ABSTRACT
The prevalence of anemia in adults with diabetes is of growing importance due to its impact on overall health and the management of diabetes-related complications. This study aimed to determine the prevalence of anemia among adult patients with diabetes at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. A retrospective study was done on 1208 patients with diabetes >18 years who attended the study setting from 2010 to 2022. Data about patients' demographics, body mass index, glycated hemoglobin (HbA1c; %), hemoglobin (Hb), serum ferritin, iron, mean corpuscular Hb, mean corpuscular volume, free thyroxine and triiodothyronine (T3), and serum thyroid-stimulating hormone (TSH) were collected. Of patients, 86.6% had anemia with a prevalence of 30.2%, 47.6%, and 22.2% for mild, moderate, and severe anemias, respectively. The prevalence of anemia was significantly higher among females, those with high serum ferritin, normal serum iron or normal serum T3, lower mean HbA1c level (%), lower serum iron or T3, and higher serum ferritin or TSH. A significant positive correlation was found between Hb level and HbA1c level (%), serum iron, free T3, and body mass index. A significant negative correlation was found between Hb level and mean corpuscular volume, serum ferritin, and serum TSH. Being female, having high serum ferritin, lower mean free T3, and a high TSH were risk factors for anemia. The prevalence of severe anemia was significantly higher among patients with uncontrolled diabetes mellitus. A high prevalence of anemia was found among studied diabetics. Anemia screening should be included in the routine assessment of patients with diabetes. A multidisciplinary approach involving endocrinologists, hematologists, and dietitians is recommended to ensure holistic care and address all aspects of the patient's health. In addition, further research should be supported to better understand the mechanisms linking diabetes and anemia and to establish evidence-based guidelines for managing anemia in diabetics.
Subject(s)
Anemia , Ferritins , Glycated Hemoglobin , Hospitals, University , Humans , Female , Male , Retrospective Studies , Middle Aged , Anemia/epidemiology , Anemia/blood , Anemia/etiology , Adult , Saudi Arabia/epidemiology , Glycated Hemoglobin/analysis , Prevalence , Ferritins/blood , Aged , Body Mass Index , Diabetes Mellitus/epidemiology , Diabetes Mellitus/blood , Iron/blood , Thyrotropin/blood , Hemoglobins/analysisABSTRACT
Exposure to sunlight, specifically ultraviolet B (UVB), is essential for cutaneous vitamin D synthesis. Despite significant daily sunlight availability in Africa and the Middle East, persons living in these regions are frequently vitamin D insufficient or deficient. Vitamin D insufficiency (25-hydroxyvitamin D (25(OH)D) between 15 and 20 ng/mL (37.5-50 nmol/L)) has been described in various population groups, ranging from 5% to 80%. Risk factors include traditional dress and avoidance of sunlight exposure, and multiple dietary factors as a result of specific cultural beliefs. Vitamin D resistance due to calcium deficiency mechanisms has been described in similar population groups, which may lead to hypovitaminosis D. Should the new diseases related to hypovitaminosis D prove to be truly associated, Africa and the Middle East will become an epicentre for many of these conditions. Urgent attention will need to be paid to cultural dress and dietary behaviours if hypovitaminosis D is to be taken seriously. Should such factors not be correctable, new strategies for supplementation or food fortification will have to be devised.
Subject(s)
Culture , Feeding Behavior , Sunlight , Vitamin D Deficiency , Vitamin D/metabolism , Africa/epidemiology , Behavior Control/methods , Climate , Feeding Behavior/ethnology , Feeding Behavior/psychology , Humans , Middle East/epidemiology , Needs Assessment , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/etiology , Vitamin D Deficiency/metabolism , Vitamin D Deficiency/therapyABSTRACT
A two-year-old child dying of pulmonary hypertension and cor pulmonale secondary to bronchopulmonary dysplasia, was demonstrated to have reactive pulmonary hypertension in response to 100% oxygen and isoproterenol infusion. In an attempt to find an oral medication to maintain pulmonary vasodilatation, experimental trials were done using hydralazine, salbutamol, nifedipine and diltiazem. Cardiac index, pulmonary and systemic vascular resistances and intrapulmonary shunts were monitored during the trials. Hydralazine, salbutamol and nifedipine were ineffective. Diltiazem 2.0 mg given every 6 h resulted in a profound and sustained decrease in pulmonary pressures and resistance, and a reversal of the cor pulmonale.
Subject(s)
Bronchopulmonary Dysplasia/complications , Diltiazem/therapeutic use , Hypertension, Pulmonary/drug therapy , Albuterol/therapeutic use , Child, Preschool , Humans , Hydralazine/therapeutic use , Hypertension, Pulmonary/etiology , Infant, Newborn , Isoproterenol/therapeutic use , Male , Nifedipine/therapeutic use , Oxygen Inhalation Therapy , Pulmonary Heart Disease/drug therapyABSTRACT
A case of osteomyelitis due to Kingella kingae is presented to illustrate the insidious onset and indolent course typical of bone infections caused by this organism. The frequently negative result obtained with Gram's stain and the fastidious nature of the organism makes diagnosis difficult. Initial therapy with an aminopenicillin such as ampicillin in addition to antimicrobial drugs for Staphylococcus aureus should be effective in resolving bone and joint infections in children.