Factors associated with undiagnosed type II diabetes mellitus, undiagnosed impaired fasting glucose and these patients' quality of life in Lebanon.

OBJECTIVE: To assess the association between undiagnosed impaired fasting glucose (UIFG) and diabetes (UD), their risk factors and the patients' knowledge about diabetes and their quality of life (QOL). METHODS: A cross-sectional study was conducted between May and September 2017 in four laboratories enrolling 495 patients. We used the Diabetes Knowledge and SF-12 questionnaires to assess the patients' knowledge about diabetes and QOL. This study meets the Wilson and Jungner criteria for disease screening. RESULTS: A higher knowledge score (ORa = 0.85) was significantly associated with the absence of diabetes compared to UPD, whereas an increased age (ORa = 1.2) and a positive family history of diabetes (ORa = 1.81) were significantly associated with higher odds of UPD. An increased knowledge score (ORa = 0.55) was significantly associated with an absence of diabetes compared to UD, whereas an increased BMI (ORa = 1.40) and an increased age (ORa = 1.07) were associated with increased odds of having UD.UD (Beta = -5.799) was significantly associated with decreased total physical component QOL score, whereas increased diabetes knowledge score (Beta = 0.415) was significantly associated with increased physical QOL. A higher diabetes knowledge score (Beta = 0.459) were associated with increased mental QOL. CONCLUSION: Seeing the relatively high percentage of UD and UIFG, we propose that screening should be considered and subject to proper assessment in the light of the findings of this study.

Previous, current, and cumulative dose effect of waterpipe smoking on LDL and total cholesterol.

The popularity of waterpipe smoking is dramatically increasing in Lebanon, reaching 36.9%, the highest among countries in the region. To the best of our knowledge, no studies have assessed the impact of waterpipe smoking on lipid levels in the Lebanese population. Therefore, the objective of the study was to evaluate the correlation between waterpipe smoking and LDL-C and total cholesterol levels in exclusive Lebanese waterpipe smokers compared to non-smokers. This cross-sectional study was conducted between October 2016 and February 2017, enrolling 308 patients (156 non-smokers and 147 waterpipe smokers) from four laboratories. Current and previous WS (beta = 66.64 and beta = 71.49) were significantly associated with higher LDL scores. Current WS was significantly associated with and total cholesterol levels (beta = 34.12). Cumulative WS (number of waterpipes per week × duration in years) was significantly associated with higher LDL-C and total cholesterol levels respectively (p < 0.001 for all 3 variables). The university level of education (beta = 8.89) and current alcohol drinking (beta = 8.81) were significantly associated with higher LDL scores. Our study demonstrated an association between previous or current waterpipe smoking and lipid level. Future research are needed to detect the direct cause of the relation between waterpipe smoking and CVD. Concerned authorities should set up awareness campaigns to increase alertness on dangers of WS and dependence, and encourage these young adults to embrace health-promoting behaviors.

Effect of exclusive cigarette smoking and in combination with waterpipe smoking on lipoproteins.

OBJECTIVE: A significant increase in total cholesterol and LDL-C is well shown in tobacco users, as compared to non-tobacco users. The additive effects of waterpipe and cigarette smoking on LDL levels have not been studied. The study's objective was to assess the correlation between cigarette smoking and LDL levels in Lebanese cigarette smokers and to check the interaction effect of waterpipe and cigarette smoking on LDL levels. METHODS: This cross-sectional study was conducted between October 2016 and February 2017 in 4 different laboratories, enrolling 308 patients (188 non-smokers, 105 cigarette smokers, 15 previous smokers). RESULTS: Current cigarette smoking (Beta=25.57; p<0.0001) was significantly associated with higher LDL levels and higher total cholesterol levels (Beta=53.29; p<0.0001) in exclusive cigarette smokers. Among current cigarette smokers who were current waterpipe smokers, a significant increase in LDL level was observed relative to current cigarette smokers who were not waterpipe smokers (Beta=66.64 vs Beta=37.37; p<0.0001). CONCLUSION: Among Lebanese current cigarette smokers, LDL levels increased relative to nonsmokers, consistent with findings in other populations. In addition, among Lebanese current cigarette smokers, current waterpipe smoking might increase adverse lipid profiles associated with adverse coronary effects more than cigarette smoking alone. The direct cause responsible for these observed variations in our study remains unidentified, with the hope that future research will reveal it.