Background: Lack of adherence to anti-diabetic medications use is linked with suboptimal glycemic control which in turn leads to increase rate of diabetic complications. The adherence to anti-diabetic medications among adult diabetic patients in Sana'a city has not been yet evaluated. Objective: This study, therefore, assessed the extent to which diabetic patients are adherent to their antidiabetic medications and explored the factors underlying such adherence attitude in Sana’a City, Yemen. Methods: A cross-sectional method was conducted among a sample of 365 diabetic patients attending public and private hospitals from March to April 2017 in Sana'a City-Yemen. Random patients were selected and data regarding their treatment adherence were obtained using a questionnaire. Adherence to diabetes medications was measured using medication adherence index followed by structured interviews. Descriptive analysis was used to compare between different groups of diabetic patients. Bivariate analyses were conducted to evaluate the associations between clinical variables. Results: The cross-sectional study included 365 patients (263 males; 102 females). A high level of medication adherence rate to anti-diabetic drugs in the present study was (70%). The adherence rate was not similar in both genders where males were more adherent than females. The most common reason for non-adherence was forgetfulness (n= 67; 61%). While the lowest factor for non-adherence was associated with ineffective (n= 7; 6%). Adherence was strongly associated with diabetes duration, monthly income, blood sugar monitoring, communication with physician, and patient’s knowledge regarding importance of medication use (p <0.05). Conclusions: The degree of adherence in patients with diabetes in Sana’a to anti-diabetic medication was shown to be mostly suboptimal. The medication adherence levels are still crucial strategy for optimal treatment against diabetes. However, additional studies on strategies to improve adherence rate and health care should be carried out in the future.

Hypothyroidism is associated with an increased risk for cardiovascular disease, which can not be fully explained by the atherogenic lipid profile, particularly total cholesterol and LDL-C, and other pathogenic factors may be involved. Plasma total homocysteine (tHcy) is an independent risk factor for cardiovascular disease and accelerated atherosclerosis. The aim of this study was to investigate the serum total homocysteine (tHcy) levels and its relation to total cholesterol, creatinine and thyroid hormones fT3, fT4 and TSH levels in overt hypothyroid patients compared to control subjects. In this study thirty recently diagnosed, non-treated overt hypothyroid patients (f=27, m=3) and twenty normal volunteers control (f=18, m=2) were included and subjected to determination of serum tHcy by enzyme immunoassay (EIA) technique, fT3, fT4 and TSH by Elecsys cobas e 601 analyzer, total cholesterol by enzymatic method and creatinine by kinetic method. The data was statistically analysed by SPSS-10 and p values less than 0.05 were considered significant.Our results showed that there were a significant increase of tHcy, TSH, T.cholesterol and creatinine levels by 113%, 12-folds, 58% and 54%, respectively, and a significant decrease of fT4 and fT3 levels by 49.6% and 56.4% , respectively, in hypothyroid patients than in control group. For tHcy (Mean±SD, 24.45±5.50 μmol/l vs 11.48±3.03 μmol/l, respectively; P < 0.001). tHcy was significantly positively correlated with TSH, creatinine and age and negatively correlated with free thyroxine (fT4) and no significant correlations with fT3 and T.cholesterol. In conclusion, our study confirmed the observation of elevated serum tHcy, T.cholesterol and creatinine in overt hypothyroidism and the presence of an inverse relation between tHcy with fT4 and a positive relation with TSH.