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CONTEXT:Current screening tests for gestational diabetes mellitus (GDM) are inconvenient. Therefore, alternative screening tests for GDM are desirable. The use of glycohemoglobin A1c (HbA1c) in screening for GDM remains controversial.AIM:We undertook this study to evaluate the utility of HbA1c in screening for GDM.SETTINGS AND DESIGN:Retrospective study in a tertiary teaching hospital.MATERIALS AND METHODS:Laboratory records were reviewed to identify pregnant women who underwent both oral glucose tolerance test (OGTT) and HbA1c measurements over a 16-months period. The association of OGTT with HbA1c was evaluated.STATISTICAL ANALYSIS USED:Data were collected using SPSS software. Comparisons of the means and calculations of sensitivities were performed.RESULTS:Of 145 eligible patients, 124 had GDM and 21 patients did not, per OGTT. The percentages of patients with HbA1c values (reference range of 4.8%–6.0%) equal to or above sequential cut-point values of 5.0%, 5.5%, 6.0%, 6.5% and 7.0% (i.e., sensitivity values) were 100%, 98.4%, 87.1%, 62.9% and 39.5%, respectively. The mean HbA1c of the patients with GDM was 6.9 + 0.8% compared to 6.4 + 0.6% for those without GDM (P< 0.006). At an arbitrary cut-off value of 6.0% (the upper limit of normal), HbA1c would have picked up 87.1% of patients with GDM.CONCLUSIONS:This study suggests that HbA1c is a reasonably sensitive screening measure of GDM in this high-risk population. Acknowledging limitations resulting from the study design, further prospective studies are warranted to verify this conclusion, and to evaluate the specificity of HbA1c as a screening test for GDM.

BACKGROUNDThyroid carcinoma (TC) is the ninth most common site of all cancers in women in the world and the second most common malignancy in Saudi Arabia. This reports updates data on the epidemiology of the disease in Saudi Arabia.OBJECTIVEDescribe and interpret changes in the frequency of TC to compare with other populations and determine proportions of certain histological types of TC.DESIGNMedical record review.SETTINGMilitary hospital in Jeddah, Saudi Arabia.PATIENTS AND METHODSWe reviewed the pathological and clinical records from January 2000 to December 2017 of patients with TC.MAIN OUTCOME MEASURESFrequency and types of TC.SAMPLE SIZE347 patients.RESULTSOver the 18-year period, out of 456 patients with TC, 347 patients had sufficiently complete records: 275 (79.3%) were female and 72 (20.7%) were male for a female to male ratio of 3.8:1. The mean (SD) age at surgery of all patients was 45.2 (16.0) years. There were 287 (82.7%) cases of papillary TC. The next common malignancy was follicular TC with 32 (9.2%) cases followed by Hurthle cell cancer with 11 (3.2%) cases. Lymphoma was found in only 7 (2%) cases. All TC types occurred at a younger age in females than males except for lymphoma. All TC types occurred with the greatest frequency in the fourth and fifth decades. There was a 2.3-fold increase in the number of TCs from 8 (2.3%) in 2000 to 26 (7.5%) in 2017. The rate per 100 000 residents of Jeddah increased for the period from 2000 to 2002 from 1.6 to 3.4 for 2015–2017. Papillary TC cases in females accounted for most of the increase.CONCLUSIONOur findings are consistent with similar studies worldwide. Etiological factors promoting the rise in TC must be investigated and may provide insight in developing suitable management strategies for the Saudi population.LIMITATIONSmall sample size and retrospective over a long period.

BACKGROUNDData on pituitary adenoma (PA) prevalence in Saudi Arabia are scarce.OBJECTIVETo estimate the epidemiology of PA in a well-defined populationDESIGNRetrospective analysis.SETTINGDepartments of Endocrinology and Radiology at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.PATIENTS AND METHODSRadiological and hormonal data of patients with pituitary adenoma by MRI were reviewed for the period January 2008 to December 2015.MAIN OUTCOME MEASURESPrevalence of PA and hormonal abnormalities.RESULTSOf 537 patients; 249 subjects (46.4%), 70 (28.1%) males and 179 (71.9%) females, were diagnosed to have PA with mean age 36.3 (14.1) years. Microadenoma and macroadenoma were seen in 171 (69%) and 78 (31%) subjects, respectively. Microadenomas were more prevalent than macroadenomas (68.7% vs. 31.3%). Microadenomas were significantly more prevalent in females, 131 (73.2 %) vs. 40 (57.1%) whereas macroadenomas were significantly more prevalent in males, 30 (42.9%) vs. 48 (26.8%) (P<.001 for both comparisons). Patients with microadenomas were significantly younger than patients with macroadenomas (P<.0001). Advanced age was significantly associated with a larger PA size (r=0.39, P<.0002). Three types of hyperfunctioning PA were seen: prolactinoma, somatotroph adenoma, and corticotroph adenoma. Five types of hypofunctioning PA were seen: panhypopituitarism, secondary hypogonadism, growth hormone deficiency, central hypothroidism and central adrenal insufficiency. Non-functioning PA were within normal laboratory hormonal values in 2% of cases.CONCLUSIONOur study showed that the prevalence of PA was greater than previously reported. This increased prevalence may have important implications when prioritizing funding for research and treatment of PA.LIMITATIONSClustering of cases within the study region might have affected estimates and limited study sample size.

Background: Diabetes mellitus is among the most common chronic non-communicable diseases. The development of microalbuminuria in type 1 diabetes increases the risk for renal and cardiovascular disease. Methods:A cross sectional study was conducted at the Primary Health Care Clinics at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. A total of 334 Saudi with type 1 diabetes were randomly selected.Results: Total of 334 patients with T2DM included in this study; 102 (30.5%) male and 232 (69.5%) female with mean age 25.8±3.4. MA was present in 99 (29.6%). MA was not significantly more prevalent in female (69.4%) with female predominance (sex ratio male: female) 1:2.3. HTN with MA was significantly more prevalent in 51(51.5%) of MA group with odd ratio 1.7 (1.2-2.4), p=0.001 with no siginificant difference between both gender. Patients with MA have significant higher HbA1c than patients with normal buminuria and there was a significant difference between gender (p<0.0001) and when compared to HbA1c groups (p=0.002). Conclusion:The frequency of microalbuminuria in patients with type 1 diabetes in this study is high. It is mandatory to have adequate diagnostic, therapeutic and educational resources in addition to competent physicians who can manage microalbuminuria in diabetic patients by using a continuing, comprehensive and coordinated approach.