BackgroundFoot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem.MethodsThis is a cross-sectional study of a cohort of 62,681 patients aged ≥25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors.ResultsThe overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%–3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%–2.16%), 0.19% (0.16%–0.22%), and 1.06% (0.98%–1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥10 years, insulin use, retinopathy, nephropathy, age ≥45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16–99.62), 14.47 (8.99–23.31), 12.06 (10.54–13.80), 7.22 (6.10–8.55), 4.69 (4.28–5.14), 4.45 (4.05–4.89), 2.88 (2.43–3.40), 2.81 (2.31–3.43), 2.24 (1.98–2.45), 2.02 (1.84–2.22), 1.54 (1.29–1.83), and 1.51 (1.38–1.65), respectively.ConclusionsRisk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower extremity nerves, should be considered among diabetic patients.

AimsThe prevalence of diabetic nephropathy and its risk factors have not been studied in a society known to have diabetes epidemic like Saudi Arabia. Using a large data base registry will provide a better understanding and accurate assessment of this chronic complication and its related risk factors.MethodologyA total of 54,670 patients with type 2 diabetes aged ≥25 years were selected from the Saudi National Diabetes Registry (SNDR) and analyzed for the presence of diabetic nephropathy. The American Diabetes Association (ADA) criterion was used to identify cases with microalbuminuria, macroalbuminuria and end stage renal disease (ESRD) for prevalence estimation and risk factor assessment.ResultsThe overall prevalence of diabetic nephropathy was 10.8%, divided into 1.2% microalbuminuria, 8.1%macroalbuninuria and 1.5% ESRD. Age and diabetes duration as important risk factors have a strong impact on the prevalence of diabetic nephropathy, ranging from 3.7% in patients aged 25–44 years and a duration of >5 years, to 21.8% in patients ≥65 years with a diabetes duration of ≥15 years. Diabetes duration, retinopathy, neuropathy, hypertension, age >45 years, hyperlipidemia, male gender, smoking, and chronologically, poor glycemic control has a significantly high risk for diabetic nephropathy.ConclusionThe prevalence of diabetic nephropathy is underestimated as a result of a shortage of screening programs. Risk factors related to diabetic nephropathy in this society are similar to other societies. There is thus an urgent need for screening and prevention programs for diabetic nephropathy among the Saudi population.

ABSTRACT.Purpose: To assess diabetic retinopathy prevalence and its risk factors in a society with type 2 diabetes epidemic using the Saudi National Diabetes Registry (SNDR). Method: This is a cross-sectional study using patient's clinical data found in SNDR data base. A cohort of 50 464 Saudi patients with type 2 diabetes aged ≥25 years were selected to assess for the prevalence and risk factors for diabetic retinopathy. Results: The overall prevalence of diabetic retinopathy is 19.7%, where 9.1% have non-proliferative diabetic retinopathy (NPDR), 10.6% have proliferative diabetic retinopathy (PDR) and 5.7% have macular oedema (ME). Duration of diabetes and age are the most significant risk factors for diabetic retinopathy with odds ratio (OR) and 95% confidence interval (95% CI) 8.88 (8.30-9.50) and 5.76 (5.10-6.55), respectively. Nephropathy, neuropathy, insulin use, poor glycemic control, hypertension and male gender significantly increased the risk for diabetic retinopathy. Smoking, hyperlipidemia and obesity significantly reduced the risk for diabetic retinopathy among type 2 Saudi diabetic cohort. Conclusion: vThe low prevalence of diabetic retinopathy in our registry may be a result of the shortage or absence of well-structured screening programmes. Therefore, many patients with NPDR might have been missed. A prevention programme is needed to reduce the effect of diabetic retinopathy risk factors in this society.

Background: Saudi Arabia is a community thrilled by sudden social and economical changes, leading to a sharp increase in the prevalence of abnormal glucose metabolism. Age-specific diabetes and impaired fasting glucose prevalence is the focus of this study with the expected risk factors. Methods: A nationwide, household, randomized, population based cohort of 18 034 participants aged ≥30 years was selected to test for abnormal glucose metabolism using fasting plasma glucose (FPG) according to American Diabetes Association (ADA) criteria. Results: The prevalence of diabetes was 25.4% with 40.3% being unaware of their disease, while impaired fasting glucose (IFG) affected 25.5% of the total sample. IFG to diabetes ratio was one in this study, decreasing with age and increasing with body weight. Age ≥45 years, hypertension, history of gestational diabetes mellitus (GDM), and high triglycerides are the strongest risk factors in diabetic patients, while history of GDM, dyslipidemia, obesity, and high triglycerides are the most significant risk factors in IFG participants. Conclusions: Abnormal glucose metabolism has reached an epidemic level in this society, where half of adults and older are affected. Risk factors are behind this epidemic and the quick shift from IFG to diabetes in this society.

Diabetes and thyroid dysfunction found to exist simultaneously. In this regard, the present study looked into the prevalence of different forms of thyroid dysfunction and their risk factors among Type 2 diabetic Saudi patients. Methodology. A cross-sectional retrospective randomized hospital-based study of 411 Type 2 diabetic Saudi patients of >25 years of age was conducted to test the prevalence of different types of thyroid dysfunction and their risk factors. Results. The prevalence of different types of thyroid dysfunction is 28.5%, of which 25.3% had hypothyroidism, where 15.3%, 9.5%, and 0.5% are clinical, subclinical, and overt hypothyroidism, respectively. The prevalence of hyperthyroidism is 3.2%, of which subclinical cases accounted for 2.7% and overt hyperthyroidism accounted for 0.5%. Risk factors for thyroid dysfunction among Saudi Type 2 diabetic patients are family history of thyroid disease, female gender, and duration of diabetes of >10 years, while the risk was not significant in patients with history of goiter and patients aged >60 years. Smoking and parity show a nonsignificant reduced risk. Conclusion. Thyroid dysfunction is highly prevalent among Saudi Type 2 diabetic patients, and the most significant risk factors are family history of thyroid disease, female gender, and >10 years duration of diabetes.