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Since thyroid dysfunction is a common disorder and affecting all populations regardless of iodine status, a comprehensive evaluation of thyroid dysfunction in Bahrain is essential to draw a national strategy, increase public awareness, and recognize the role of ethnicity.Following the approval of the Research Ethics Committee, the study was initiated by collecting laboratory and patient's data that have performed thyroid function tests (TFTs) during January 2018 till January 2019 at the Royal Services of Bahrain Defense Force (BDF) Military Hospital. TFTs data for 19,736 subjects were collected and analyzed using SPSS.Based on the TFTs measurements and including treated euthyroid, 44.9% of subjects had thyroid dysfunction categorized as treated euthyroid (15.1%), hypothyroid (20%), hyperthyroid (3.3%), and subclinical hypothyroid (6.5%). Females having thyroid dysfunction were 2.9 times more than males, and the most female age group affected was 20-40 years old (14.1%). Furthermore, the frequency and the levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were related to the TSH level above or below 10 µIU/l. The frequencies of TPOAb and TGAb were 79% and 61%, respectively, in the treated hypothyroid group that have TSH10 µIU/l and were significantly higher than the counterpart groups of TSH between 4-10 µIU/l (44% and 40%, respectively) (p0.001). Similarly, the mean values of TPOAb and TGAb were significantly different between TSH10 µIU/l and the counterpart groups of TSH between 4-10 µIU/l (p0.001).This study showed that hypothyroidism predominates in the Bahraini population, and most of the patients were females with an age group of 20-40 years old. In addition, the thyroid dysfunctions were correlated with the high percentages of positive frequencies with TPOAb and TGAb, indicating the predomination of autoimmune thyroid diseases. Besides, the determination of risk factors in relation to hypothyroidism occurrence such as genetic predisposition and loci genetic variants is highly essential. Also, more national studies and public awareness are needed to reduce the potential illnesses of thyroid dysfunction.

Diabesity (diabetes associated with obesity) is a major global and local public health concern, which has almost reached an epidemic order of magnitude in the countries of the Arabian Gulf and worldwide. We sought to review the lifestyle trends in this region and to highlight the challenges and opportunities that health care professionals face and attempt to address and correct them. In this regard, we aimed to review the regional data and widely held expert opinions in the Arabian Gulf and provide a thematic review of the size of the problem of diabesity and its risk factors, challenges, and opportunities. We also wished to delineate the barriers to health promotion, disease prevention, and identify social customs contributing to these challenges. Lastly, we wished to address specific problems with particular relevance to the region such as minimal exercise and unhealthy nutrition, concerns during pregnancy, the subject of childhood obesity, the impact of Ramadan fasting, and the expanding role of bariatric surgery. Finally, general recommendations for prevention, evidence-based, and culturally competent management strategies are presented to be considered at the levels of the individual, community, and policymakers.

Type 2 diabetes mellitus is prevalent especially in Gulf countries and poses serious long-term risks to patients. A multifaceted treatment approach can include nutritional supplements with antioxidant properties such as 5-aminolevulinic acid (5-ALA) with sodium ferrous citrate (SFC). This prospective, randomized, single-blind, placebo-controlled, dose escalating pilot clinical trial assessed the safety of 5-ALA with SFC at doses up to 200 mg 5-ALA/229.42 mg SFC per day in patients living in Bahrain with type 2 diabetes mellitus that was uncontrolled despite the use of one or more antidiabetic drugs. Fifty-three patients (n=53) from 3 sites at one center were enrolled by Dr. Feryal (Site #01), Dr. Hesham (Site #02), and Dr. Waleed (Site #03) (n=35, 5-ALA-SFC;n=18, placebo). There was no significant difference in incidence of adverse events reported, and the most frequent events reported were gastrointestinal in nature, consistent with the known safety profile of 5-ALA in patients with diabetes. No significant changes in laboratory values and no difference in hypoglycemia between patients receiving 5-ALA and placebo were noted. Overall, the current results support that use of 5-ALA-SFC up to 200 mg per day taken as 2 divided doses is safe in patients taking concomitant oral antidiabetic medications and may offer benefits in the diabetic population. This trial is registered with ClinicalTrials.govNCT02481141.

The aim of the present article is to increase awareness concerning safe driving for patients with diabetes in the Gulf Cooperation Council (GCC) countries and to provide recommendations concerning the management of these patients. The cognitive, motor, and sensory skills required for driving can be adversely affected by diabetes as well as the side effects of anti-diabetic medications, particularly hypoglycemia. The prevalence of diabetes in the GCC countries is among the highest in the world. As the number of diabetic drivers in these countries continues to increase, the number at risk of having a motor vehicle accident is also expected to increase. We reviewed the available literature concerning driving and diabetes, particularly in relation to the current situation in the GGC countries. Unfortunately, very little published information is available addressing this issue in the GCC countries. Most of the GCC countries lack legislation on driving and diabetes. We have proposed recommendations to help diabetic drivers in the GCC countries as well as to provide guidance to health care professionals managing these patients.