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Investigate the effectiveness of IDegLira, a fixed-ratio combination of insulin degludec/liraglutide, in a real-world setting in patients with type 2 diabetes mellitus in the United Arab Emirates.This non-interventional study enrolled adults switching to IDegLira from basal insulin (BI) or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with/without concomitant oral antidiabetic drugs (OADs). Primary endpoint was change in HbA1c from baseline, assessed using a mixed model for repeated measurements.Among 263 patients (BI ± OADs, n=206; GLP-1 RA ± OADs, n=57), mean baseline HbA1c was 9.29% (78 mmol/mol). After 26 weeks, HbA1c was significantly reduced (BI ± OADs, -0.83% [-9.0 mmol/mol] and GLP-1 RA ± OADs, -1.24% [-13.5 mmol/mol]; both p0.0001). Fasting plasma glucose (FPG) was significantly reduced (-39.48 mg/dL [BI ± OADs] and -82.49 mg/dL [GLP-1 RA ± OADs]; both p0.0001). Before treatment initiation, 3/263 patients experienced ≥1 severe hypoglycaemic episode and 7/263 patients experienced ≥1 non-severe hypoglycaemic episode compared with 1/263 patients who had ≥1 severe and 1/263 who had ≥1 non-severe episode at end of study. Body weight decreased significantly among patients switching from BI ± OADs (-1.05 kg [p0.0001]). Treatment was well tolerated.IDegLira significantly reduced HbA1c and FPG in this real-world setting, along with less frequent episodes of hypoglycaemia. Switching to IDegLira offers effective treatment intensification for type 2 diabetes patients with inadequate glycaemic control.

Introduction: Bethesda classification of thyroid nodules cytology is an agreed upon method of classifying thyroid nodules according to risk of malignancy. Among them, Bethesda class III (Atypia of Undetermined Significance, AUS) has been a topic of great controversy. The reported estimated risk of malignancy associated with it varies in different studies. Our study investigates the associated incidence of malignancy in a single tertiary center in UAE. Methodology: Data were retrospectively collected over a 10-year period from January 2009 till December 2018 for cytology diagnosis of AUS. Patient charts were reviewed for method of management. Surgical and histopathology records were reviewed to compare findings on cytology versus histopathology. Results: A total of 180 cases were diagnosed Bethesda III (AUS) with a mean age of 45.09 ± 14.7 years. One hundred cases (55.6%) of them underwent surgical resection, and histopathological diagnosis was obtained. Among the operated cases, 46 were benign and 54 were malignant. Papillary thyroid cancer was the most common malignancy, seen in 39 (72.2%) of cases, and follicular cancer was the second most common, seen in 13 (24.1%) cases. Conclusion: The findings highlighted in our study suggest a higher incidence of malignancy in Bethesda III category than previously reported. It also puts in question the utility and benefit behind keeping a time gap and repeating FNA as previously recommended.

Introduction: Obesity is a chronic relapsing disease of which, globally, the prevalence has reached epidemic proportions. The ACTION-IO study (NCT03584191) investigated the perceptions, attitudes, and behaviors of people with obesity (PwO) and healthcare professionals (HCPs), which can help in devising strategies for its optimal management. Here, we present the results from the United Arab Emirates (UAE). Methods: The ACTION-IO study was a cross-sectional study conducted in 11 countries, including the UAE, that collected data via a survey. Eligible UAE PwO were ≥18 years with a BMI of ≥30 kg/m2 (self-reported height and weight). Eligible HCPs were in direct patient care. Data were collected in the UAE between July 11, 2018, and September 5, 2018. Results: A total of 750 PwO and 200 HCPs completed the survey in the UAE. Both PwO (82%) and HCPs (78%) acknowledged obesity as a chronic disease and agreed that it has a large impact on overall health (PwO 88% and HCPs 80%). More HCPs felt that diabetes and stroke (both 91%) had a larger impact on overall health than did obesity. Many PwO (76%) assumed full responsibility for their weight loss; 84% of HCPs acknowledged responsibility for actively contributing to patient weight loss efforts. The top motivator for weight loss among PwO was wanting to be more fit/in better shape (45%), while HCPs believed the main motivator was general health concerns (83%). The top barrier against initiating weight management discussions provided by HCPs was that they felt PwO were not interested in losing weight (69%), whereas only 10% of PwO selected this response. The mean delay between struggling with excess weight and having a weight management discussion with an HCP was 4 years. Discussion/Conclusion: These UAE results highlight differences in the perceptions and attitudes toward obesity from PwO and HCPs and reflect a need to understand weight management concerns to initiate earlier and more effective PwO–HCP conversations. The findings will inform educational needs on the biological basis of obesity and its clinical management and will help to address regional barriers for effective obesity care.

Background: The health and social burdens of diabetes mellitus (DM) are steadily increasing worldwide, reflecting the impact of urbanization, industrial transitions, and shifting to nonhealthy, sedentary life patterns’, as well as the high sugar, low-fiber food consumptions. All these factors have contributed to the global increase in the prevalence of DM and metabolic disorders. Objectives: The objective is to study the prevalence of DM among adult cohorts in Dubai and the extent of behavioral health risk factors associations. Methodology: A cross-sectional household health survey with multistage, stratified cluster random sample of 9,630 participants including 2,496 households was carried out in Dubai 2019. About 5,371 non-United Arab Emirates (UAE) national, 2,245 UAE-nationals, of different age-groups, gender, education, nationality, smoking, and marital status were included in the survey. The survey questionnaire was adapted from the one used in the World Bank’s Living Standards Measurement Surveys (LSMSs) and the WHO’s World Health Surveys (WHSs). Self-reported diabetes was considered as well as newly diagnosed diabetes based on HbA1C results. About 75 well-trained surveyors, 25 well-trained nurses, and other laboratory technicians conducted the survey. SPSS 21 and Stata 12 software was used for data management. Results: The data indicate that the prevalence of diabetes among Dubai Emiratis is much higher than Dubai expats (19.3 vs. 12.4% p = 0.000). The association between diabetes and age was evident regardless of nationality. Rates of diabetes were higher in males (15.4%) compared to females (11.8%) (p < 0.001). About 11.2% of those considered overweight have DM, while the prevalence is 21.5% in obese people (p = 0.000). Physical inactivity, smoking, and hypertension (HTN) were strongly associated with higher rates of DM. Regardless of nationality, lower levels of education were statistically significantly associated with the prevalence of DM (p = 0.000), while single marital status was associated with the lowest rate of DM. Conclusions: Dubai household health survey 2019 indicated that the prevalence of DM among Dubai adults was still high as an overall estimation. Higher rates of diabetes were significantly associated with Emirati nationality, older age-groups, male gender, physical inactivity, high BMI, HTN, smoking, marital status of divorced, separated or divorced as well as low educational level groups.

Background Evidence based practice revealed that health related behavioral risks and lifestyle factors significantly contributed to certain Non Communicable Diseases NCDs such as diabetes mellitus cardiovascular illnesses and some types of cancer Objectives To study the prevalence and profile of health related behavioral risks factors includes tobacco use physical activity obesity amp overweight as well as healthy food consumption among a representative sample of Dubai population Methodology Dubai HouseholdHealth Survey was carried out in as a cross sectional multistage stratified cluster survey Houses were visited to obtain detailed information on the different health related issues About families were randomly selected by stratified cluster sampling techniques With a response rate of the final sample equals to individuals The design and methodology of the survey were adapted from those used in the World Bank rsquo s Living Standards Measurement Surveys LSMS and the World Health Organization rsquo s World Health Surveys WHS Data collection was made by well trained researchers and well trained nurses The duration of data collection lasted to working days under strict technical and administrative procedure Data was collected electronically using well calipered tablets Data entry coding cleaning weighing and analysis have been carried out using the SPSS program Findings The present study revealed that among the respondents were males and were Emirati The study showed that proportion of current smoker was it was for males and for females The survey findings underlined a suboptimal intake of fruits and vegetables in the Dubai population Overall of the sample reported consuming a fruit ndash times a day At the same context of the survey population took a vegetable to times a day In concern with the physical activities an alarming high prevalence of physical inactivity among the sampled population of Dubai was observed with of them didn rsquo t perform vigorous intensity activities other than those done as part of work considered inactive In addition only of the survey population did moderate intensity activities for at least minutes at a time as part of work ndash days per week and hence considered inactive Conclusions Multiple behavioral risk factors were significantly highlighted among Dubai Population pointing out physical in activity at the population level high consumption of non healthy food and high levels of tobacco use This indicates true epidemiological transition which necessitate aggressive multidimensional interventions and policy actions

The recurrence of hypoglycemic episodes leads to attenuation of the normal counter-regulatory mechanisms that are controlled by the hypothalamus, which results in hypoglycemia unawareness (HU). In this case report, we described for the first time the differential expression of TNF-α, IL-1β, IL-6, and IFN-γ in a blood sample that was taken from a 27-year-old patient with type 1 diabetes mellitus (T1DM) who was diagnosed with HU. The anti-diabetic regimen is currently based on insulin injection, but the patient is planning to start the use of an insulin pump to have better control of glucose levels. Our results showed a trend toward an increase in the expression of IL-1β, IL-6, and IFN-γ in T1DM patient with HU. However, the mRNA level of TNF-α showed a significant decrease. These observations suggest that systemic inflammation could be an underlying cause of HU.

Rhinocerebral mucormycosis is a rare but usually fatal infection caused by fungi from the order Mucorales. These fungi has strong predilection for growth into arteries, lymphatics and nerves and this is the reason for their rapid spread to adjacent tissues with accompanying tissue ischemia and infarction due to vascular occlusion after a fibrin reaction and mucor thrombus. We describe a 54 year old Thai national male with poorly controlled type 2 diabetes, ischemic heart disease, hypertension and renal impairment who presented to the emergency department with fever, vomiting and painful left eye swelling, which progressed rapidly leading to complete opthalmoplegia and vision loss. The diagnosis of mucormycosis was confirmed later and was the patient was started on Amphotericin B therapy. Despite stable clinical course, he suddenly developed a fatal intracerebral hemorrhage and died within 24 hours of the bleed. We wonder weather patients with cerebral fungal infection should perhaps have an early neurosurgical intervention to rule out the presence of mycotic aneurysm; particularly that many cases of fatal cerebral bleed have been reported in association with Rhinocerebral mucormycosis. Key words: Rhinocerebral mucormycosis; Diabetes, Cerebral Hemorrhage, Fungal infection.

Background: The pathogenetic mechanisms underlying type2 diabetes are quite complex and differ between different ethnic groups. This might results in different responses to medications. Data from LEAD trials showed that liraglutide was associated with significant reduction in weight HbA1c and blood pressure values. Unfortunately there are no enough data on Arab population. Objectives: We aimed to assess the changes in blood pressure, lipids profile, and liver function test upon starting liraglutide and after 6 months of therapy in Arab patients with type 2 diabetes as primary objective. Results: 365 agreed to sign an informed consent. 29% of the studied population was males (n=106) compared to 71% females (n=259). There was no significant change in systolic blood pressure, however average diastolic blood pressure improved significantly (74.4 ± 10 to 72 ± 9 mmHg at 6 months P