Libyan Journal of Medicine最新文献

{"title":"Prevalence and impact of hyponatremia in chronic obstructive pulmonary disease. A systematic review and meta-analysis.","authors":"Purnima Adhikari, Raju Rana, Rohini Punja, Prakashini Koteshwar, Rahul Magazine, Mohan K Manu, Santa Kumar Das, Sharma Paudel, Chandni Gupta","doi":"10.1080/19932820.2026.2642904","DOIUrl":"10.1080/19932820.2026.2642904","url":null,"abstract":"<p><p>Hyponatremia has been found to be associated with chronic obstructive pulmonary disease (COPD) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, there is a lack of systematic evidence on the prevalence and impact of hyponatremia in COPD and AECOPD patients. We performed a systematic search on three major databases for articles published on or before 31 July 2025. We included all the studies reporting the prevalence or number of hyponatremia cases in COPD patients (stable and exacerbation) aged 18 years and above. Pooled prevalence was calculated by a random effects model using RStudio. The Joanna Briggs Institute (JBI) tool was used for quality evaluation of the included studies. In this systematic review and meta-analysis, we included 11 studies out of 284 studies retrieved in the initial search. Of these 11 studies, three were COPD studies, and eight were AECOPD studies. The pooled prevalence of hyponatremia among COPD patients was 14% (95% CI: 4%-28%), with significant heterogeneity (<i>I</i>² = 98.3%, <i>p </i>< 0.0001). The pooled prevalence of hyponatremia in AECOPD patients was 19% (95% CI: 9%-32%), with significant heterogeneity (<i>I</i>² = 98.8%, <i>p </i>< 0.0001). Most of the studies showed that hyponatremia was not associated with mortality as an outcome of AECOPD. This study found a high prevalence of hyponatremia in both COPD and AECOPD patients; however, substantial heterogeneity (<i>I</i>² > 98%) necessitates cautious interpretation of pooled estimates. Future studies with standardized diagnostic criteria and larger sample sizes are needed to establish more precise prevalence rates.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2642904"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of research quantity, quality, and impact in MENA research centers.","authors":"Amin Bredan","doi":"10.1080/19932820.2026.2626625","DOIUrl":"10.1080/19932820.2026.2626625","url":null,"abstract":"<p><p>Research performance in the Middle East and North Africa (MENA) is often assessed using national aggregates that mask substantial institutional variation. Evidence on how output, quality, and excellence relate to economic resources and institutional capacity across the region remains limited. Data from the SCImago Research Centers Rankings were used to analyze 321 non-university, non-health research centers across 22 MENA countries. Indicators included research output, Quality, Excellence, collaboration, innovation, and Institutional Citation Impact per researcher (ICI/T). Analyses were conducted at both country and institutional levels using descriptive statistics, correlation analysis, and clustering. The analysis reveals extreme heterogeneity within and across countries. National income is strongly associated with research Excellence but shows a much weaker relationship with baseline Quality. ICI/T is strongly associated with Excellence and displays reduced variance at higher values, indicating increasing stability of elite performance. Clustering identifies multiple tiers of research systems that cut across income categories. A small group of countries exhibits disproportionately high Excellence relative to weak institutional impact, consistent with structural decoupling. International collaboration supports Quality but does not predict Excellence, while regional and industry collaboration remain limited. Economic resources accelerate elite research performance but do not guarantee high baseline quality. Long-term research performance in the MENA region depends primarily on institutional alignment, governance, and sustained capacity building rather than output expansion alone.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2626625"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidities increase the severity of COVID-19: an analysis and epidemiological study conducted in Algeria.","authors":"Madjda Akacha, Abdelhalim Khenchouche, Mounira Amrane, Abbas Mehnane, Abdelmadjid Lacheheb, Nasir A Ibrahim, Nosiba S Basher, Mohammed Saad Aleissa, Assia Derguini, Rahma Abubakr Musa Adam, Azza M I Al-Asmar, Karim Houali","doi":"10.1080/19932820.2026.2670005","DOIUrl":"10.1080/19932820.2026.2670005","url":null,"abstract":"<p><p>The COVID-19 pandemic revealed the importance of pre-existing conditions, or comorbidities, as major predictors of disease severity and mortality worldwide. In this context, the major goal of this study was to examine the impact of common comorbidities on the clinical outcomes of COVID-19 patients in Sétif, Algeria, as well as to evaluate the local epidemiological risk profile. We conducted a thorough analysis of 12,932 COVID-19 participants in the Sétif community, focusing on the prevalence and impact of many illnesses, most notably diabetes, cardiovascular disease (CVD), and hypertension. We also looked at geographical inequalities in comorbidity prevalence to help influence local patient care methods. Our data revealed a strong link between these comorbidities and poor COVID-19 outcomes. Patients with heart disease, hypertension, and diabetes had a considerably greater incidence of severe COVID-19, with computed odds ratios (ORs) of 1.50, 1.34, and 2.89, respectively, indicating that diabetes was the best predictor of severity in this cohort. This investigation demonstrated that the presence of comorbidities considerably exacerbated the severity and mortality rate of SARS-CoV-2 infection. These findings highlight the importance of establishing thorough, personalised techniques and more effective diagnostic and treatment approaches for COVID-19 patients that explicitly account for the varied prevalence of underlying health issues.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2670005"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy students' knowledge and attitudes regarding GLP-1 receptor agonist adverse effects in obesity management: a cross-sectional study.","authors":"Alaa A Khojah, Malaz J Gazzaz, Mohammed M Aldurdunji, Ahmad E Safiraldeen, Ibrahim R Al-Qurashi, Mohammad A Alhazmi, Ashraf N Abdalla, Roaya S Alqurashi, Saad M Wali","doi":"10.1080/19932820.2026.2749899","DOIUrl":"10.1080/19932820.2026.2749899","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are important therapeutic options for obesity and type 2 diabetes mellitus. Despite their increasing use, safety concerns remain, and pharmacy students' knowledge of their adverse effects is unclear. This study evaluated pharmacy students' knowledge and attitudes regarding GLP-1 RA adverse effects in obesity management. A cross-sectional questionnaire-based study was conducted among undergraduate Doctor of Pharmacy (Pharm.D.) students (1st-7th year) at Umm Al-Qura University, Saudi Arabia, between November and December 2025. A newly developed questionnaire, reviewed by two experts and pilot-tested among 10 students, assessed 17 knowledge and five attitude items covering indications, mechanisms, adverse effects, and clinical scenarios. Of 1,118 eligible students, 296 completed the survey (response rate: 26.5%). Descriptive statistics and multivariable regression analyses were performed using RStudio (version 2024.9.1.394). Among participants (63.9% male), the mean knowledge score was 7.6 ± 4.0/17. Most agreed that adverse effects significantly impact clinical use (59.4%) and supported further education on less common side effects (61.1%). Nausea was the most frequently recognized adverse effect (59.1%), whereas thyroid C-cell tumors observed in rodent studies (25.0%) and diabetic retinopathy complications (36.5%) were less commonly identified. Only 37.2% correctly recognized that hypoglycemia is uncommon with GLP-1 RA monotherapy. Higher knowledge scores were significantly associated with greater confidence in knowledge (OR = 1.11, 95% CI: 1.06-1.17; <i>p</i> < 0.001) and stronger endorsement of further education on less common side effects (OR = 1.11, 95% CI: 1.06-1.18; <i>p</i> < 0.001), whereas gender and academic year were not significant predictors of any attitude item. Pharmacy students demonstrated limited knowledge but generally positive attitudes regarding GLP-1 RA safety. These findings highlight the need to strengthen pharmacovigilance and evidence-based medication safety education within pharmacy curricula to improve clinical preparedness and patient counseling.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2749899"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of EMMPRIN as a biomarker in nonodontogenic carcinomas: a histological study.","authors":"Ben Amer M Antisar, Omar M Enas, Elsheikh M Sahar, Musrati S Ahmed","doi":"10.1080/19932820.2025.2598896","DOIUrl":"10.1080/19932820.2025.2598896","url":null,"abstract":"<p><p>EMMPRIN is a widely distributed cell surface glycoprotein that belongs to the immunoglobulin (Ig) superfamily. It induces the production of extracellular matrix metalloproteinases (MMPs) and plays an important role in angiogenesis via stimulation of vascular endothelial growth factor (VEGF). The aim of the present work was to assess and compare the expression of extracellular matrix metalloproteinase inducer (EMMPRIN) in different oral nonodontogenic carcinomas. Fifty-four diagnosed cases of oral nonodontogenic carcinomas were selected, and biopsies were taken from the tumor tissue, fixed, processed, and cut into sections to be stained with hematoxylin and eosin (H&E) for routine histopathological examination. Immunohistochemistry was performed for EMMPRIN. All cases showed positive EMMPRIN expression with different intensities. The results were recorded and statistically analyzed using student <i>t</i>-test, Pearson correlation, test and ANOVA test. This study concluded that elevated EMMPRIN expression is correlated with tumor proliferation, angiogenesis, metastasis, and invasion.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2598896"},"PeriodicalIF":1.7,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of percutaneous vertebroplasty combined with minimally invasive pedicle screw fixation versus percutaneous vertebroplasty alone in the treatment of elderly osteoporotic vertebral compression fractures.","authors":"Chunfeng Ma, Zhineng Chen, Qun Fang, Yue Shu","doi":"10.1080/19932820.2026.2670006","DOIUrl":"10.1080/19932820.2026.2670006","url":null,"abstract":"<p><p>The study aimed to assess the comparative efficacy of percutaneous vertebroplasty (PVP) combined with minimally invasive pedicle screw fixation versus PVP alone in elderly patients with osteoporotic vertebral compression fractures (OVCF). Ninety-four elderly patients with OVCF were randomly classified into the control (47 patients) and combined (47 patients) groups. The control group received PVP, while the combined group received PVP combined with minimally invasive pedicle screw fixation. Perioperative indicators such as intraoperative blood lose, operative time, and hospitalization time were recorded. Pain was assessed using the VAS before and at baseline and 1, 3, and 7 days postoperatively. At 1 and 3 days postoperatively, Serum CRP levels, WBC, and neutrophil counts were measured postoperatively. Radiographic outcomes (vertebral height ratio and Cobb angle), ADL scores, JOA scores, and ODI were evaluated preoperatively and at 3 months post-operation. Postoperative complications were documented. Baseline characteristics were comparable. The combined group showed superior pain relief, vertebral height restoration, Cobb angle correction, functional recovery, and reduced inflammatory markers (CRP, WBC, neutrophils) postoperatively (all <i>P</i> < 0.05). Blood loss and hospital stay were shorter in the combined group, though operative time was longer (<i>P</i> < 0.05). Complication rates did not differ significantly (<i>P</i> > 0.05). PVP combined with minimally invasive pedicle screw fixation yields better outcomes in elderly OVCF patients by enhancing pain control, vertebral height, and functional recovery without increasing perioperative risk.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2670006"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of risk factors of breast cancer among women in Dodoma, Tanzania: a community-based cross-sectional study.","authors":"James J Yahaya, Angelina A Joho","doi":"10.1080/19932820.2026.2625359","DOIUrl":"10.1080/19932820.2026.2625359","url":null,"abstract":"<p><p>Assessment of risk factors of breast cancer in the general population provides insightful information towards prevention of breast cancer. This study aimed to assess the risk factors of breast cancer among women in a community from a resource-limited setting in sub-Saharan Africa. This descriptive community-based cross-sectional study was conducted in Dodoma, Tanzania, from July to December 2020. The study included women aged between 18 and 70 years. The data were analyzed using SPSS program version 25.0. Independent <i>t</i>-test was used to compare the mean age of the participants for the availability of risk factors of breast cancer. A two-tailed <i>p</i> < 0.05 was considered significant. A total of 354 women were analyzed, and the median age was 27.0 (23.0-35.3) years. Only 11.8% (<i>n</i> = 18) of all the participants did not have any of the risk factors examined. Not engaging in physical activity was the most frequent risk factor which accounted for 68.2% (<i>n</i> = 242) of all the participants. There were more 60.7% (<i>n</i> = 215) of the study participants with a low mean age (22.9 ± 3.5) who had more than 5 risk factors compared to 39.3% (<i>n</i> = 139) of the participants with a high mean age (25.3 ± 9.4) who had more than 5 risk factors, with no statistically significant difference (95% CI = 0.91-2.22, <i>p</i> = 0.31). There is a large proportion of women younger than 40 years in the population of Tanzanian women with many risk factors of breast cancer. This may contribute to the currently observed increase in the incidence of breast cancer in Tanzania for women aged less than 40 years. Therefore, there is an urgency for targeted awareness and screening for breast cancer among younger women in Tanzania so as to increase early detection and diagnosis.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2625359"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum iodine and thyroid function in Malagasy adults: a cross-sectional study in a tertiary-level hospital in Antananarivo, Madagascar.","authors":"Sitraka Angelo Raharinavalona, Rija Eric Raherison, Thierry Razanamparany, Maminirina Ratojoniaina, Andrianirina Dave Patrick Rakotomalala","doi":"10.1080/19932820.2026.2690694","DOIUrl":"10.1080/19932820.2026.2690694","url":null,"abstract":"<p><p>Iodine status and thyroid disorders remain understudied subjects in low-income countries such as ours. The objectives of the present study were to assess the serum iodine (SI) level and thyroid function in Malagasy adults seen at the Soavinandriana Hospital Center in Antananarivo and to determine the association between high levels of serum iodine (HLSI) and dysthyroidism. This cross-sectional study was conducted over the course of two years (September 1, 2021 to August 31, 2023). The SI was used as a proxy for iodine status in the absence of urinary assays. Thyroid function was assessed by thyroid stimulating hormone (TSH) and free tetra-iodothyronine (fT4). The HLSI was defined by the total serum iodine >100 µg/L. Dysthyroidism was defined by abnormal TSH and/or fT4 levels indicative of hypo- or hyperthyroidism. Among 195 patients, the prevalences of serum iodine excess and dysthyroidism were 12.8% and 15.4%, respectively. HLSI was significantly more common in subjects <60 years old (<i>p</i>-value < 0.0001), and less common in those with hypertension (<i>p</i>-value < 0.0001), dyslipidemia (<i>p</i>-value < 0.0001), diabetes mellitus (<i>p</i>-value = 0.0082) and ex-smoking (<i>p</i>-value < 0.0001). Adjusted for age and gender, the association between HLSI and dysthyroidism was significant (OR = 108 [17-680]). HLSI and dysthyroidism were prevalent among Malagasy adults. The presence of one condition would encourage the search for the other. Their management is primarily preventive through their periodic monitoring.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2690694"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student perceptions of a three-minute thesis presentation activity in undergraduate pharmacology education: a post-intervention evaluation.","authors":"Eman O Alsheikh, Saad M Wali","doi":"10.1080/19932820.2026.2713951","DOIUrl":"10.1080/19932820.2026.2713951","url":null,"abstract":"<p><p>Communication skills are a core competency in pharmacy education; however, traditional presentation approaches often place limited emphasis on clarity, engagement, and meaningful integration of knowledge. This study evaluated student perceptions and immediate post-activity knowledge following implementation of a Three-Minute Thesis (3MT) group presentation task among third-year Doctor of Pharmacy (Pharm.D) undergraduate students in a pharmacology course at Umm Al-Qura University, Makkah, Saudi Arabia. A single-group, post-intervention, cross-sectional evaluation design was used. Learning outcomes were assessed using a structured 20-item evaluation questionnaire measuring five domains (engagement, perceived learning, communication confidence, satisfaction, and peer perception) and a five-item knowledge quiz administered immediately after the activity. A total of 59 students participated (79.7% response rate). Perceptions were highly positive across all domains, with the highest mean scores observed for satisfaction ($M = 4.37$, $SD = 0.80$) and peer perception ($M = 4.32$, $SD = 0.79$), followed by engagement ($M = 4.21$, $SD = 0.74$), perceived learning ($M = 4.16$, $SD = 0.81$), and communication confidence ($M = 4.11$, $SD = 0.77$). Subscale reliability was strong (Cronbach's $alpha = 0.79-0.92$). Quiz performance reflected high immediate post-activity knowledge, with a mean score of 3.86 out of 5 ($SD = 1.18$), and 72.9% of participants achieving scores of 4 or 5. The 3MT-style format is a feasible and highly engaging active-learning strategy in undergraduate pharmacology. While the descriptive single-group design limits direct causal inferences, the strong student reception and solid immediate knowledge profiles demonstrate its pedagogical viability and educational value. Future controlled, multi-institutional studies are warranted to evaluate long-term impacts.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2713951"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking the cycle: patient activation role in improving diabetes self-care adherence for alleviating diabetes distress.","authors":"Mohamed Gamal Elsehrawy, Faisal Khalaf Alanazi, Hassanat Ramadan Abdel-Aziz, Mona Mohamed Abdelaziz Barakat, Nermen Abdelftah Mohamed, Mahitab Mohamed Abdelrahman","doi":"10.1080/19932820.2026.2644567","DOIUrl":"10.1080/19932820.2026.2644567","url":null,"abstract":"<p><p>Effective diabetes care must address not just the clinical metrics but also this psychological interplay, empowering patients to drive the proactive engagement needed for long-term health. This study aims to explore the mediating effect of the patient activation role on diabetes self-care adherence and diabetes distress. A cross-sectional study was conducted with a convenience sample of 428 adults with type 2 diabetes recruited from diabetes clinics. Participants completed validated surveys through the Patient Activation Measure, Diabetes Distress Scale, and Summary of Diabetes Self-Care Activities. The data were analyzed using correlation and structural equation modeling to test the proposed mediation model. Significant negative correlations were found between patient activation and diabetes distress (<i>r </i>= 0.310, <i>p</i>< 0.001), and positive correlations were found between patient activation and self-care adherence (<i>r</i> = 0.588, <i>p </i>< 0.001). As hypothesized, patient activation significantly mediated the relationship between higher self-care adherence and lower diabetes distress, accounting for 45% of the total effect (indirect effect: <i>β </i>= -0.268). These findings demonstrate that patient activation is a key mechanism through which self-care adherence reduces diabetes distress. This suggests that interventions specifically designed to enhance patient activation can break the cycle of distress by empowering individuals to engage more effectively in self-care behaviors, ultimately improving both psychological and clinical outcomes in diabetes management. Integrating routine assessments of patient activation and distress into clinical practice is recommended.</p>","PeriodicalId":49910,"journal":{"name":"Libyan Journal of Medicine","volume":"21 1","pages":"2644567"},"PeriodicalIF":2.5,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}