and social limitations.Chronic complications like retinopathy, cardiovascular events, renal impairment and peripheral vascular disease constitute the major obstacles to the functionality of the diabetic individual. These complications disable the diabetic individual through functional and emotional impacts.Lessrecognized diabetic complications are increased risk of cognitive decline including attention, concentration, visuospatial reasoning, memory and psychomotor speed. There is clear evidence that links diabetes to an increased risk of dementia, Alzheimer's disease and depression.Having a rather hectic and complicated life style including multiple medications, frequent blood testing, dieting, and somewhat rigid timetable add up to the diabetic disability and environmental dysfunction.The National Health Interview Survey [NHIS] has examined the level of disability in diabetics compared to non-diabetics. It was found that diabetics are 2-3 times less able to walk V mile, climb stairs and do house work than non-diabetics.Multiple factors are implicated in the pathogenesis of physical disability in diabetics. These include cardiovascular disease, obesity, stroke, visual impairment, peripheral nerve dysfunction, peripheral arterial disease, falls and depression.Disability in persons with diabetes is influenced by a number of factors either personal or diabetes related. Personal factors: Activity limitation disability in diabetics is increased with increased age, female gender, diabetics with less education and those with lower socioeconomic status. Diabetes related factors: More activity limitation was noted in diabetics using insulin, and those with chronic complications.Aggressive management of hyperglycemia, blood pressure control, hyperlipidemia control, aspirin use, smoking cessation and regular screening of foot, eye, kidneys and cardiovascular system may prevent disabilities.Structured exercise programs of walking, strength and balance training are associated with improved physical abilities.Weight loss may improve physical capacity through decrease in mechanical problems as well as decrease in other diabetic complications