OBJECTIVE: To assess the relative efficacy and safety of basal insulin regimens in adults with type 1 diabetes mellitus (T1DM).

METHODS: A systematic review and Bayesian network meta-analysis (NMA) of randomized controlled trials comparing two or more basal insulin regimens were conducted. The following basal insulin regimens were included: Neutral Protamine Hagedorn (iNPH) (once [od], twice [bid], and four times daily [qid]), insulin detemir (iDet) (od and bid), insulin glargine 100 IU (iGlarg) (od), and insulin degludec (iDegl) (od). We searched the following databases: MEDLINE via OVID, Embase via OVID, and the Cochrane Library (Wiley). Study quality was appraised using Cochrane risk-of-bias checklist for randomized controlled trials. Two outcomes (change in hemoglobin A [HbA] and rate of severe/major hypoglycemia [SH]) were analyzed. Network inconsistency was assessed using Bucher and chi-square tests.

RESULTS: Thirty studies met the eligibility criteria. Twenty-five were included in the HbA network and 16 in the SH network. All studies were of moderate quality. No network inconsistency was evident in the HbA network. Of the seven regimens of interest, iDet (bid) had the highest probability of being best (mean change in HbA -0.48; 95% credible interval -0.69 to -0.29). In contrast, the SH network demonstrated both considerable uncertainty and significant network inconsistency (χ test, P = 0.003).

CONCLUSIONS: Of the specified frequency regimens, iDet (bid) had the highest probability of being the best basal insulin regimen in terms of reduction in HbA. Ranking of the regimens in terms of the SH rate was highly uncertain and no clear conclusion could be made.

The advances in information and communication technologies have changed the way the governments interact with their citizens. The development of the internet and its vast capabilities played a vital role in this change. According the UN report 2010, the UN e-Government development index of the world rated United Arab Emirates in 49 which comes late 17 places than 2008 ranking. During 2008 the UAE ranked in 32. Therefore, it can be seen that UAE is having some troubles in citizens’ adoption of the e-Government. In this paper, we will examine the key berries to the use of the e-Government services by citizens through testing the effect of 11 independent variables on the citizens’ use of e-Government in municipal of Emirate of Abu Dhabi.

Medication non-compliance is an ignored health problem in developing countries, which have an alarming average of less than 50% of patients complying with medication instructions. Such non-compliance is considered a major challenge to effective management of most chronic diseases such as diabetes mellitus, hypertension, and dyslipidemia. Objective: To evaluate the factors affecting patient compliance and the impact of better compliance on the control of chronic diseases. Another objective is to measure the prevalence of intentional and non-intentional non compliance and their causes. Method: A cross-sectional study was conducted for 240 patients with chronic diseases who are followed up at Al-Qassimi Hospital, Sharjah, United Arab Emirates (ARE) during the period of September 2008 until March 2009. The hospital ethical committee approval was obtained before the commencement of the study. A validated data collection form and questionnaire were used to collect patients' demographics, degree of knowledge about their medications and concurrent diseases. Patients were selected based on inclusion and exclusion criteria which include chronic diseased adult patients who have one or more of the following chronic conditions (Diabetes, hypertension and/or dyslipidemia) confirmed in the patients' medical file (not on their initial diagnosis). Participants should have an active prescription without changes for at least 90 days at the time of study recruitment. Descriptive statistics were reported and statistical analysis using SPSS software version 18 was done to correlate patient demographics and patient compliance and to measure the correlation of patient compliance and the control of chronic diseases using chi square test. Results: The mean age of participants was 56.6 ± 12.4 years. Most of participants were illiterate (62.5%). Most of them had family history with chronic disease (69.2%). Most patients have more than one chronic disease (86.7%). More than three quarters of participants (77.5%) do not control one or more of their diseases. Also high percentage of participants (76.7%) was on polypharmacy regimen (mean number of drug used 7.0 ± 3.0). The most prominent complication related to chronic diseases that participants suffered from is cardiovascular diseases (27.6%). Forgetfulness is the main reason for non-intentional non-compliance (75%), while polypharmacy was considered the main causes for intentional non-compliance (13.3%). The current study revealed that there is significant association between patients' young age, having family member with chronic disease, having complications and good compliance (p-value < 0.05). Also, there is a statistically significant association between good compliance and better achievement of chronic diseases control (p-value < 0.05). It was also found that level of education and number of chronic diseases have no correlation with compliance (P-value > 0.05) Conclusion: Medication compliance is very important to control chronic diseases such as diabetes mellitus, hypertension and/or dyslipidemia and decrease their complications. Results of the study showed that there is a positive association between good compliance and achievement of better control of chronic diseases. The current study also revealed that there is significant association between patients' young age, having family member with chronic disease, having complications and good medication compliance.