In cooperation with Action on Diabetes Project as a main sponsor and coordination with the leading companies, who are committed to support health care in the Gulf region, Qatar Diabetes Association member of Qatar Foundation, the International Diabetes Federation (IDF) Middle East and North Africa (MENA) regional Diabetes conference was held from 14th to 16th of December, 2012 at Qatar National Convention Center (QNCC) in Doha - Qatar. It was an important diabetes event at regional level and a successful effort to highlight the prevalence of diagnosed and undiagnosed cases with diabetes, mortality rate due to diabetes, barriers in achieving standards of diabetes care and the status of research and development and use of modern techniques in this specific region. The motto of the conference was to provide health care professionals a common ground in order to share the latest updates of diabetes, discuss the issues in diabetes care and management and take possible actions to overcome the epidemic of diabetes. More than 500 delegates from all over the MENA region and speakers from 24 different states were invited. The first day of the conference was marked with the registration of participants and opening remarks of the congress. The inaugural speech was given by Prof. Adel El Sayed from Egypt. He also explained the agenda of the sessions.

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To assess health related quality of life (HRQOL) in patients with diabetes at presentation and to compare the changes after receiving diabetes education. This study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), a tertiary care diabetes center in Karachi - Pakistan from October 2010 to October 2011. Newly registered and follow-up patients with diabetes from the Out patients department (OPD) were interviewed on one to one basis by diabetes educator, irrespective of age, sex and duration of diabetes. HRQOL was assessed using SF-12 questionnaire having eight domains i.e. physical functioning (PF), bodily pain (BP) general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH). A total of 501 patients (259 males, 242 females) participated in the study. Mean age and duration of diabetes was 51.60 ΁ 11.69 years and 8.88 ΁ 6.91 years respectively. There were 219 (43.70%) newly registered and 282 (56.30%) regular follow-up patients. Mean scores of all the eight domains of QOL were found to be significantly different between males and females. Diabetes education was associated with increase in scores of general health and vitality in new and follow up patients with diabetes. Quality of life was better in regular follow up patients receiving diabetes education compared to newly registered patients with diabetes. Diabetes is associated with decreasing levels of both physical and emotional wellbeing. Diabetes education appears to improve quality of life, therefore its provision should be ensured in all diabetes clinics.

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A 13 year old girl presented with severe hyperglycemia. In spite of taking large doses of insulin, her sugars were uncontrolled. She had severe acanthosis nigricans, a feature of severe insulin resistance. There was associated growth retardation, dental dysplasia, excessive body hair and clitoromegaly. Genetic studies revealed a point mutation in Insulin receptor gene (INSR) confirming the diagnosis of Rabson Mendenhall Syndrome. This mutation was also detected in both her parents in heterozygous condition. She responded to insulin sensitizers administered along with high doses of insulin.

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Defects in insulin secretion and insulin action are common in both diabetes and prediabetes but which one is primary, is still unsettled. The present study focused on the normoglycemic first degree relatives of subjects with prediabetes to resolve this issue. Forty one first degree relatives of 14 isolated impaired fasting glucose (IFG) cases (R_IFG), 116 first degree relatives of 36 isolated impaired glucose tolerance (IGT) cases (R_IGT) and 77 first degree relatives of 20 combined IFG-IGT cases (R_IFG-IGT) and 20 healthy subjects without any family history of known diabetes or prediabetes were also included in this study. Serum insulin level was determined by enzyme linked immunosorbent assay (ELISA) method. Insulin secretory capacity (HOMA %B) and insulin sensitivity (HOMA %S) were calculated from fasting glucose and fasting insulin using HOMA-CIGMA software. Although fasting blood glucose in controls and normoglycemic first degree relatives of subjects with prediabetes were within normal range but the values were significantly higher among the normoglycemic first degree relatives of IFG, IGT and IFG-IGT, (p < 0.05) subjects compared to controls. HOMA %B in normoglycemic first degree relatives of subjects with prediabetes (R_IFG 80 ± 39, R_IGT 81 ± 34, R_IFG-IGT 90 ± 28) were significantly decreased compared to control subjects (107 ± 27). Dyslipidemia was evident in normoglycemic first degree relatives of subjects with prediabetes. Binary logistic regression analysis showed that HOMA %B was negatively associated (beta = -0.026, p = 0.009) with normoglycemic first degree relatives of subjects with prediabetes after adjusting for age, body mass index (BMI), high density lipoprotein (HDL) cholesterol, and low density lipoprotein (LDL) cholesterol. Beta cell secretory dysfunction is evident in normoglycemic first degree relatives of subjects with prediabetes in a Bangladeshi population.

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The aim of this study was to assess the problem of using one non-certified method of HbA1c estimation when used in patients with diabetes with sickle cell trait. Plasma of those who were found to have sickle cell trait on routine HbA1c using automated HPLC instrument were submitted to a quantitative colorimetric method based on turbidimetric immunoassay for the determination of HbA1c in the whole blood. The total enrolled patients were 205. Mean HbA1c by HPLC method was 9.2 ± 2.2% and by the turbidimetric immunoassay method, it was 5.6 ± 1.4%. Those with HbA1c < 7% by turbidimetric immunoassay constituted 87.8%, which is far higher than the figure produced by HPLC method where it was 16.1% only. About 91.8% of the patients had HbA1c higher by 1 - 6.9% using the HPLC method. Because of the common prevalence of sickle-cell trait in Basrah, use of the turbidimetric immunoassay method for the estimation of HbA1c in patients with diabetes should be completely prohibited.

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Penile necrosis occasionally occurs in patients with chronic renal failure, due to vascular calcification in association with high serum levels of calcium and/or phosphorus. The condition has been called calciphylaxis or calcific uremic arteriolopathy. Only about 120 patients have been reported worldwide so far. It occurs in about 4% of patients on maintenance hemodialysis in diabetes mellitus with renal failure. The numbers of such patients are likely to increase. We present a known patient with diabetes with renal failure who presented with necrosis of the distal shaft of penis and tips of toes. The patient needed partial amputation of the penis followed by amputation of the distal toes. The condition is significant because of the poor overall prognosis. For diagnosis, the small vessel thrombosis with calcification and hypertrophy of the intimal layer is pathognomic. In the absence of definite guidelines treatment modalities include surgical debridement supported by antibiotics, biophosphonates, sodium thiosulphate, cinacalcet and tissue plasminogen activator.

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