Muath Alsurur

Interprofessional education (IPE) is being increasingly recognized globally as an essential component of healthcare curricula. Given the limited research o

Background and Objectives: Type 2 diabetes mellitus (T2DM) substantially increases the risk of heart failure (HF) and worsens its prognosis. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), initially developed for glycemic control, have shown important cardiovascular benefits. This systematic review and meta-analysis evaluated the effects of SGLT2i on HF hospitalizations, cardiovascular (CV) death, and renal outcomes, as well as their safety profile, in patients with T2DM and established HF. Materials and Methods: Following PRISMA 2020 guidelines, we systematically searched PubMed, the Cochrane Library, and Web of Science for randomized controlled trials (RCTs) comparing SGLT2i with placebo in adults with T2DM and HF. Data on HF hospitalizations, CV death, other clinical outcomes, and adverse events were extracted. Risk of bias was assessed using the Cochrane RoB2 tool, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using RevMan 5.4.1. Results: Ten RCTs including more than 21,000 participants met the inclusion criteria. Most were large, international, double-blind trials with overall low risk of bias. SGLT2i reduced the composite of worsening HF or CV death by about 21% (pooled HR 0.79, 95% CI 0.69–0.89), mainly driven by a consistent reduction in HF hospitalizations across trials. Effects on CV death alone were directionally favorable but not uniformly significant. Furthermore, SGLT2i were associated with beneficial effects on cardiac function and patient-reported health status and showed consistent renoprotective effects. The safety profile was favorable, with a small increase in genital infections and no excess of hypoglycemia or other serious adverse events. Conclusions: In patients with T2DM and HF, SGLT2i meaningfully reduce HF events and provide additional renal benefits with good tolerability. Our findings consolidate and update the current evidence by focusing specifically on RCTs enrolling patients with both T2DM and established HF across the spectrum of ejection fraction, thereby reinforcing the role of SGLT2i as a key component of guideline-directed therapy in this high-risk population.

Background and Objectives: Diabetic complications represent a major healthcare challenge globally. The Kingdom of Saudi Arabia has one of the highest prevalence rates, yet comprehensive data on complication profiles from southern regions remain limited. This study characterizes the spectrum of diabetic complications and identifies associated risk factors in the Najran region of southern Saudi Arabia. Materials and Methods: A hospital-based retrospective analysis of 500 diabetic patients from two major public hospitals in the Najran region was conducted using electronic medical records from January 2022 to December 2023. A systematic sampling approach was adopted. Type 1 diabetes (T1D), Type 2 diabetes (T2D), and their complications were defined using standardized criteria. Data extraction utilized a validated proforma, and analysis employed SPSS version 20. Separate analyses were conducted for T1D and T2D, with multivariable logistic regression identifying independent predictors of complications (p < 0.05). Results: The study included 200 T1D (median age 14.0 years, IQR 3.0) and 300 T2D patients (median age 23.0 years, IQR 7.0). The high proportion of T1D patients (40%) reflects the hospital’s role as a specialized pediatric and young adult diabetes referral center. Among T1D patients, 63.5% (127/200) developed complications, predominantly microvascular, whereas 50.0% (150/300) developed complications in T2D. Poor glycemic control was the strongest predictor of complications in both groups (p = 0.01). Rural residence significantly increased complication risk in T2D patients (p = 0.02). Disease duration showed differential effects; complications appeared earlier in T1D (median 6.5 years) versus T2D (median 8.2 years). Conclusions: This study gives the first comprehensive analysis of diabetic complications from southern Saudi Arabia, revealing distinct patterns and associated risk factors. The findings provide regional perspective on diabetic complications in Najran, highlighting the importance of early glycemic control and equitable healthcare access. The results are not intended for nationwide generalization, rather, they point to the need for region-specific diabetes management strategies.