BackgroundMedical nutritional therapy is an important aspect of diabetes care, there is an increasing awareness of breakfast skipping, late dinner and meal contents on diabetes control.AimTo assess dietary habits, physical activity and diabetes perception among patients with type 2 diabetes.MethodsThis case-control study was conducted among patients with diabetes mellitus at the diabetes center in Tabuk City, Saudi Arabia during the period from March through June 2017. One hundred patients with type 2 diabetes and 150 control subjects were interviewed to collect demographic data regarding, breakfast skipping, late dinner intake, and fruit, vegetables, sweet food, and fast food consumption. Diabetic patients’ perception of their disease was also assessed. (If diabetes is serious, it can be prevented and reversible). Data were analyzed by SPSS version 20 using Chi-square and independent-samples t-test.ResultsIn the present study, body mass index (BMI) (p<0.001), fast food consumption (p<0.001), fruit consumption (p=0.004), and breakfast skipping (p<0.001) were higher among patients with diabetes compared to controls. No differences were found regarding the level of exercise, smoking, late dinner intake and diabetes perception. A significant statistical difference was observed between poor and accepted control regarding sweet food intake (p=0.046) and exercise (p=0.017).ConclusionPatients with type 2 diabetes had higher BMI, and were more likely to skip breakfast, consume less fast food and more fruits than control subjects. More physical activity and less sweet food consumption was observed among patients with accepted glycemic control.

Type 2 diabetes is a metabolic disease characterized by elevated blood sugar. It has serious complications and socioeconomic impact. The MicroRNAs are short single-stranded and non-coding RNA molecules. They regulate gene expression at the post-transcriptional levels. They are important for many physiological processes including metabolism, growth, and others. The phosphoinositide 3-kinase (PI3K) is important for insulin signaling and glucose uptake. The genome wide association studies have identified the association of certain loci with diseases including T2D. In this study we have examined the association of miR126 rs4636297 and Phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) gene Variations rs7713645, rs706713 (Tyr73Tyr), and rs3730089 (Met326Ile) with T2D using the amplification refractory mutation system PCR. Results indicated that there was a significant different (p-value < 0.05) in the Mir126 rs4636297 genotypes distribution between cases and controls, and the minor allele of the rs4636297 was also associated with T2D with OR = 0.58, p-value < 0.05. In addition results showed that there were significant differences (p-value < 0.05) of rs4636297 genotype distribution of patients with normal and patient with abnormal lipid profile. Results also showed that the PIK3R1 rs7713645 and rs3730089 genotype distribution was significantly different between cases and controls with a p-values < 0.05. In addition, the minor allele of the rs7713645 and rs3730089 were associated with T2D with OR = 0.58, p-value < 0.05). We conclude that the Mir126 rs4636297 and PIK3R1 SNPs (rs7713645 and rs3730089) were associated with T2D. These results need verification in future studies with larger sample sizes and in different populations. Protein-protein interaction and enzyme assay studies are also required to uncover the effect of the SNPs on the PI3K regulatory subunit (PI3KR1) and PI3K catalytic activity.

Diabetes mellitus is a major risk factor for vascular complications and mortality, glycemic variability (GV) has emerged as a measure of time and magnitude of plasma glucose, its association with cardiovascular complications is controversial. The current study aimed to assess the association of GV with myocardial infarction. An electronic literature search was conducted in PubMed, Medline, and Google Scholar databases for relevant articles. Articles in the English language during the period from 2010 to April 2020 were eligible. The keywords fasting blood glucose variability (FBGV), glucose variability, myocardial infarction, and acute coronary syndrome, were used with the protean OR and AND. Out of the 185 articles retrieved, only seven full texts fulfilled the inclusion and exclusion criteria. The author's name, year of publication, the study type, number of patients, and the results were extracted. There were seven full texts, one from Brazil, one from Australia, two from the USA, and three from Asia. Two were randomized controlled trials and five were prospective cohorts (included 109,058 participants). A significant negative association was found between GV and myocardial infarction, odd ratio (OD) 1.93, 95% CI=1.08-3.44, P-value=0.03, I 2 for heterogeneity=87%, P-value=0.0001. However, it is difficult to reach a conclusion due to the small number of the included studies and the high heterogeneity observed. Further well-controlled trials using the same methods are needed to resolve the issue.

Breakfast skipping and late dinner intake were associated with obesity, while only late dinner consumption was associated with poor glycemic control. Further larger multi-center studies investigating the chronotype and glycemic index are recommended.

COVID-19 shares some features of giant-cell arteritis, in which the diagnosis needs a high suspicion for prompt investigation and therapy. When the diseases coexist this might lead to diagnosis delay with grave consequences. We reported a case of a post-COVID-19 giant cell arteritis and polymyalgia rheumatica with visual loss. We treated the patient with pulse methylprednisolone 1 gm daily for 3 consecutive days followed by 60 mg prednisolone for 4 weeks until normalization of ESR, and then, gradual withdrawal. Oral Paracetamol, vitamin-D3, and calcium carbonate were added to the treatment regimen. The headache continued, so, we started perineural injection therapy (PIT) once daily, for 6 sessions, at which the headache was completely resolved after the third injection. The vision was regained completely after the sixth injection.