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Introduction: Diabetes mellitus has emerged as a global public health issue due to its increasing prevalence and the increased risk of developing cancers. Pancreatic cancer is believed to be both a consequence of pre-existing diabetes and a potential cause of new-onset diabetes., Aim: This study aims to compare the characteristics of patients with pancreatic ductal adenocarcinoma and newly diagnosed or long-standing diabetes mellitus., Methods: A multicentric retrospective study was conducted over 13 years at two university hospitals in Sousse, Tunisia. Included patients had whether a newly diagnosed or a long-standing diabetes mellitus with histologically confirmed pancreatic ductal adenocarcinoma. Statistical analysis using appropriate tests was conducted., Results: The prevalence of diabetes mellitus was 44.6% among three hundred and seven patients with pancreatic cancer. The male-to-female ratio in patients with pancreatic ductal adenocarcinoma was 2.6:1. Patients' mean age was 63.9 years, with the majority being over 50 years old. Most patients had no family history of diabetes and exhibited significant weight loss, low body mass index, and uncontrolled diabetes. The comparison between individuals with newly diagnosed diabetes and those with long-standing diabetes revealed numerous similarities, apart from significant differences in drinking patterns (p = 0.03), tumor size (p = 0.018), and smoking in the subgroup of males (p = 0.044)., Conclusion: Patients over 50 with newly diagnosed diabetes mellitus, particularly those who consume alcohol occasionally and men who are not heavy smokers, should undergo further evaluation to identify potential early-stage pancreatic ductal adenocarcinoma.

Background: In Tunisia, the prevalence of diabetes mellitus increased from 15.5% on 2016 to 23% by 2023. While Chronic Kidney Disease (CKD) stills the most dreaded complications of diabetes, studies on the prevalence of chronic kidney disease non-dialysis diet are scarce. The aim of this study was to assess the prevalence of chronic kidney disease among the Tunisian diabetic population based on investigators' specialty, demographic criteria (gender, age, duration of diabetes and geographic distribution) and diagnosis criteria (albuminuria and/or eGFR)., Methods: This observational, multicentric, and cross-sectional study enrolled all diabetic subjects from all regions of Tunisia with at least 3 months of follow-up before the inclusion date, from 09 January to 08 February 2023. CKD diagnosis was established based on the KDIGO guidelines. The study was carried out at medical departments and ambulatory clinics of different healthcare providers. Baseline data were collected by investigators using an electronic case report form (eCRF). Continuous variables were described by means, median, standard deviation, and quartiles. Categorical data were tabulated in frequencies and percentages., Results: The overall prevalence of CKD among the 10,145 enrolled patients with diabetes mellitus was 38.7% with a 95%CI [37.8-39.6%]. 50.9% were male, with a mean age of 67.5 (± 11.3) years. The mean diabetes duration was 16.1 years (± 8.9). The highest CKD prevalence was noted among nephrologists (82.2%), while it was similar between the cardiologists and the primary care physicians (30.0%). CKD prevalence was highest among males (43.0% versus 35.1%) and increased proportionally with patients' age and diabetes duration. CKD was more frequent in the Mid-East Area when compared to other regions (49.9% versus 25.3 to 40.1% in other regions). Albuminuria was present within 6.6% of subjects with CKD, and it was found an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² within 13.3% of subjects wit h CKD. 18.9% had both criteria., Conclusions: In Tunisia, CKD among diabetics had a prevalence of 38.7%, approaching European prevalence. The prevalence discrepancy worldwide of CKD can be improved with a larger population size and by implementing standardized practices., (© 2024. The Author(s).)

Context: Diabetic foot trophic disorders and their complications leading to the risk of amputation remain a major public health problem., Objective: To determine the level of podiatric risk in our diabetic patients according to the classification of the International Working Group of the Diabetic Foot (IWGDF) and study the relationship between the level of education and the level of podiatry risk.., Methods: This is a descriptive and analytical cross-sectional study including all diabetics hospitalized at the National Institute of Nutrition in Tunis for chronic diabetes imbalance, carried out over a period of two months (July - August 2019)., Results: The mean age of the patients was 55.08 ± 14.22 years. The sex ratio was 0.67. The majority of our patients were type 2 diabetics (90.24%). During the clinical examination of the foot, plantar hyperkeratosis was the most noted manifestation (65.85%). Based on the IWGDF classification, 42.68% of patients had a grade 0 podiatric risk. Regarding the overall educational level, we noted 76.83% patients with a poor educational level and 23.17% patients with a satisfactory level of education. The overall educational level is significantly associated with the podiatric grade (p <0.05)., Conclusions: Therapeutic education or even podiatric education of the patient is important in the prevention of complications of the foot. Patient-centered training in foot care practice in public health facilities would reduce the rate of morbidity and mortality from complicated diabetic foot.

Fasting during the month of Ramadan is one of the essential beliefs amongst Muslims. For the person with diabetes mellitus (DM), however, fasting presents a major challenge. Indeed, Fasting Ramadan may predispose patients with DM to several risks such as hypoglycemia, hyperglycemia and dehydration. Physicians should be ready to prepare their patients to this period in order to avoid risks. This paper provides physicians with 10 pitfalls to avoid when educating patients with DM who decided to fast Ramadan.