BACKGROUND AND OBJECTIVESThe prevalence of gestational diabetes (GDM) has increased recently worldwide, mainly due to adoption of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. The objectives of this study were to determine the prevalence of GDM in Saudi women and to assess risk factors and pregnancy outcomes using the IADPSG criteria.DESIGN AND SETTINGA prospective descriptive study of pregnant Saudi women presenting at the Maternity and Children Hospital, Medina, Saudi Arabia, between October 2011 and June 2014.METHODSFasting plasma glucose, glycated hemoglobin, and random plasma glucose concentrations were obtained for all participants at the first antenatal visit. In women with normal results, screening for GDM was performed at 24 to 28 weeks of gestation, with a 75-g oral glucose tolerance test (OGTT). Women who had GDM were treated with diet, exercise, and insulin as needed. Pregnancy outcomes were recorded after delivery. Multiple logistic regression was used to assess possible risk factors for GDM.RESULTSEarly screenings showed abnormal glucose in 211 of 954 women (22.1%). In 445 women, the OGTT showed GDM in 183 women (39.4%). GDM cases identified by OGTT and by early screening increased the rate of GDM to 51% (292 women). Older maternal age, higher body mass index, higher blood pressure, past GDM, history of delivering a malformed child, and family history of diabetes were the main risk factors for GDM. GDM increased the risk of neonatal hypoglycemia (OR 9.353), low Apgar score (OR 5.546), and induction of labor (OR 2.33). The newborns of GDM mothers had a higher birth weight: 3043 g vs. 2890 g in the non-GDM group (P=.004). Other maternal and neonatal outcomes were not significantly different between the two groups.CONCLUSIONThe prevalence of GDM is high among Saudi women. Timely and effective treatment reduces perinatal morbidity and improves outcomes.

BackgroundWomen with gestational diabetes mellitus (GDM) are required to control their blood glucose shortly after GDM diagnosis to minimize adverse pregnancy outcomes. A real time-continuous glucose monitoring system (RT-CGMS) provides the patient with continuous information about the alterations in levels of the blood glucose. This visibility may empower the patient to modify her lifestyle and engage in therapeutic management. The aim of this study was to determine whether a single application of RT-CGMS to pregnant women shortly after GDM diagnosis is useful as an educational and motivational tool.MethodsThis study was a prospective open label randomized controlled study conducted at Maternity and Children Hospital, Medina, Saudi Arabia. A total of 130 pregnant women with GDM were randomised to either blood glucose self-monitor alone (SMBG group) (n = 62) or in addition to SMBG, patients wore a Guardian® REAL-Time Continuous Glucose Monitoring System (Medtronic MiniMed) once for 3–7 days, within 2 weeks of GDM diagnosis (RT-CGMS group) (n = 68). The primary outcomes were maternal glycemic control and pregnancy outcomes. Secondary outcomes were the changes in parameters of glucose variability, which includes mean sensor readings, standard deviation (SD) of blood glucose, and area under the curve for hyper and hypoglycaemia at the end of the RT-CGMS application.ResultsHbA1c, mean fasting and postprandial glucose levels were similar in both groups at the end of the pregnancy. Pregnancy outcomes were comparable. However, there was significant improvement in the parameters of glucose variability on the last day of sensor application; both mean glucose and the SD of mean glycaemia were reduced significantly; P = 0.016 and P = 0.034, respectively. The area under the curve for hyper and hypoglycaemia were improved, however, the results were not statistically significant.ConclusionAlthough a single application of RT-CGMS shortly after GDM diagnosis is helpful as an educational tool, it was not associated with improvement in glycemic control or pregnancy outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s13098-016-0161-5) contains supplementary material, which is available to authorized users.

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Painful Diabetic Neuropathy (PDN) is associated with a significant reduction in health-related quality of life (HRQOL). Glycemic control and improving HRQoL are now recognized as the main goals of patientcentered diabetes care. This pre-post quasi study aimed to assess HRQoL in type 2 diabetic patients with PDN before and after pregabalin therapy from October 2017 to April 2018. Adult Saudis outpatients (N=103) with PDN, under no specific therapy, were selected from three private hospitals in Jeddah, Saudi Arabia. Neuropathy Symptom Score, Numeric Rating Scale (NRS-11), neurological examination, 10 gm monofilament, and Ewing's reflex tests were used for assessment. All enrolled patients received pregabalin 75 mg once for 1 week followed by twice daily; then higher doses were used based on response (median dose 150 mg for 6 weeks). Weekly follow up was performed for patient's severity using NRS-11 and for drug side effects. HRQOL was assessed before and 6 weeks after pregabalin therapy using the Arabic version of The RAND 36-item Health Survey. Patients had severe PDN (median of 7), poor metabolic control (median A1C of 9.1) and disabling both mental (36.71) and physical summary scores (32.50) of HRQoL (both below 50). Higher baseline A1C was significantly associated with higher pain severity (r=0.467, p=0.000) and lower pain score-QoL (r=-0.267, p=0.006). After 6 weeks of therapy, significant improvements were detected in pain severity, metabolic control and all subparameters of HRQoL (p=0.000 for all). The major side effect was dose-dependent somnolence (18%). Uncontrolled type 2 adult Saudi patients with severe PDN have disabling HRQoL. Six weeks of pregabalin therapy was safe and effective and was associated with the improvement of physical and mental parameters of HRQoL. Given its recent restrictions in Saudi Arabia, risk of misuse and dependency, other therapeutic modalities for these patients should be similarly investigated.

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