Keyword: Algeria
2 results found.
Original Article
Australian Journal of Biomedical Research, 2(3), 2026, aubm028, https://doi.org/10.63946/aubiomed/19640
ABSTRACT:
Background: Celiac disease is a chronic immune-mediated enteropathy caused by gluten exposure in genetically susceptible individuals, for which lifelong adherence to a gluten-free diet remains the only validated treatment. Data on dietary adherence and health-related quality of life in North African pediatric populations remain limited. This study aimed to assess GFD adherence, HRQoL, and factors associated with poor adherence among Algerian children with CD.
Methods: This prospective observational cohort study was conducted in the Pediatric Department B of the University Hospital Center of Oran, Algeria, between January 2022 and June 2024. Children aged 2–16 years with confirmed CD (2020 ESPGHAN diagnostic criteria) were consecutively enrolled and prospectively followed at approximately three-month intervals (mean follow-up 18 ± 6 months). GFD adherence was assessed through structured dietary interviews; nutritional status was evaluated clinically and by laboratory assays (hemoglobin, ferritin, vitamin D); HRQoL was measured using the PedsQL and PROMIS pediatric measures. Univariate and multivariable logistic regression were used to identify factors associated with poor adherence, with odds ratios and adjusted odds ratios (aORs) and their 95% confidence intervals.
Results: Of 130 children assessed, 100 were included (mean age, 8.7 ± 3.4 years); 38% were classified as adherent and 62% as non-adherent. Children subsequently classified as non- adherent had lower baseline global quality-of-life scores than adherent children (59.7 ± 12.8 versus 78.4 ± 9.6; p < 0.001). Anxiety scores were higher in the non-adherent group among 84 children with available scores (57.2 ± 9.3 versus 46.8 ± 7.8; p < 0.001). Limited access to gluten-free products (adjusted odds ratio, 4.34; 95% confidence interval, 2.00–9.40), economic difficulties (3.70; 1.80–7.60), and psychological stress (2.60; 1.20–5.40) were associated with non-adherence. Nutritional abnormalities were present at enrollment in 72% of children and were associated with lower baseline quality-of-life scores (p < 0.001).
Conclusions: GFD adherence is suboptimal among Algerian children with CD and is associated with socioeconomic and psychosocial barriers and reduced HRQoL. Multidisciplinary management addressing nutritional, socioeconomic, and psychological factors is warranted. Given the observational design, the associations identified should not be interpreted as causal; larger multicenter longitudinal studies are needed to confirm these findings.
Methods: This prospective observational cohort study was conducted in the Pediatric Department B of the University Hospital Center of Oran, Algeria, between January 2022 and June 2024. Children aged 2–16 years with confirmed CD (2020 ESPGHAN diagnostic criteria) were consecutively enrolled and prospectively followed at approximately three-month intervals (mean follow-up 18 ± 6 months). GFD adherence was assessed through structured dietary interviews; nutritional status was evaluated clinically and by laboratory assays (hemoglobin, ferritin, vitamin D); HRQoL was measured using the PedsQL and PROMIS pediatric measures. Univariate and multivariable logistic regression were used to identify factors associated with poor adherence, with odds ratios and adjusted odds ratios (aORs) and their 95% confidence intervals.
Results: Of 130 children assessed, 100 were included (mean age, 8.7 ± 3.4 years); 38% were classified as adherent and 62% as non-adherent. Children subsequently classified as non- adherent had lower baseline global quality-of-life scores than adherent children (59.7 ± 12.8 versus 78.4 ± 9.6; p < 0.001). Anxiety scores were higher in the non-adherent group among 84 children with available scores (57.2 ± 9.3 versus 46.8 ± 7.8; p < 0.001). Limited access to gluten-free products (adjusted odds ratio, 4.34; 95% confidence interval, 2.00–9.40), economic difficulties (3.70; 1.80–7.60), and psychological stress (2.60; 1.20–5.40) were associated with non-adherence. Nutritional abnormalities were present at enrollment in 72% of children and were associated with lower baseline quality-of-life scores (p < 0.001).
Conclusions: GFD adherence is suboptimal among Algerian children with CD and is associated with socioeconomic and psychosocial barriers and reduced HRQoL. Multidisciplinary management addressing nutritional, socioeconomic, and psychological factors is warranted. Given the observational design, the associations identified should not be interpreted as causal; larger multicenter longitudinal studies are needed to confirm these findings.
Case Report
Australian Journal of Biomedical Research, 2(2), 2026, aubm020, https://doi.org/10.63946/aubiomed/18515
ABSTRACT:
Background: The rising prevalence of childhood obesity and sedentary lifestyles has blurred the traditional distinction between type 1 and type 2 diabetes. Double diabetes represents the coexistence of autoimmune β-cell destruction and insulin resistance, posing diagnostic and therapeutic challenges, particularly in adolescents.
Case presentation: We report the case of a 17-year-old obese female with a three-year history of type 1 diabetes who developed marked insulin resistance and metabolic syndrome features. Despite high insulin requirements (1.6 U/kg/day), glycemic control remained poor (HbA1c 12.8%). Clinical examination revealed obesity (BMI 32.4 kg/m²) and acanthosis nigricans. Laboratory evaluation showed preserved C-peptide secretion, dyslipidemia, elevated leptin and homocysteine levels, and positivity for anti-GAD65 and islet cell antibodies, supporting the diagnosis of double diabetes.
Management and Outcomes: A combined therapeutic strategy including optimization of basal-bolus insulin therapy, adjunctive metformin, structured nutritional intervention, and regular physical activity was implemented. Six months later, and at the stage of her transition, HbA1c decreased to 7.8%, body weight was reduced by 8 kg, daily insulin requirements decreased by 35%, and lipid parameters improved significantly.
Conclusion: This case highlights the importance of early recognition of double diabetes in youth and demonstrates that integrated metabolic and autoimmune-targeted management can significantly improve glycemic control and cardiometabolic risk.
Case presentation: We report the case of a 17-year-old obese female with a three-year history of type 1 diabetes who developed marked insulin resistance and metabolic syndrome features. Despite high insulin requirements (1.6 U/kg/day), glycemic control remained poor (HbA1c 12.8%). Clinical examination revealed obesity (BMI 32.4 kg/m²) and acanthosis nigricans. Laboratory evaluation showed preserved C-peptide secretion, dyslipidemia, elevated leptin and homocysteine levels, and positivity for anti-GAD65 and islet cell antibodies, supporting the diagnosis of double diabetes.
Management and Outcomes: A combined therapeutic strategy including optimization of basal-bolus insulin therapy, adjunctive metformin, structured nutritional intervention, and regular physical activity was implemented. Six months later, and at the stage of her transition, HbA1c decreased to 7.8%, body weight was reduced by 8 kg, daily insulin requirements decreased by 35%, and lipid parameters improved significantly.
Conclusion: This case highlights the importance of early recognition of double diabetes in youth and demonstrates that integrated metabolic and autoimmune-targeted management can significantly improve glycemic control and cardiometabolic risk.