Aim: We compare the incidence rates of cataract in persons with diabetes with and without diabetic retinopathy in Saudi Arabia, for the first time. In addition, we explored the role of new factor, diabetes age of onset and several other known factors. Methods: In a community-based cross-sectional study, 334 persons with diabetes type 2 were randomly selected from a diabetic register. Detailed history and comprehensive ophthalmic examination was done at an eye clinic. Body Mass Index, blood pressure and glycosylated hemoglobin were also recorded. Results: In 668 eyes, cataract and diabetic retinopathy were present in 35.5% and 32.2%, respectively. Diabetic retinopathy, age, duration of diabetes and systolic BP were found to be independent risk factors for cataract. Whereas, gender, BMI, HbA1c use of insulin and diastolic BP have no significant association with cataract. Persons with cataract had significantly higher age of onset of diabetes. Most of the cataracts were cortical followed by PSC, while minority were nuclear. Conclusion: DR is an independent risk factor of developing cataract in persons with diabetes. Others are age, duration of DM and hypertension. Age-of-onset of DM is a new factor we report it to be significantly associated with cataract.

Dietary management is considered as a major step in assessing a patient’s knowledge related to nutritional aspects, treatment, and complications of diabetes. Diabetes patients frequently face difficulty in identifying the recommended diet, including its quality and quantity. In the Kingdom of Saudi Arabia (KSA), sedentary lifestyle, along with food choices and portion sizes, have increased considerably and this has resulted in the soaring risk of diabetes. In addition, there is paucity of literature focusing on the Dietary Knowledge (DK) of type 2 diabetics in KSA. The study aimed to assess and evaluate the DK of type 2 diabetics. An analytical cross-sectional study was conducted among 350 type 2 diabetics using a valid and reliable self-prepared questionnaire comprising of 21 questions. Results showed that type 2 diabetics had an overall poor DK (28.57%). Sub-group analysis further revealed that diabetes patients had poor knowledge related to the consumption of carbohydrates and food choices, whereas they had good knowledge related to lipids and fats, proteins and food types. The role of diet in controlling of diabetes is considered imperative, but still, diabetes patients are unaware how they should approach this issue. The patient empowerment approach can be used to counsel patients with a poor DK. Primary care physicians and dietitians should work together and carry out individualized, tailored and patient-centered dietary education sessions.

Background and Objectives: There is a paucity of literature on the dietary attitude (DA) of patients with type 2 diabetes in the Kingdom of Saudi Arabia (KSA). Although the prevalence of diabetes mellitus (DM) is high in Gulf countries, there remains a lack of understanding of the importance of dietary behavior in diabetes management among patients. Understanding the behavior of patients with diabetes towards the disease requires knowledge of their DA. Therefore, this study aimed to assess and evaluate the DA of type 2 diabetes patients, and it is the first of its kind in the KSA. Material and Methods: An analytical cross-sectional study was conducted among 350 patients with type 2 diabetes. A self-administered DA questionnaire was used to collect the data. Psychometric properties of the questionnaire were assessed by face validity, content validity, exploratory factor analysis, and internal consistency reliability. The data were collected using a systematic random sampling technique. Results: The overall DA of the patients was inappropriate (p = 0.014). Patients had an inappropriate DA towards food selection (p = 0.003), healthy choices (p = 0.005), food restraint (p < 0.001), health impact (p < 0.001), and food categorization (p = 0.033). A poor DA was also observed in relation to the consumption of red meat (p <0.001), rice (p < 0.001), soup and sauces (p = 0.040), dairy products (p = 0.015), and junk food (p < 0.001). Conclusions: It is highly recommended that patients with diabetes receive counseling with an empowerment approach, as this can bring about changes in their dietary behavior, which is deeply rooted in their daily routine. Healthcare providers should also be well-informed about patients’ attitudes and beliefs towards diabetes to design tailored educational and salutary programs for this specific community. Diabetes self-management educational programs should also be provided on a regular basis with a special emphasis on diet and its related components.

The COVID-19 pandemic, an unprecedented global crisis, has indelibly reshaped all facets of life globally – health, economy, environment, and societal fabric [1–3]. Major societal events are often transformative. The predominant focus on the pandemic’s negative impacts, necessitates a more balanced perspective to prevent a skewed understanding of its overall impacts. Additionally, unveiling the hidden […]

Lifestyle factors – including dietary risks, alcohol and tobacco consumption, sedentary behaviours, and physical inactivity – significantly influence health outcomes both immediately and over the long term. Short-term impacts manifest in changes to physical and psychological quality of life [1], sleep [2], and social well-being [3]. Conversely, persistent unhealthy lifestyle behaviours substantially elevate the risk […]

Background: Screening of diabetic retinopathy (DR) using the current digital imaging facilities in a primary health care setting is still in its early stages in Saudi Arabia. This study aims to reduce the risk of vision impairment and blindness among known diabetic people through early identification by general practitioners (GP) in a primary health care setting in Saudi Arabia. The objective of this study was to evaluate the accuracy of diabetic retinopathy (DR) detection by general practitioners (GPs) by comparing the agreement of DR assessment between GPs and ophthalmologists’ assessment as a gold standard. Methods: A hospital-based, six-month cross-sectional study was conducted, and the participants were type 2 diabetic adults from the diabetic registries of seven rural PHCs, in Saudi Arabia. After medical examination, the participants were then evaluated by fundus photography using a non-mydriatic fundus camera without medication for mydriasis. Presence or absence of DR was graded by the trained GPs in the PHCs and then compared with the grading of an ophthalmologist which was taken as a reference or a gold standard. Results: A total of 899 diabetic patients were included, and the mean age of the patients was 64.89 ± 11.01 years. The evaluation by the GPs had a sensitivity of 80.69 [95% CI 74.8– 85.4]; specificity of 92.23 [88.7– 96.3]; positive predictive value, 74.1 [70.4– 77.0]; negative predictive value, 73.34 [70.6– 77.9]; and an accuracy of 84.57 [81.8– 89.88]. For the consensus of agreement the adjusted kappa coefficient was from 0.74 to 0.92 for the DR. Conclusion: This study demonstrates that trained GPs in rural health centers are able to provide reliable detection results of DR from fundus photographs. The study highlights the need for early DR screening programs in the rural areas of Saudi Arabia to facilitate early identification of the condition and to lessen impact of blindness due to diabetes.