Background: Medications non-adherence is responsible for treatment failure and a reason of higher cost of medical care. It had been proved that, in general, diabetic patients are non-adherent to their treatment and only a small number of them were found to be adhering with all aspects of diabetic care. Objectives: To assess and evaluate the most common factors associated with medications adherence among Type 2 Diabetes Mellitus (DM) patients attending Ribat University Hospital Diabetic Clinic (RUHDC) Khartoum state, Sudan. Methods: Single Centre Descriptive cross sectional hospital based study was carried out among 351 patients using structured questionnaire and patients cards. Results: A total of 351 patients were recruited in the study; 65.8% were females. About 64.4% were on oral medications and 35.6% on insulin. Adherence to medications among total Type 2 DM patients was 45%. Main barriers to medication adherence were drugs unavailability (34.3%) and forgetfulness (30.7%). Medications knowledge was 41.2% for patients on oral medications and 38.4% for insulin users. Conclusion: Adherence to anti-diabetic drugs in this study was found to be sub-optimal but considered reasonable in comparison with that reported by many African countries. Poor medications knowledge, drug brand unavailability and forgetfulness were the main reasons for medications non adherence. Family support, improving healthcare system and changing patents' behavior will be needed to improve medications adherence.

Background. The frequent expansion of the energy drinks (EDs) market has caused an extensive increase in the consumption of EDs, especially among younger populations. However, the lack of knowledge on EDs and their perceived beneficial effects could lead to excessive EDs consumption, which is strongly associated with serious side effects. This study aimed to assess the knowledge and perceived beneficial effects of EDs consumers and determine the consumption patterns and side effects experienced by different EDs consumers among the Malaysian population. Methods. A descriptive cross-sectional study was conducted in Malaysia from February to April 2021. A structured and validated questionnaire, consisting of 5 sections with 46 items, was distributed online. Only 515 out of 591 invited participants agreed to participate in the study. Descriptive and inferential analysis were done using SPSS. Results. The median age of participants was 23 ± 7.3 years. The majority of participants (65%) were unaware of the active ingredients of EDs, and approximately 40% of them had no idea that EDs contain caffeine. The main reason for consuming EDs was to stay awake (43%), and Red Bull was the most preferred brand (57%). Lack of rest (57%), headache (53%), and nervousness (49%) were the most experienced side effects. A significant difference was observed between consumption patterns and knowledge and perceived beneficial effects ( p < 0.05 ). Our data showed a significant association between respondents’ demographic data (e.g., coffee intake, smoking, and alcohol status) and their consumption pattern. Conclusion. ED consumers in Malaysia were found to have limited knowledge on EDs. Therefore, attention should be drawn to the Ministry of Health regarding the significant side effects such as palpitation and nervousness experienced by ED consumers. Hence, awareness ought to be raised by adopting regulations or policies to regulate the sales and warning labels of EDs in Malaysia.

Background: Hypoglycemia is a traumatic dilemma that has a critical impact on not only the patient's quality of life but also their families and communities. Improving Patient's awareness and knowledge regarding hypoglycemia symptoms is crucial to avoid serious implications like loss of consciousness and even death. Objective: This study aimed to assess patients' knowledge of hypoglycemia symptoms and source of diabetes information among insulin users type 2 diabetes. Methods: A single centre, hospital-based, analytical, and cross-sectional study was carried out among diabetic patients using insulin attended to Ribat University Hospital Diabetes Clinic (RUHDC), Khartoum State, Sudan during a period of study. A validated questionnaire was used to obtain socio-demographic characteristics of respondents and the patients' knowledge regarding hypoglycemia symptoms was assessed whether good, medium or poor. Data were analyzed, using (SPSS). Descriptive (frequencies) and inferential statistics (association used chi-square) were used at a level of confidence p ≤ 0.05. Results: A majority of patients (52%) had poor knowledge of hypoglycemia symptoms and the common symptoms known to patients were hands tremor (67.2%), blurred vision (52.8%) and sweating (65.6%). No associations were found among hypoglycemia symptoms knowledge, socio-demographic and diabetes duration. Only (25.6%) had regular visiting to educating center and physicians were the major source of diabetes knowledge (74.4%). Conclusion: This study proved low patients hypoglycemia symptoms knowledge and physician were the main sources of informa-How to cite this paper:

Background: Type 2 diabetes is a progressive disease and as the result of patient's age and diabetes duration, β-cell ability for insulin secretion deteriorates continually and finally fails to meet body requirement. Intensification of treatment drug regimen including addition of insulin is critical to maintain glycemic target and reduce developing of long-term complications. Objective: The main purpose of this study was to investigate the effect of diabetes duration and patients' age on addition of insulin to treatment regimen. Methods: A single centre, cross-sectional hospital-based study was done among 351 diabetes Mellitus (DM) patients visiting Ribat University Hospital Diabetic Clinic, Khartoum State, Sudan. Data was collected using constructed, validated and multiple-choice questionnaire. Results: From 351 patients enrolled in the study, female were 65.8% and male 34.2%. About 64.4% were on oral anti-diabetic; 35.6% on insulin; about 31.6% shifted to insulin when their ages above 40 years; and 22.8% when diabetes duration was above 5 years. Co-morbidity was 54.4% and 60.2% of patients had hypertension. Conclusion: Interactions between age and longer duration of diabetes were mostly significant reasons for transferring patients to insulin. Percent of insulin users and co-morbidity was within international range.

Objectives Antibiotic usage has evolved over the years among the Arab population, and it has also gone under misuse resulting in the development of antimicrobial resistance (AMR). Therefore, the current study aimed to address this issue by evaluating the level of knowledge and attitude of Arab population towards antibiotic usage and AMR to develop a pathway to reduce the risk of antibiotic resistance. Methods A cross-sectional study was carried out among Arab population, including 11 countries from the Middle East and North Africa. A validated and translated questionnaire, consisting of 34 questions, was adopted to achieve the study objectives. Two phases of data collection (online and offline) were performed, and SPSS was used for data analysis. Key findings Three thousand three hundred and nineteen participants were successfully recruited, and the mean age was 37.6 ± 11.73. Approximately 63% of participants wrongly answered they should stop antibiotics when they feel better, and 73.3% of them thought antibiotics could treat cold and flu. Nearly half of the respondents indicated that they were uncertain of how antibiotic resistance affects the body (48.1%), and they were unaware if it could affect them or their families (63.1%). While the majority of the respondents were prescribed antibiotics by a doctor, over half of them were not given any advice on how to take them. Our data showed a significant relationship between respondents’ demographic data (e.g. country, age and education) and their knowledge and attitude. Conclusions Participants had poor knowledge of antibiotics and AMR; thus, efforts are needed to conduct health campaigns in public places and create and implement programmes aiming to raise knowledge and awareness of people in the Arab regions. These could aid to curb the risk of antibiotic resistance and increase the chance of successful treatment for infectious diseases.

Background: Exercise is important component of diabetes management. Regular exercise improves blood glucose, reduces hazard of cardiovascular diseases, decreases weight, increases insulin sensitivity and strengthens patients' general health. Regular exercise can prevent or delay type 2 diabetes in those of high-risk populations. Although there are great benefits of regular exercise, unfortunately majority of people with type 2 diabetes are not active. Objectives: The main goal of this study was to assess patients adherence to regular exercise among type 2 diabetes Mellitus (T2DM) attending Ribat University Hospital Diabetic Clinic (RUHDC) Khartoum state, Sudan. Methods: Analytical cross sectional hospital based study was carried out among 351 patients from August 2012 to February 2013. Structured questionnaire and patients cards were used to collect data. Results: Out of 351 patients, female were 65.8% and male 34.2%. Patients older than 60 years 48.4%, illiterate 21.0%, only 44.2% had basic educational level, house wife 56.1% and retired 18.5%. Majority had irregular exercise program (80.1%), 12.1% specified lack of time whilst 87.9% did not specify any other reasons as barrier for regular exercise "no reason". Daily activity was the main type of physical activity (59.8%). Although insignificant, irregular exercise was higher among female patients, their age above 60 years, patients had low education levels and those had financial problems. Conclusion: Regular exercise was low in this study. Lack of time, female, patients older than 60 years, had low education levels, and had financial problems, which were the main barriers of regular exercise. Family support, tailored patients' education and reduction of patients' use of technology and modern living can improve the patients' activity.

Background: Individuals with type 2 diabetes who have optimum condition management are exposed to a significantly higher risk of developing cardiovascular disease (CVD) compared to those who do not have diabetes. People with diabetes are estimated to have a fourfold greater risk of developing CVD than people without diabetes. CVD risk factors other than diabetes include older age, obesity hypertension, dyslipidemia, smoking, and a family history of coronary or kidney diseases. Objectives: The study aims to assess the cardiovascular risk factors among type2 diabetes at Ribat Hospital Diabetes Clinic, Sudan. Methods: T2 DM patients were evaluated for the presence of CVD risk factors by using data collecting form to extract data verbally and from patients’ files. Results: Out of 147 T2 DM files, 92 (61.7 %) were female, 57 (38.3 %) were male, and 58 (38.9 %) patients were ≥ 60 year old. Patients who had poor glycemic control were 112 (75.2 %) and those who met the glycemic target were only 37 (24.8 %). Older age (P = 0.01) and diabetes duration (P = 0.026) were associated with poor glycemic control. Prevalence of hypertension was 61 (40.9 %), dyslipidemia 31 (20.8 %), and physical inactivity 112 (75.2 %). All patients had at least one CVD risk factor and those having all three risk factors were 48 (32.2 %). Conclusion: All T2 DM diabetic patients in RHDC had at least one CVD risk factor and almost a third of them had all three risk factors. Poor glycemic control, physical inactivity, hypertension, and age ≥ 60 had a higher prevalence of CVD risk factors.