Journal of diabetes and endocrine practice最新文献

{"title":"Knowledge and Confidence of Omani Pediatric Residents in Managing Diabetic Ketoacidosis: A Cross-Sectional Survey","authors":"Maryam Al-Rawahi, Hussain Alsaffar","doi":"10.1055/s-0043-1772453","DOIUrl":"https://doi.org/10.1055/s-0043-1772453","url":null,"abstract":"Abstract Introduction Diabetic ketoacidosis (DKA) is a common complication of type 1 diabetes mellitus. Unfortunately, medical errors are not uncommon during the management of DKA leading to significant morbidity and mortality. There are many studies conducted to assess the knowledge of junior doctors in the management of DKA in many countries including Bahrain and Iraq. Objectives This study aims to assess the knowledge and confidence of Omani pediatric residents in the management of DKA and compare the findings with the results of previous studies from the region. Methods A cross-sectional study was conducted among all enrolled pediatric residents in the Oman Medical Specialties Board in 2021, using an online survey that consists of three parts with a total of 30 questions to gain information about demographics, knowledge, and overall confidence in the management of DKA in children. The questionnaire was adopted from the Bahraini and Iraqi studies. Results In total, 69 pediatric residents (15M:54F) out of 84 had responded to the survey, giving a response rate of 82%. More than half of the responders were junior residents R1 and R2 (59.3%). The overall performance score of knowledge among the residents mainly ranged between 50 and 75%. However, R2 resident performance was better as their score ranged between 80 and 85%. Only 5.7% of our residents had a performance score above 90%. The overall confidence of residents in managing patients with DKA was directly proportional to their year of residency, ranging from not confident to very confident, demonstrating that most residents from R1 to R3 rated themselves as “fair” compared with 58.3% of 4th-year residents who rated themselves as confident. In comparison to similar studies in Bahrain and Iraq, our junior residents showed better knowledge in some aspects, for example, identifying the correct biochemical criteria to diagnose DKA, 88.7 vs. 65% from Bahrain and 20.7% from Iraq. Conclusion The overall knowledge and confidence of the Omani pediatric residents were satisfying. However, there are still some gaps in knowledge to be bridged about the management of pediatric DKA. Continuous educational activities are desired. Therefore, more sessions about DKA management are to be scheduled, perhaps applying some simulation training to boost their knowledge and confidence.","PeriodicalId":486848,"journal":{"name":"Journal of diabetes and endocrine practice","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135150382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rabson–Mendenhall Syndrome with Severe Insulin Resistance Type A: The Need to Act Faster than the Disease","authors":"Tawfik Muammar, Radwa Helal","doi":"10.1055/s-0043-1772243","DOIUrl":"https://doi.org/10.1055/s-0043-1772243","url":null,"abstract":"Abstract Introduction Rabson–Mendenhall syndrome (RMS) is an autosomal disorder where severe insulin resistance is observed. Insulin levels decrease over time and suppress gluconeogenesis in the liver. Fatty acid oxidation is affected, leading to frequent episodes of ketoacidosis. The changes in RMS are much faster than in patients with type 2 diabetes. RMS patients have a significantly reduced life expectancy and may die during adolescence or early adulthood. Case Presentation A 15-year-old girl presented with poorly controlled diabetes. She was diagnosed with RMS at the age of 50 days, and her genetic study showed a homozygous mutation for R141W in the INSR gene. Her insulin level was high at 737 μIU/mL, insulinoma antigen 2 and glutamic acid decarboxylase antibodies were negative, and C-peptide was > 18 ng/mL. There is a strong family history of RMS on her mother's side. Her hyperglycemia was treated with an insulin pump (requiring up to 300 units of insulin/day) and oral rosiglitazone for the first 6 years. Rosiglitazone was replaced by oral insulin-like growth factor 1 (IGF1). Over the last 3 years, she had four further episodes of diabetic ketoacidosis triggered by infections and severe lipodystrophy. A trial of leptin and subcutaneous IGF1 has failed. The patient has a closed-loop insulin pump MiniMed 780G with a total daily dose of 261 units (4.6 U/kg/day). Results During the past 15 years, the patient suffered many health, psychological, family, and school issues. These issues were due to RMS itself, complications of diabetes, side effects of medications, and technology failure. Our multidisciplinary team tackled all issues by providing the most appropriate care, mediation, and technology. Conclusion To act faster than the disease progression, we need to know the whole list of issues our patient could face, as this will help us to look at the entire picture rather than treating different pieces separately. Effective cooperation between the teams is crucial and needs to be organized through a family physician or by the team involved the most in patient care. Although technology has limitations, it still helps when used appropriately.","PeriodicalId":486848,"journal":{"name":"Journal of diabetes and endocrine practice","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135393391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent Fasting, Ramadan Fasting, and Nutrition in the Elderly","authors":"Salem A. Beshyah","doi":"10.1055/s-0043-1772452","DOIUrl":"https://doi.org/10.1055/s-0043-1772452","url":null,"abstract":"Welcome to the third issue of Journal of Diabetes and Endocrine Practice in 2023. We have three review articles, one original article, and one case report. We hope they make an interesting and useful reading. The three review articles are somewhat related to the common theme of fasting and nutrition. First, The “Ramadan fasting and diabetes” review by Khadija Hafidh et al from the MENA Endocrine Group provides a comprehensive summary of the international literature productivity in 2022. Second, the effect of intermittent fasting versus continuous caloric restriction on body weight and metabolic parameters in adults with overweight or obesity is narrated by Jessica Abou Chaaya and colleagues from the American University of Beirut. Third, the challenges andmanagement strategies in the nutrition of older people with diabetes are appraised by Khalid Farooqui et al from Hamad Medical Corporation of Doha, Qatar. The single original article By Maryam Salim Alrawahi and Hussain Alsaffar presents the knowledge and confidence of Omani pediatric residents in managing diabetic ketoacidosis investigated by an online survey. The case report is from pediatric endocrine practice. The case presents a slipped capital femoral epiphysis after 2 months from starting growth hormone therapy by Wasnaa Hadi Abdullah and Hussain Alsaffar.","PeriodicalId":486848,"journal":{"name":"Journal of diabetes and endocrine practice","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slipped Capital Femoral Epiphysis after 2 Months from Starting Growth Hormone Therapy","authors":"Wasnaa Hadi Abdullah, Hussain Alsaffar","doi":"10.1055/s-0043-1771500","DOIUrl":"https://doi.org/10.1055/s-0043-1771500","url":null,"abstract":"Abstract Recombinant growth hormone (GH) is a widely used hormonal therapy for children and adolescents with GH deficiency or short stature related to certain conditions. Generally, GH therapy has a good safety profile; however, it could have rare but significant orthopaedic complications including slipped capital femoral epiphysis (SCFE). Pediatric endocrinologists are aware of these possible complications, and they are responsible for appropriately counseling their patients before commencing this hormone. However, the pediatric endocrinologist may not be the first clinician who encounters the orthopaedic complications of GH, as the patient may seek an emergency medical opinion from people from other specialties. Here, we report the case of a 13-year-old Iraqi adolescent boy who presented with limping that appeared only 2 months after receiving GH (0.035 mg/kg/d). He was diagnosed with SCFE in a relatively very short time after commencement of the treatment. Despite this, the patient was not considered to be at high risk of SCFE. A careful evaluation of SCFE in patients complaining of a limp or hip and knee pain during GH therapy is highly recommended.","PeriodicalId":486848,"journal":{"name":"Journal of diabetes and endocrine practice","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Management Strategies in the Nutrition of Older People with Diabetes","authors":"Khalid Farooqui, Adeel Ahmad Khan, Theresa Paul, Jaseem Sirajudeen, Haseeb Ahmad Khan, Farah K. Farooqui, Khalid RFA Ferih, Hani Hassan Al-Yahary, Farrookh Haider, Abdel-Naser Elzouki","doi":"10.1055/s-0043-1771201","DOIUrl":"https://doi.org/10.1055/s-0043-1771201","url":null,"abstract":"Abstract Diabetes has increased in prevalence and is the most common chronic metabolic disease worldwide. Its incidence and prevalence have particularly increased among older adults over the last few decades. The older adult population older than 60 years is diagnosed chiefly with type 2 diabetes, prediabetes, and type 1 diabetes in a small percentage; there is also an incidence of a transient form of diabetes secondary to chronic underlying diseases or as a part of their treatment-related complications. The primary goal in managing older adults with diabetes is to maintain glycemic status against the risk of hypoglycemia and its complications. In the older adult population, the problem of polypharmacy and nutrition must be kept in mind while achieving glycemic targets and preventing diabetes complications. Few studies have highlighted the importance of nutrition in older adults with diabetes and hypoglycemia as a complication leading to increased morbidity and mortality. Many factors in the older aged groups interplay in diabetes patients. Increasing the risk of hypoglycemia and managing nutritional aspects is paramount in older adults with diabetes mellitus. This review highlights various aspects of nutritional management in older adults with diabetes based on the current evidence available in the literature. However, most dietary recommendations for older adults with diabetes are based on studies in the adult population, and further studies targeting the older adult population are needed.","PeriodicalId":486848,"journal":{"name":"Journal of diabetes and endocrine practice","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Intermittent Fasting versus Continuous Caloric Restriction on Body Weight and Metabolic Parameters in Adults with Overweight or Obesity: A Narrative Review","authors":"Jessica Abou Chaaya, Jana Dib El Jalbout, Mona P. Nasrallah","doi":"10.1055/s-0043-1771447","DOIUrl":"https://doi.org/10.1055/s-0043-1771447","url":null,"abstract":"Abstract Obesity and type 2 diabetes have reached epidemic proportions worldwide, including the Middle East and North Africa region. Intermittent fasting (IF) has been increasingly used to manage overweight/obesity and its metabolic complications. Physiologically, IF shifts the body's metabolism into ketosis (the metabolic switch) and induces cellular changes, which have a theoretical benefit over and above continuous caloric restriction (CCR). In this narrative overview of IF, the focus is on summarizing studies that compare IF to CCR in adults with overweight or obesity. The most commonly practiced types of IF (5:2, the alternate day fast, and the time-restricted eating) were included. Nine studies of 1-year duration or longer, with weight loss as the primary outcome, were summarized. The effect on body weight and improved metabolic parameters such as blood pressure, glycemic indicators, and lipid profile are described. Overall, IF was well tolerated and effective for weight loss in a manner comparable to CCR. The benefits were similar among adults with type 2 diabetes. There were no additional metabolic effects or benefits over and above CCR. However, more studies are needed to address specific details of IF, such as the type and timing of fasting and its application to different populations. In conclusion, IF is safe and beneficial for weight loss in adults with overweight/obesity with or without diabetes. It can be used as an alternative to CCR.","PeriodicalId":486848,"journal":{"name":"Journal of diabetes and endocrine practice","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135812977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}