Ashraf Hussein

Objective: To assess the relationship between self care practices among diabetic patients and their diabetes control.
Subjects and Method: A total of 400 diabetic patients who were registered at two primary health care centers in Abha City, Kingdom of Saudi Arabia, were interviewed within the period from 1/8/20011 to 31/8/2011. Self-care practices of diabetic patients were assessed using the Summary of Diabetes Self-Care Activities (SDSCA). Biochemical laboratory inves-tigations were assessed, including plasma levels of fasting blood glucose.
Results: Most patients were type 2 diabetics (93.8%). Almost half of patients had poor fasting blood glucose control (47.8%), while 27.8% were managed by insulin. The mean scores for all components of practiced diabetes self-care activities were considerably low. The highest mean scores for diabetes self-care activities were foot care and specific diet (3.4±2.1 and 2.4±1.3, respectively). Younger diabetic patients tend to have significantly better mean scores for diabetes self-care. Male diabetic patients had significantly better mean scores for diabetes self-care as regard the items of general diet (p=0.01) and exercise (p<0.001). On the other hand, female diabetic patients had significantly better mean scores for diabetes self-care as regard the item of foot care (p=0.003). Generally, better educated diabetic patients have significantly better mean scores for diabetes self-care. Diabetic patients who had university education attained the highest mean scores for all self-care activities compared with illiterate or school-educated (i.e., primary, intermediate or secondary) patients. Differences were statistically significant for all items, except specific diet. Non-smoker diabetic patients have better mean scores for all diabetes self-care activities. However, differences were statistically significant only for the item of “exercise”. Type 1 diabetic patients have significantly better mean scores for diabetes self-care activities for the items of general diet (p<0.001), specific diet (p=0.007) and blood glucose (p<0.001). Patients with less duration of disease had significantly better mean scores for diabetes self-care activities for the items of exercise (p=0.020) and blood glucose (p=0.007). Patients with good control of diabetes had significantly better mean scores for all items of diabetes self-care activities except the item of “exercise”.

Conclusions: All components of practiced diabetes self-care activities are considerably low. Younger, male non-married educated patients have better self-care activities. Non-smoker patients have better mean scores for all self-care activities. Type 1 diabetic patients have better self-care activities. Patients with good control of diabetes have better diabetes self-care activities.
Recommendations: Health education for diabetes self-care activities need to be enforced. Points of insufficiency as regard diabetes self-care activities should be investigated and corrected. Continuing medical education for PHC providers should include and emphasize the education of diabetic patients on self-care activities.

AbstractBackground Interest to evaluate the prognostic value of the inflammatory marker, IL-6 in young patients with ACS. Methods 140 young patients (18–40 years old) with ACS, were included in this non-randomized prospective study. They were subjected to (a) full clinical evaluation (b) Laboratory evaluation (c) Standard 12 leads \{ECG\} and Echocardiography and (d) coronary angiography. The patients were divided into two groups, those with acute chest pain and positive coronary angiography (110 patients), and those with acute chest pain but with normal coronary angiography (control group, 30 patients). Results The IL-6 level was significantly higher in patients with documented \{CAD\} compared to the control group (39.56 ± 2.5 Vs 3.83 ± 0.79 P < 0.001). IL-6 level was significantly higher in patients with significant lesions who needed to perform \{PCI\} (92 patients) than patients with non-significant atherosclerotic plaques needing just medical treatment (18 patients) (45.5 ± 23.17 Vs 9.22 ± 1.93 P < 0.001). Higher level of IL-6 in \{STEMI\} patients (63 Patients 57%) than \{NSTEMI\} (23 Patients 21%) and \{UA\} (24 Patients 22%) (49.56 ± 23 Vs 43.5 ± 17 Vs 9.5 ± 2.53 respectively with P < 0.001) was observed. The optimal cutoff value for IL-6 level to predict morbidity was 41 pg/ml with a sensitivity of 100%, specificity of 66%, and positive predictive value of 25%, negative predictive value of 100% and the diagnostic accuracy of 69%. Conclusion The use of IL-6 as a prognostic marker for \{ACS\} may be of Value; it may predict the severity of \{CAD\} as well as the mortality and morbidity of young patients with acute coronary syndrome.

Objective: To assess the relationship between self care practices among diabetic patients and their diabetes control.
Subjects and Method: A total of 400 diabetic patients who were registered at two primary health care centers in Abha City, Kingdom of Saudi Arabia, were interviewed within the period from 1/8/20011 to 31/8/2011. Self-care practices of diabetic patients were assessed using the Summary of Diabetes Self-Care Activities (SDSCA). Biochemical laboratory inves-tigations were assessed, including plasma levels of fasting blood glucose.
Results: Most patients were type 2 diabetics (93.8%). Almost half of patients had poor fasting blood glucose control (47.8%), while 27.8% were managed by insulin. The mean scores for all components of practiced diabetes self-care activities were considerably low. The highest mean scores for diabetes self-care activities were foot care and specific diet (3.4±2.1 and 2.4±1.3, respectively). Younger diabetic patients tend to have significantly better mean scores for diabetes self-care. Male diabetic patients had significantly better mean scores for diabetes self-care as regard the items of general diet (p=0.01) and exercise (p<0.001). On the other hand, female diabetic patients had significantly better mean scores for diabetes self-care as regard the item of foot care (p=0.003). Generally, better educated diabetic patients have significantly better mean scores for diabetes self-care. Diabetic patients who had university education attained the highest mean scores for all self-care activities compared with illiterate or school-educated (i.e., primary, intermediate or secondary) patients. Differences were statistically significant for all items, except specific diet. Non-smoker diabetic patients have better mean scores for all diabetes self-care activities. However, differences were statistically significant only for the item of “exercise”. Type 1 diabetic patients have significantly better mean scores for diabetes self-care activities for the items of general diet (p<0.001), specific diet (p=0.007) and blood glucose (p<0.001). Patients with less duration of disease had significantly better mean scores for diabetes self-care activities for the items of exercise (p=0.020) and blood glucose (p=0.007). Patients with good control of diabetes had significantly better mean scores for all items of diabetes self-care activities except the item of “exercise”.

Conclusions: All components of practiced diabetes self-care activities are considerably low. Younger, male non-married educated patients have better self-care activities. Non-smoker patients have better mean scores for all self-care activities. Type 1 diabetic patients have better self-care activities. Patients with good control of diabetes have better diabetes self-care activities.
Recommendations: Health education for diabetes self-care activities need to be enforced. Points of insufficiency as regard diabetes self-care activities should be investigated and corrected. Continuing medical education for PHC providers should include and emphasize the education of diabetic patients on self-care activities.