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5. Combining Glucagon-Like Peptide 1 Analogues with Sodium-Glucose Cotransporter 2 Inhibitors to Treat Patients with Type 1 Diabetes, BMI > 25 Kg/M2, and Chronic Kidney Disease – a Randomised, Controlled Pilot Study

Author

Al-Ozairi, Ebaa, primary, Taghadom, Etab, additional, Irshad, Mohammad, additional, Al Yousef, Anas, additional, al Kandari, Jumana, additional, Al-Najim, Werd, additional, Alabdulkader, Shahd, additional, Miras, Alexander D., additional, and le Roux, Carel W., additional

Published
2024
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12. Association Between Depression, Diabetes Self-Care Activity and Glycemic Control in an Arab Population with Type 2 Diabetes

Author

Al-Ozairi,Abdullah, Taghadom,Etab, Irshad,Mohammad, Al-Ozairi,Ebaa, Al-Ozairi,Abdullah, Taghadom,Etab, Irshad,Mohammad, and Al-Ozairi,Ebaa

Abstract

Abdullah Al-Ozairi,1,2 Etab Taghadom,2,3 Mohammad Irshad,3 Ebaa Al-Ozairi3,4 1Department of Psychiatry, Faculty of Medicine, Kuwait University, Safat, Kuwait; 2Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait; 3Dasman Diabetes Institute, Dasman, Kuwait; 4Department of Medicine, Faculty of Medicine, Kuwait University, Safat, KuwaitCorrespondence: Ebaa Al-Ozairi, Dasman Diabetes Institute, PO Box 1180, Dasman, 15462, Kuwait, Email ebaa.alozairi@dasmaninstitute.orgPurpose: Poor self-care behavior and depression are associated with worse glycemic control, but the relationship between these variables is poorly reported. The present study aimed to describe self-care behaviors and explore the association between depression, self-care and glycemic control in people with type 2 diabetes in an Arab population.Patients and Methods: This study recruited 446 patients with type-2 diabetes from an outpatient clinic in Kuwait and completed assessments of diabetes self-care using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire and depression using the Patients Health Questionnaire-9 (PHQ-9) scales. Multiple linear regression models were used to determine the associations between depression, self-care behaviors and glycemic control.Results: Self-care behaviors were highest for medication taking (92.9%), an average for foot care (61.4%), blood glucose testing (60%) and healthy diet (55.7%), and lowest for exercise (27.1%). Depression, poor self-care activities and poor HbA1c levels were inter-correlated in univariate analysis (p< 0.03). In regression analysis, following healthful eating (B= − 0.27, p< 0.001), general eating plan (B= − 0.21, p= 0.01), more space carbohydrates evenly throughout the day (B= - 0.17, p= 0.03) and exercise at least 30 minutes (B= − 0.17, p= 0.02) behaviors were associated with better HbA1c levels. However, depression was associated with poor scores of following a general eating plan (B= − 0.20, p= 0.03), space carb

Published
2023

13. Effect of COVID-19 vaccine on blood glucose metrics in Arabic people with type 1 diabetes

Author

Al-Ozairi, Ebaa, Irshad, Mohammad, Taghadom, Etab, Varghese, Anisha, Sojan, Litty, and Alkandari, Jumana

Subjects
Endocrinology, Diabetes and Metabolism
Abstract

IntroductionPeople with diabetes are at a higher risk for coronavirus disease-19 (COVID-19) and hence are prioritized for vaccination. The aim of the current study was to investigate the effects of COVID-19 vaccination on blood glucose control in Arabic people with type 1 diabetes (T1D). Secondary aim was to compare the responses between the two vaccines approved for use in Kuwait.MethodThis retrospective study compared ambulatory glucose metrics, using a continuous glucose monitoring device, measured for 14 days before, and 7 days and 14 days after, the first and second dose of the COVID-19 vaccine in Arabic people with Type 1 diabetes (T1D). We also explored possible links with vaccine type and other clinical characteristics. Glucose metrics calculated were time in range (TIR, 3.9–10 mmol/L), time above range (TAR, 10.1- 13.9 mmol/L or >13.9 mmol/L), time below range (TBR, 3- 3.9 mmol/L or ResultsWe enrolled 223 participants in the study. Over the 7 days period after the first vaccination dose there was a decrease in TIR (mean difference (SD) –1.9% ± 14.8%; p = 0.05) and increase in TAR >10 mmol/L (2.2% ± 15.9%; p = 0.04), with no effects on TBR. These effects were not seen after the second dose or 14 days after either dose. There was a decrease in CV over the 7 days period after the first (−1.2% ± 7.4%; p = 0.02) and second vaccine doses (−1.1% ± 6.9%; p = 0.03), with no effects noted 14 days after either dose. In subgroup analysis similar effects on TIR and TAR were also seen in those who had received the viral vector-based vaccine, but not the mRNA-based vaccine, although the decrease in CV was seen in those who had received the mRNA based vaccine but not the viral vector-based vaccine.ConclusionWe found a temporary impairment in glucose control in the first 7 days, particularly among individuals receiving viral vector vaccines. The group receiving mRNA vaccine was likely to experience an increase in glucose levels above the target range. However, the temporary change in metrics appears to return to pre-vaccination levels after one-week post-vaccination. The effects on glycemic parameters were more neutral after the second dose.

Published
2023
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21. Prevalence and risk factors for diabetic peripheral neuropathy, neuropathic pain and foot ulceration in the Arabian Gulf region

Author

Ponirakis, Georgios, primary, Elhadd, Tarik, additional, Al Ozairi, Ebaa, additional, Brema, Imad, additional, Chinnaiyan, Subitha, additional, Taghadom, Etab, additional, Al Kandari, Jumana, additional, Al Wotayan, Rehab, additional, Al Ozairi, Abdulla, additional, Aljohani, Naji, additional, AlMistehi, Wael, additional, Al Qahtani, Nora, additional, Khan, Shawana, additional, Dabbous, Zeinab, additional, Siddique, Mashhood A, additional, Petropoulos, Ioannis N, additional, Khan, Adnan, additional, Almuhannadi, Hamad, additional, Ashawesh, Khaled AE, additional, Dukhan, Khaled M, additional, Mahfoud, Ziyad R, additional, Zirie, Mahmoud A, additional, Jayyousi, Amin, additional, and Malik, Rayaz A, additional

Published
2022
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22. A randomised crossover trial: Exploring the dose–response effect of carbohydrate restriction on glycaemia in people with well‐controlled type 2 diabetes.

Author

Al‐Ozairi, Ebaa, Reem, Al Awadi, El Samad, Abeer, Taghadom, Etab, Al‐Kandari, Jumana, Abdul‐Ghani, Muhammad, Oliver, Nick, Whitcher, Brandon, and Guess, Nicola

Subjects
RESEARCH, GLYCEMIC control, BLOOD sugar monitoring, LOW-carbohydrate diet, BLOOD sugar, TYPE 2 diabetes, TREATMENT effectiveness, RANDOMIZED controlled trials, WEIGHT loss, DIETARY carbohydrates, STATISTICAL sampling, CROSSOVER trials, DOSE-response relationship in biochemistry
Abstract

Background: Trials investigating the role of carbohydrate restriction in the management of glycaemia in type 2 diabetes (T2D) have been confounded by multiple factors, including degree of calorie restriction and dietary protein content, as well as by no clear definition of a low‐carbohydrate diet. The present study aimed to provide insight into the relationship between carbohydrate restriction and glycaemia by testing the effect of varying doses of carbohydrate on continuous glucose concentrations within a range of intakes defined as low‐carbohydrate at the same time as controlling for confounding factors. Methods: This was a randomised crossover trial in participants with T2D (HbA1c: 6.6 ± 0.6%, 49 ± 0.9 mmol mol–1) testing five different 6‐day eucaloric dietary treatments with varying carbohydrate content (10%, 15%, 20%, 25%, and 30% kcal). Diets exchanged %kcal from carbohydrate with fat, keeping protein constant at 15% kcal. Daily self‐weighing was employed to ensure weight stability throughout each treatment arm. Between dietary treatments, participants underwent a washout period of at least 7 days and were advised to maintain their habitual diet. Glycaemic control was assessed using a continuous glucose monitoring device. Results: Twelve participants completed the study. There were no differences in 24‐h and post‐prandial sensor glucose concentrations between the 30 and 10%kcal doses (7.4 ± 1.1 mmol L–1 vs. 7.6 ± 1.3 mmol L–1 [p = 0.28] and 8.1 ± 1.5 mmol L–1 vs. 8.5 ± 1.4 mmol L–1 [p = 0.28], respectively). In our exploratory analyses, we did not find any dose–response relationship between carbohydrate intake and glycaemia. A small amount of weight loss occurred in each treatment arm (range: 0.4–1.1 kg over the 6 days) but adjusting for these differences did not influence the primary or secondary outcomes. Conclusions: Modest changes in dietary carbohydrate content in the absence of weight loss at the same time as keeping dietary protein intake constant do not appear to influence glucose concentrations in people with well‐controlled T2D. Summary: This study randomised people with T2D to receive five different doses of carbohydrate from 10% to 30% of calories in random order to see what effect it had on their blood glucose. Key points: Decreasing the carbohydrate content of the diet from 30 to 10%kcal had no detectable effect on blood glucose concentration. There was no observed relationship between the dose of carbohydrate as a %kcal and glucose concentration. It is possible that a low carbohydrate diet needs to be combined with high protein to lower glucose in type 2 diabetes. This study was specifically designed to prevent weight loss and therefore our results do not mean that a low carbohydrate which causes weight loss would not be beneficial for type 2 diabetes. [ABSTRACT FROM AUTHOR]

Published
2023
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