Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study

Abstract

Background: Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective: Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method: A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result: (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion: There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation: Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.

Prevalence of Glycemic Control and Factors Associated With Poor Glycemic Control: A Systematic Review and Meta-analysis

“…In the present meta-analysis, the pooled prevalence of good and poor glycemic control in Ethiopia was estimated using 46 articles. 19,24,25, 47 - 89 In a random effect model, the pooled prevalence of good glycemic control was found to be 38.08% (95% CI: 34.08, 42.08) with significant heterogeneity among the included articles ( I 2 = 96.57%, P < .001) ( Figure 2 ). The potential sources of higher heterogeneity were investigated further.…”

“…The pooled prevalence of good glycemic control was calculated from 5918 of the 15 457 study population and poor glycemic control was calculated from 9539 of the 15 457 study population. The original articles’ sample sizes ranged from 100 24, 55 to 2554. 49 Likewise, articles published between 2012 and 2021 were included in this study.…”

Physical activity can improve diabetes patients' glucose control; A systematic review and meta-analysis

“…For ages, people in the Arabian Peninsula and the Horn of Africa, particularly Ethiopia, have practiced khat chewing [ 59 , 60 ]. Even though there were a few contradicting observations while exploring the effects of khat on glucose metabolism and insulin secretion in the literature, it has been demonstrated to increase serum glucose level-hyperglycemia [ 61 , 62 , 63 , 64 , 65 , 66 ]. Chewing khat has a considerable unfavorable impact on glucose management in diabetes in Ethiopia, according to the current study.…”

Correlates of Glycemic Control Among Patients With Type 2 Diabetes in Eastern Ethiopia: A Hospital-Based Cross-Sectional Study

“…Khat also has a cytotoxic effect on pancreatic cells and insulin synthesis, affecting regulation of blood glucose ( 41 ). However, there were contradictory findings about its effect on glycemic control ( 40 , 42 ). Therefore, another study is suggested to determine the actual effects of khat on the blood glucose level.…”