ABSTRACT
[This retracts the article DOI: 10.7759/cureus.18074.].
ABSTRACT
BACKGROUND: Type 2 diabetes mellitus (T2DM) is defined as a chronic medical condition in which the blood glucose level remains high. The risk factors of T2DM are high body mass index due to obesity or being overweight, genetics, and certain medical conditions. Lifestyle modification plays a crucial role in T2DM regulation and prevention, and if it is not controlled well by either lifestyle modification or DM regulatory medications, it may lead to medical complications ranging from mild to life-threatening complications. AIM: The purpose of this study is to find the contributory factors of noncompliance with oral antidiabetic drugs and lifestyle modifications in patients with T2DM in the eastern province of Saudi Arabia. This will help control one of the most widespread comorbidities that might otherwise be a significant burden on patients' health and financial status as well as on the government. METHODOLOGY: A cross-sectional questionnaire study was conducted on T2DM patients in the eastern province of Saudi Arabia through a link distributed on social media, and the contributory factors of noncompliance to diabetes medication and lifestyle modification were evaluated. RESULTS: A total of 426 participants were included in the study. Regarding compliance with DM medications, 199 (46.7%) participants were adherent to their medications, 148 (34.7%) were not adherent to their medication, 42 (9.9%) were sometimes adherent, and 37 (8.7%) were mostly adherent to their medication. Regarding lifestyle modification, the level of adherence to a healthy diet and exercise among T2DM patients in the eastern province was low and unsatisfactory. According to the participants, the most reported factors contributing to noncompliance with DM medications and lifestyle modifications were forgetfulness, lack of knowledge about diabetes and the importance of controlling it, side effects of the medications, and difficulty in following a healthy diet. Regarding the influence of sociodemographic variables on the level of adherence in T2DM patients, factors such as age, marital status, occupation, comorbidities, diagnosis period, and previous complaints of DM complications showed significant associations with compliance with DM medication. CONCLUSION: The findings of this study revealed that the level of adherence to DM medications among T2DM patients in the eastern province was suboptimal. Although free medicines were available with a high level of healthcare access through government primary healthcare centers (PHCCs), poor adherence was observed. This study highlighted that medication adherence might be affected by age, marital status, occupation, chronic diseases, diagnosis period, and previous complaints of DM complications. Regarding lifestyle modification, this study showed that the level of adherence to a healthy diet and exercise among T2DM patients in the eastern province was low and unsatisfactory. Our recommendation is to measure the presence of dietician clinics, patient relationships with their healthcare providers, and their effect on patient compliance with DM medications. Further research is needed to include other factors that could influence adherence, such as patient-healthcare provider communication. Moreover, it is suggested that PHCCs discuss with noncompliant patients the reasons that prevent them from adhering to their medication and lifestyle modifications as part of their care plan.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is a multi-organ disease with a wide range of manifestations. Coagulopathy is one of the well-recognized complications of COVID-19. We report the case of a 42-year-old man who presented with progressively worsening low back pain of two days in duration. The pain was burning in character, non-radiating, and was not related to movement. The patient had a recent history of severe COVID-19 pneumonia requiring mechanical ventilation and has stayed in the intensive care unit for eight days. He was discharged three days before the acute onset of his back pain. Examination of the lumbar spine was unremarkable. However, lower limb examination revealed coldness and absent pulses bilaterally. The patient underwent computed tomography angiography which revealed complete occlusion of the lower abdominal aorta at its bifurcation. Emergency endovascular treatment was performed to aspirate the clot. The symptoms resolved following the procedure and the patient was discharged on the third post-intervention day. Saddle aortic embolism is a rare life-threatening condition that may present solely with low back pain. The case demonstrated a possible complication of COVID-19 that occurred after the recovery from the acute phase of the disease.
