AbstractObjectiveThe aim of the present study was to investigate vitamin D status among female out-patients in Saudi Arabia during the summer and winter seasons.DesignData were retrospectively collected using medical record abstraction.SettingA multidisciplinary hospital in Riyadh between January and December 2009.SubjectsSaudi females (age ≥19 years;n1556) attending out-patient clinics for various complaints comprised the studied population. The population was subdivided into two groups depending on the date of their visit where blood samples were collected: summer (n659) and winter groups (n897). The summer group was further subdivided into premenopausal (age 19–49 years;n425) and postmenopausal subgroups (age ≥50 years;n234). Similarly, the winter group was subdivided into premenopausal (n543) and postmenopausal subgroups (n354). Serum levels of 25-hydroxyvitamin D (25(OH)D) were measured using HPLC.ResultsThe prevalence of vitamin D deficiency (25(OH)D <50 nmol/l) was high in both premenopausal and postmenopausal groups (80 % and 68 %, respectively) during the summer, as well as during the winter (85 % and 76 %, respectively).ConclusionsA high prevalence of vitamin D deficiency among Saudi female out-patients was observed throughout the year despite the routine supplementation with 10–20 μg vitamin D3for postmenopausal women. Clinicians should seriously consider determining the vitamin D status of Saudi females routinely and prescribing them proper supplementation.

In patients with T1DM who fast Ramadan, there was no difference in rates of hypoglycemia or hyperglycemia between CSII and MDI. However, CSII was associated with less glucose variability.

BackgroundVitamin D deficiency has been implicated in several chronic, non-communicable diseases independent of its conventional role in bone and calcium homeostasis. In this retrospective study, we determined the prevalence of vitamin D deficiency and its association to several cardiometabolic indices among patients visiting King Abdulaziz Medical City (KAMC), a tertiary hospital in Riyadh, Saudi Arabia.MethodsA total of 3475 charts of out-patient subjects who visited KAMC from September 2009 until December 2010 were reviewed and included. Variables of interest included measurements of vitamin D status, glycemic and renal profile, as well as trace elements (calcium and phosphorous).ResultsThe over-all prevalence of vitamin D deficiency in the cohort studied was 78.1% in females and 72.4% in males. 25(OH) vitamin D was significantly associated with increasing age and weight (p-values < 0.0001 and 0.005, respectively). It was also positively associated with albumin, calcium and phosphorous (p-values < 0.0001, < 0.0001 and 0.0007, respectively) and negatively associated with alkaline phosphatase as well as circulating levels of PTH (p-values 0.0002 and 0.0007, respectively).ConclusionIn conclusion, vitamin D deficiency is overwhelmingly common among patients seen at KAMC regardless of the medical condition, and it is significantly associated with increasing age, weight and markers of calcium homeostasis. Findings of the present study further stress the spotlight on vitamin D deficiency epidemic in the country and region in general.

ObjectiveFasting Ramadan is associated with changes in lifestyle patterns of patients with diabetes who choose to perform fasting. We aimed to determine the attitude and habits of patients with type 1 diabetes during fasting Ramadan.MethodsThe study comprised a prospective cohort of patients with type 1 diabetes who were on insulin pump or multiple daily insulin injections (MDI) regimen. Patient questionnaires included the frequency of self-monitoring of blood glucose (SMBG), the need to make changes in insulin regimen by patients, timings of insulin administration, performing carbohydrate counting and levels of physical activity.ResultsA total of 156 patients were studied (61 patients on insulin pump and 95 patients on MDI). Patients on pump therapy performed SMBG more frequently than those on MDI regimen (4.8 ± 1.4 and 3.7 ± 1.7 times per day, respectively, P = 0.001) and were more likely to perform carbohydrate counting (32.7% and 8.4% of pump and MDI patients, respectively, P < 0.001). There was no difference in the percentage of patients who made changes in insulin doses (74.5% of the pump group and 77.3% of MDI patients) or those who had any level of physical activity (12.5% of the pump group and 21.1% of the MDI group). The timing of administering meal insulin in relation to sunset meal was variable with a preference to taking the injection immediately at sunset. There was no difference in glucose control between both groups as measured by frucotsamine levels or the number of days that patients have to stop fasting.ConclusionFasting Ramadan is associated with significant and variable changes in the attitude and behaviors of patients with type 1 diabetes with no difference in glucose control between patients on insulin pump or MDI regimen. Further studies are needed to define the role of education and its effect on these attitudes and patient care in this population.ClinicalTrials.gov Identifier: NCT01941238.

Purpose IDegAsp, a co-formulation of long-acting basal (insulin degludec) and rapid-acting bolus (insulin aspart) insulin, provides separate prandial and basal glucose-lowering effects with relatively low risk of hypoglycaemia. Its efficacy and safety have been investigated in a large clinical trial programme (BOOST). We present the rationale and design of the ARISE study, which aims to assess glycaemic control and other clinical parameters associated with IDegAsp use in real world. Methods ARISE is a ~26-wk-long, prospective, non-interventional, single-arm study of patients with type 2 diabetes (T2D) initiating IDegAsp treatment. Approximately 1112 patients with T2D aged ≥18 years previously on anti-hyperglycaemic drugs except IDegAsp will be enroled across six countries from 15 Aug 2019 to 12 Nov 2020. IDegAsp treatment will be initiated at the physicians’ discretion and as per the local label. Key exclusion criteria include previous participation, or previous IDegAsp treatment. The primary and secondary endpoints are change in HbA1c from baseline (wk 0) to study end (wk 26–36) and the proportion of patients achieving the target HbA1c level of <7% at the study end, respectively. A mixed model for repeated measurements will analyse the primary endpoint. Conclusion Between-country differences in the prescription patterns of glucose-lowering agents in people with T2D warrant examination of their clinical use in different geographical settings. The ARISE study is designed to assess the clinical use of IDegAsp from real world in six different countries. Findings from the ARISE study will supplement those of previous randomised controlled studies by establishing real-world evidence of IDegAsp use in the participating countries. Trial registration ClinicalTrials.gov, NCT04042441. Registered 02 August 2014, https://clinicaltrials.gov/ct2/show/NCT04042441

Introduction Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec (a basal insulin) and insulin aspart (a prandial insulin). The aim of this study was to investigate clinical outcomes in people with type 2 diabetes (T2D) after initiating IDegAsp treatment in a real-world setting. Methods This 26-week, open-label, non-interventional study was conducted in Australia, India, Malaysia, Philippines, Saudi Arabia, and South Africa. Data were obtained from 1102 adults with T2D initiating or switching to IDegAsp from antidiabetic treatments (including oral antidiabetic drugs, basal insulin, basal–bolus insulin, premix insulin, and glucagon-like peptide 1 receptor agonist) per local clinical practice. Results Compared with baseline, there was significant improvement in HbA1c at end of study (EOS, first visit within weeks 26–36; estimated change − 1.4% [95% CI − 1.51; − 1.29]; P < 0.0001 [primary outcome]). From baseline to EOS, there were significant reductions in fasting plasma glucose (− 2.7 mmol/L [95% CI − 2.98; − 2.46]; P < 0.0001), body weight (− 1.0 kg [95% CI − 1.51; − 0.52]; P < 0.0001), and basal insulin dose in insulin-experienced participants (− 2.3 units [95% CI − 3.51; − 1.01]; P < 0.001). The incidence rates of non-severe (overall and nocturnal) and severe hypoglycaemia decreased significantly ( P < 0.001) between the period before baseline and before EOS. Conclusion In adults with T2D, initiating or switching to IDegAsp from previous antidiabetic treatment was associated with improved glycaemic control, lower basal insulin dose (in insulin-experienced participants), and lower rates of hypoglycaemia. Trial Registration Clinical trial registration NCT04042441. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02212-3.

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