Severe depression, unhealthy diet and heart attack risk in Iran

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A study from Iran demonstrates a link between severe depression and heart attack risk. Furthermore, major depression is associated with an uhealthy diet and cardiovascular disease risk factors such as overweight and high levels of cholesterol and blood pressure. An unhealthy diet and CVD risk factors, in turn, are likely to further increase the risk of heart attack.

After the war between Iran and Iraq between 1980 and 1988, psychological illness increased and it is reported that 60,000 Iranians suffer from such conditions. There is a high incidence of suicide, believed to reflect the high levels of depression in Iran.

1. Yary T, Soleimannejad K, Rahim FA, et al. Contribution of diet and major depression to incidence of acute myocardial infarction (AMI). Lipids in Health and Disease 2010; 9: 133. (0pen access)

Medical costs of diabetes in the United Arab Emirates

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Direct treatment costs of diabetes in the United Arab Emirates (UAE) increased with the presence and progression of chronic diabetes-related complications, a study has found. Hospitalization costs constituted a large proportion and were increasingly higher with the presence and progression of diabetes-related complications.

The total annual direct treatment costs among diabetes patients without complications was US$1,605, which is 3.2 times higher than the per capita expenditure for health care in the UAE (US$497) during 2004. The cost increased 2.2 times with the presence of diabetes-related complications for patients with microvascular complications, by 6.4 times for patients with macrovascular complications and 9.4 times for patients with both micro and macrovascular complications.

The annual direct hospitalization costs of diabetic patients increased by 3.7 times for patients with microvascular complications, by 6.6 times for patients with macrovascular complications and by five times for patients with both micro and macrovascualr complications. Overall, costs increased with age, diabetes duration and were higher for patients treated with insulin compared to those treated with oral hypoglycemic agents or with diet control only.

1. Al-Maskari F, El-Sadig M, Nagelkerke N. Assessment of the direct medical costs of diabetes mellitus and its complications in the United Arab Emirates. BMC Public Health 2010; 10: 679. (open access)

Depression linked to diabetes complications in the United Arab Emirates

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A study conducted in the United Arab Emirates (UAE) demonstrated that diabetes patients with depression or anxiety are more likely to have eye-related complications (retinopathy, glaucoma) and vascular/neurological complications in the lower limbs (peripheral vascular disease, peripheral neuropathy).

In particular, patients who are depressed tended to have poorer self-care, more severe physical symptoms and were less likely to adhere to prescribed diabetes care regimens. The study also indicated that Islam has a profound impact on the mental health beliefs and practices of people in the Arab region. For example, people tend to believe that mental illness is associated with supernatural influences, such as jinn (aka genies), the evil eye or magic, rather than physical or biomedical; some also believe that a mental illness may be divine punishment as a result of disobedience or sin, or due to weak faith. This in turn, affects a patient’s motivation to seek proper care for depression or anxiety.

“These findings raise the possibility that improving mental health as part of a comprehensive management plan for diabetes may improve the overall long term outcomes of diabetes patients,” the study concluded.

1. Sulaiman N, Hamdan A, Tamim H, et al. The prevalence and correlates of depression and anxiety in a sample of diabetic patients in Sharjah, United Arab Emirates. BMC Family Practice 2010; 11: 80. (open access)