Saudi Medical Horizons Journal

Impact of early Adenotonsillectomy on Quality-of-Life improvement in Children with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.

Tue, 09 Dec 2025 00:00:00 +0100

Obstructive sleep apnea syndrome (OSAS) in children is a prevalent pediatric illness, marked by partial or complete upper airway obstruction during sleep that significantly impacts quality of life. Adenotonsillectomy is the initial surgical treatment for kids with adenotonsillar hypertrophy. Nonetheless, AT's comparative effectiveness versus other therapies in terms of QoL improvement is contentious. This study systematically compares the effects of AT vs. WWST on QoL, cognition, and behavior in pediatric OSAS patients. A PRISMA-compliant systematic review and meta-analysis were conducted. The search was conducted across PubMed, Web of Science, Ovid Medline, Google Scholar, and ClinicalTrials.gov, encompassing studies published between 2000 and 2024. Studies were included if they reported QoL outcomes in pediatric OSAS patients comparing AT with WWST. Risk of bias was assessed using ROB 2 for randomized controlled trials (RCTs), and statistical analyses were performed using RevMan. Four RCTs (N=1436) met the inclusion criteria. AT significantly improved QoL, as measured by OSA-18 (pooled mean difference: -14.16[-25.40, -2.93]; P < 0.00001, I² = 79%) and PedsQL (pooled mean difference: 4.92 [3.37, 6.47]; P < 0.00001, I² = 0%). However, AT did not significantly improve cognitive and executive functions (BRIEF mean difference: -2.44 [-18.32, 13.44], P = 0.05, I² = 77%). Risk of bias showed variability in blinding and attrition rates. AT greatly enhances QoL in children with OSAS compared to WWST, while its effect on cognition and executive function remains uncertain. Long-term outcomes and cost-effectiveness should be addressed by future studies to inform clinical decision-making.

Efficacy and Safety of Vaginal Laser Therapy for Stress Urinary Incontinence: Systematic Review of Randomized Controlled Trials

Tue, 09 Dec 2025 00:00:00 +0100

Vaginal laser therapy has emerged as a popular, minimally invasive treatment for stress urinary incontinence (SUI), proposed to work through thermal tissue remodeling. However, evidence from randomized controlled trials (RCTs) is conflicting, creating uncertainty for its clinical use. To systematically review and synthesize evidence from RCTs on the efficacy and safety of vaginal laser therapy for the treatment of pure SUI in women. A systematic review was conducted following PRISMA guidelines. A comprehensive search of PubMed/MEDLINE, Web of Science, SCOPUS, and Cochrane Central was performed. Only RCTs comparing vaginal laser (Er:YAG or CO2) to sham procedures, pelvic floor muscle training (PFMT), or other controls in women with SUI were included. Six RCTs with a total of 466 participants were included. The findings were highly inconsistent. Two sham-controlled RCTs reported significant improvement in the laser group for objective cure (59% vs. 36% sham) and quality of life. In contrast, three other sham-controlled RCTs found no significant difference between laser and sham on primary outcomes, with one reporting a subjective cure rate of less than 2% in both groups. One trial found laser to be non-inferior to PFMT at 4 months, but both interventions had low long-term success, with most patients seeking alternative treatments within two years. Heterogeneity was high regarding laser parameters, outcome measures, and patient populations. The procedure was consistently safe, with only minor, transient adverse events reported. Given the high cost and unproven efficacy, vaginal laser should not replace established SUI treatments. It should be considered investigational and used only in the context of further large, well-designed RCTs with long-term follow-up.

The Association Between Inflammatory Bowel Disease (IBD) and Thyroid Disorders: Systematic Review

Tue, 09 Dec 2025 00:00:00 +0100

Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is associated with various extraintestinal manifestations, including thyroid disorders. The relationship between IBD and thyroid dysfunction—such as hypothyroidism, hyperthyroidism, and thyroid cancer—remains unclear, with conflicting evidence on prevalence, risk factors, and underlying mechanisms. This systematic review followed PRISMA guidelines, analyzing studies from PubMed, Web of Science, Scopus, and Embase. Eligible studies included observational and genetic investigations on IBD and thyroid disorders. Data extraction and quality assessment were performed using the Newcastle-Ottawa Scale (NOS) and Cochrane Risk of Bias tools. Thirteen studies were included, revealing significant associations between IBD and thyroid disorders. Increased thyroid cancer risk in UC (SIR=10.34) and CD (SIR=10.45) patients. Reduced hypothyroidism prevalence in UC (OR=0.33) in some cohorts. Shared genetic pathways (e.g., IP-10 cytokine mediation) between IBD and autoimmune thyroid disease. Geographic and demographic variations, with higher malignancy risks in Asian IBD populations. IBD is associated with an elevated risk of thyroid disorders, particularly thyroid cancer, though hypothyroidism risk may vary by IBD subtype and population. Immune-mediated mechanisms, including cytokine dysregulation, likely contribute to these associations. Clinicians should consider thyroid screening in high-risk IBD patients, especially those with long-standing disease or specific demographic risk factors. Further research is needed to clarify causal pathways and the impact of IBD treatments on thyroid function.

The Influence of Vitamin D Levels on IVF Outcomes: A Systematic Review

Tue, 09 Dec 2025 00:00:00 +0100

Vitamin D has been implicated in reproductive health, with potential effects on in vitro fertilization (IVF) outcomes. However, existing evidence remains conflicting. This systematic review evaluates the association between vitamin D levels and IVF success, including embryo quality, clinical pregnancy, and live birth rates. A comprehensive search of PubMed, Web of Science, Scopus, and Embase was conducted following PRISMA guidelines. Thirty studies (randomized controlled trials, prospective/retrospective cohorts) were included after screening 1,393 records. Data on vitamin D status (deficient [<20 ng/mL], insufficient [20–29 ng/mL], sufficient [≥30 ng/mL]) and IVF outcomes were extracted and qualitatively synthesized. Risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane tools. Findings were heterogeneous. Some studies reported improved embryo quality (e.g., higher blastocyst formation) and pregnancy rates with sufficient vitamin D (e.g., ≥30 ng/mL), particularly in women with polycystic ovary syndrome (PCOS) or thyroid autoimmunity. However, others found no significant association, including a large RCT showing no benefit from supplementation. Live birth rates were lower in deficient women in two studies (7.1% vs. 46%). Subgroup analyses highlighted variability by age, BMI, and genetic factors (e.g., VDR polymorphisms). While vitamin D sufficiency may enhance certain IVF outcomes, evidence is inconsistent, and optimal thresholds remain unclear. Routine supplementation cannot yet be universally recommended, but screening for deficiency appears prudent. Future research should prioritize standardized measurements and large RCTs focusing on live birth rates.

Celiac Disease and Type 1 Diabetes in Families: A Systematic Review of Genetic Association

Tue, 09 Dec 2025 00:00:00 +0100

Type 1 Diabetes (T1D) and Celiac Disease (CeD) often co-occur, indicating a shared genetic predisposition. This systematic review synthesizes current evidence on their genetic relationship, highlighting familial risk implications. A thorough search across databases including PubMed/MEDLINE and SCOPUS led to the inclusion of eleven studies that investigated the genetic link between these conditions. Notably, the Human Leukocyte Antigen (HLA) region, particularly the DQ2 and DQ8 haplotypes, emerged as the primary shared genetic risk factor. Additionally, specific HLA class II and I alleles were found to modulate the risks further associated with both diseases. Beyond HLA, non-HLA gene polymorphisms, such as those in PTPN22, INS, and MSH5, contribute to the shared susceptibility and distinguish between T1D alone and T1D with CeD. The review indicates an underlying immune dysregulation characterized by altered cytokine levels and suggests molecular mimicry as a potential mechanism due to homologous epitopes present in the auto-antigens of both conditions. The findings reflect a complex genetic architecture primarily centered on the HLA region, alongside relevant non-HLA immune-related genes, explaining the familial aggregation of T1D and CeD. While universal HLA screening for T1D may not be economically viable, targeted HLA genotyping, particularly when integrated with additional risk markers, is promising for identifying high-risk individuals for CeD, facilitating proactive monitoring, and stratifying familial risk.

Pelvic Floor Dysfunction in Young Females Associated with High-Impact Physical Activity: Prevalence, Risk Factors, and Preventive Interventions – A Systematic Review

Tue, 09 Dec 2025 00:00:00 +0100

Pelvic floor dysfunction (PFD), including urinary incontinence (UI) and pelvic organ prolapse, is a significant yet underreported issue in young female athletes (aged 15–45) participating in high-impact sports. This systematic review synthesizes evidence on the prevalence, risk factors, and effectiveness of preventive interventions for PFD in this population. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of electronic databases identified 23 eligible studies. The prevalence of UI was high, ranging from 26.1% in CrossFit athletes to 51.8% in runners, with stress UI being the most common subtype. High-impact sports like running and gymnastics were associated with transient morphological changes to the pelvic floor and reduced muscle endurance. Key risk factors included sport-specific loading patterns, parity, and high training volume. Only one randomized controlled trial compared interventions, finding hypopressive exercises and pelvic floor muscle training (PFMT) to be equally effective. Qualitative studies identified stigma and a lack of education as major barriers to seeking care. High-impact sports significantly increase the risk of PFD in young female athletes. Current evidence supports the need for sport-specific preventive strategies, but methodological heterogeneity and a scarcity of intervention studies highlight the necessity for more standardized, longitudinal research. Addressing psychosocial barriers and integrating PFD education into athletic training are crucial for improving early detection and management.

Association between Vitamin D Deficiency and Insulin Resistance in Type 2 Diabetic Adult Patients: Systematic Review

Tue, 09 Dec 2025 00:00:00 +0100

The recognized biomarker of vitamin D status have been repeatedly linked to an increased risk of insulin resistance, metabolic syndrome, and the subsequent development of type 2 diabetes, according to an increasing body of epidemiological evidence. This systematic review aimed to investigate the relationship between vitamin D deficiency and insulin resistance (IR) in adults with Type 2 Diabetes Mellitus (T2DM). It highlights a consistent inverse association between vitamin D levels and IR, but the efficacy of vitamin D supplementation in improving IR remains inconsistent across various interventional studies. The review followed PRISMA guidelines and included a systematic search of studies in multiple databases, yielding 13 studies with 1,396 participants. Most observational studies (8 of 11) showed a significant inverse correlation between serum 25-hydroxyvitamin D and HOMA-IR. However, interventional studies produced conflicting results; one randomized controlled trial (RCT) indicated improvement in HOMA-IR with high-dose vitamin D supplementation, while others found no effect. The overall evidence quality was deemed low, with a high risk of bias attributed to the lack of control for confounders like body mass index (BMI) and physical activity. Despite the consistent reporting of an inverse relationship in observational studies, interventional data do not support a causal link. The inconsistency across studies may reflect confounding by BMI, sunlight exposure, and physical activity. Consequently, current evidence does not strongly advocate for vitamin D supplementation as an isolated treatment for improving insulin resistance in T2DM, underlining the necessity for more rigorous clinical trials.

The Link Between Glycemic Control and Complications after Cataract Surgery in Type 2 Diabetes: A Systematic Review

Tue, 09 Dec 2025 00:00:00 +0100

Cataract surgery is a common procedure in patients with type 2 diabetes mellitus (T2DM), who face a higher risk of postoperative complications. Glycated hemoglobin (HbA1c) is a standard measure of glycemic control, but its role as a predictor for surgical outcomes in ophthalmology remains unclear, leading to debate over preoperative HbA1c thresholds. This systematic review aimed to synthesize the evidence on the association between preoperative HbA1c levels and the risk of complications following cataract surgery in patients with T2DM. A systematic search was conducted following PRISMA guidelines across PubMed/MEDLINE, Web of Science, SCOPUS, and Embase. Observational studies investigating the link between preoperative HbA1c and postoperative complications in T2DM patients were included. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Newcastle-Ottawa Scale. Twelve studies were included. The evidence revealed a complication-specific relationship. Elevated preoperative HbA1c (e.g., >7%) was a significant independent risk factor for cystoid macular edema (relative risk 2.01) and diabetic macular edema, supported by a clear pathophysiological link. Conversely, large-scale studies found no significant association between HbA1c and the risk of acute endophthalmitis. Several studies indicated that overall diabetes severity (e.g., renal function, complication burden) was a more robust predictor of surgical risk than glycemic control. The relationship between preoperative HbA1c and post-cataract surgery complications is not uniform. A comprehensive preoperative assessment that includes retinal status, renal function, and overall diabetes complication severity is recommended for individualized risk stratification and optimized surgical outcomes.

CT versus MRI for the Initial Assessment of Suspected Acute Stroke: A Systematic Review of Diagnostic and Management Outcomes

Tue, 09 Dec 2025 00:00:00 +0100

While non-contrast computed tomography (NCCT) is widely used for its speed and availability, magnetic resonance imaging (MRI) offers superior diagnostic accuracy. The optimal first-line imaging strategy for suspected acute stroke remains debated. This study systematically reviews and compares the diagnostic accuracy, impact on management, workflow times, and patient outcomes of CT-based versus MRI-based imaging protocols. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of PubMed/MEDLINE, Web of Science, Scopus, and Embase was performed from inception through 2025. Eighteen studies were included. MRI, particularly diffusion-weighted imaging (DWI), demonstrated significantly higher sensitivity for detecting acute ischemia compared to NCCT. MRI-based selection was associated with a 50% reduction in thrombolysis administration to stroke mimics. However, MRI use consistently resulted in longer door-to-needle times (delays of 2 to 30 minutes). Evidence on functional outcomes was mixed; several large registry studies found no significant difference in 90-day functional independence or symptomatic intracranial hemorrhage (sICH) rates after adjusting for confounders, while others reported significantly improved safety profiles (lower sICH and mortality rates) and functional outcomes with MRI. MRI is the diagnostic gold standard for detecting acute ischemic stroke and reduces inappropriate thrombolysis. An optimal, hybrid approach is recommended: utilizing fast multimodal CT as a first-line tool to minimize delays, while reserving MRI for complex cases where its superior diagnostic capability is most impactful. These findings support a tailored imaging strategy to optimize both the efficiency and precision of acute stroke care.

The Impact of Stress and Anxiety on Dysmenorrhea Severity: A systematic review

Tue, 09 Dec 2025 00:00:00 +0100

Primary dysmenorrhea (PD) affects a significant proportion of menstruating individuals, with stress and anxiety increasingly recognized as modifiable factors influencing pain severity. This systematic review synthesizes evidence on the relationship between stress/anxiety and dysmenorrhea severity, exploring underlying mechanisms and clinical implications. Following PRISMA guidelines, we conducted a comprehensive search across PubMed, Web of Science, Scopus, and ScienceDirect. Included studies assessed stress (perceived stress, PTSD, occupational stress) or anxiety (generalized/trait anxiety) in individuals with PD, using validated scales. Risk of bias was evaluated using the Newcastle-Ottawa Scale and Cochrane RoB 2.0. Of 2,305 screened records, 45 studies met inclusion criteria, with 13 analyzed in detail. Cross-sectional studies (n=12) predominated, alongside one RCT study. Significant associations between stress/anxiety and PD severity (e.g., OR=2.8 for perceived stress (95% CI: 1.9–4.1); r=0.782, p<0.001 for stress-pain correlation). PTSD and occupational stress exacerbated dysmenorrhea (β=10.48, p=0.001; p <0.05, respectively). Neurobiological mechanisms (e.g., amygdala hypertrophy, HPA axis dysfunction) were implicated in pain amplification. Stress and anxiety are significantly associated with dysmenorrhea severity, potentially mediated by neuroendocrine and inflammatory mechanisms.

The Association Between Preterm Birth and the Risk of Autism Spectrum Disorder: A Systematic Review

Tue, 09 Dec 2025 00:00:00 +0100

Autism spectrum disorder (ASD) is a neurodevelopmental condition with a complex etiology involving genetic and environmental factors. Preterm birth, a significant global health issue, has been frequently identified as a potential risk factor, but a comprehensive synthesis of the evidence is needed. This systematic review aimed to evaluate and synthesize the current evidence on the association between preterm birth and the risk of ASD. The review was conducted following the PRISMA guidelines. A systematic search of PubMed, Web of Science, SCOPUS, and Science Direct was performed. Two independent reviewers screened titles, abstracts, and full-text articles. Observational studies investigating the association between preterm birth and ASD were included. Data were extracted using a standardized form, and the risk of bias was assessed using the Newcastle-Ottawa Scale. Results demonstrated a significant association between preterm birth and an increased risk of ASD, characterized by a strong dose-response relationship where risk escalates with decreasing gestational age. For instance, one large cohort study reported adjusted prevalence rate of 3.72 for boys born extremely preterm. This association was largely independent of shared genetic and environmental factors, as shown in co-sibling analyses. Studies reported alarmingly high ASD prevalence rates, up to 20.8%, in very preterm cohorts. Preterm birth is a major, independent risk factor for ASD, with a clear inverse relationship between gestational age and risk. The findings underscore the critical need for systematic developmental surveillance and early ASD screening in preterm populations. Future research should focus on elucidating the underlying neurobiological mechanisms to inform targeted interventions.

The Association Between Thyroid Dysfunction and the Risk of Fractures: A Systematic Review

Tue, 09 Dec 2025 00:00:00 +0100

Thyroid hormones are crucial regulators of bone metabolism. While overt thyroid dysfunction is a recognized risk factor for osteoporosis, the association between subclinical thyroid dysfunction, variations within the euthyroid range, and fracture risk remains complex and less clearly defined. This systematic review aimed to comprehensively evaluate the association between various states of thyroid dysfunction and the risk of incident fractures. A systematic literature search was conducted in accordance with PRISMA guidelines across PubMed, Web of Science, SCOPUS, and ScienceDirect. Studies investigating the association between thyroid dysfunction (overt and subclinical hypo-/hyperthyroidism, euthyroid variations, autoimmune thyroiditis, and thyroid cancer) and fracture risk were included. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Newcastle-Ottawa Scale. Thirteen studies met the inclusion criteria. The evidence consistently demonstrated that subclinical hyper-thyroidism and lower thyroid-stimulating hormone (TSH) levels, even within the euthyroid range, were associated with an increased risk of fractures and impaired bone microarchitecture. Several large cohort studies found a lower fracture risk in patients with thyroid cancer, particularly those with postoperative hypoparathyroidism, suggesting a protective effect from intensive calcium and vitamin D supplementation and a low bone turnover state. The relationship between thyroid function and fracture risk is multifaceted. Subclinical hyperthyroidism and low TSH were significant, independent risk factors. The association extends into the euthyroid range, influenced by thyroid hormone sensitivity and autoimmunity. The reduced fracture risk in thyroid cancer patients highlights the critical role of iatrogenic factors and proactive management.

Exploring the impact of nutrition and lifestyle in the pathogenesis of acne vulgaris

Tue, 09 Dec 2025 00:00:00 +0100

Introduction: Acne vulgaris is a common chronic inflammatory skin condition that affects adolescents and young adults. Its development is influenced by hormonal, microbial, and environmental factors. Emerging research suggests that lifestyle and nutrition may significantly affect acne severity and prevalence, but there is limited evidence from the Saudi population.

Objectives: To determine the prevalence of acne vulgaris and evaluate associated dietary and lifestyle risk factors among individuals in Saudi Arabia.

Methods: A cross-sectional survey was conducted across Saudi Arabia between July and December 2024. Participants aged 18 and above with current or past acne vulgaris were recruited through social media platforms. A validated questionnaire assessed demographic data, lifestyle habits (hydration, sleep, physical activity, smoking), dietary patterns (fast food, dairy, chocolate), and acne history. Data were analyzed using SPSS version 21, with p-values ≤ 0.05 considered statistically significant.

Results: A total of 559 participants were included, with 65.3% females and 34.7% males. Overall, 45.6% of participants were aged 25 years or below. One-third consumed less than 1 liter of water daily, and 42.6% reported no physical activity. Acne onset commonly occurred between ages 11 and 20, with moderate severity being most prevalent. Statistically significant associations were found between acne treatment-seeking behavior and water intake, physical activity, and demographic variables.

Discussion: The findings support the role of modifiable lifestyle factors in acne pathogenesis. Hydration, exercise, and dietary habits may influence both development and management of acne vulgaris.

Conclusion: Lifestyle and dietary behaviors significantly impact acne vulgaris. Public health efforts and patient education targeting these factors may improve acne outcomes in the Saudi population.

Public Knowledge of Cardiovascular Diseases and its Risk Factors in Makkah City, Saudi Arabia

Tue, 09 Dec 2025 00:00:00 +0100

Background and aim: Cardiovascular diseases (CVDs) are among the leading causes of death globally, with both modifiable and non-modifiable risk factors playing major roles in their development. Limited research exists on public awareness of CVDs in Makkah, Saudi Arabia. This study aims to assess the level of knowledge regarding CVDs and their risk factors among the adult population in Makkah.

Methods: A descriptive cross-sectional study was conducted between January and April 2025 among the general population in Makkah City. Data were collected using a validated Arabic-based, self-administered online questionnaire. Participants included residents aged 18 and above from various educational and occupational backgrounds.

Results: A total of 676 participants were participated, with 63.2% being female. The majority (38.3%) were aged 18–25 years, and 74.0% held a university degree. Most respondents (94.8%) were Saudi nationals. Although 91.7% had heard of heart attacks, only 57.4% demonstrated good overall knowledge of CVDs and their risk factors. Notably, those with higher education levels, CPR training, or prior CPR experience showed significantly better awareness.

Conclusion: Despite high exposure to general CVDs information, many participants displayed limited understanding of less common symptoms and specific risk factors. Educational efforts, particularly those incorporating cardiopulmonary resuscitation (CPR) training, withtargeting younger and less-informed groups, are essential to improve public awareness and reduce the risk of CVDs.

Assessment of attitudes and behaviors toward noise’s exposures and its effect on hearing in Al-Qassim, Saudi Arabia: a cross-sectional study

Tue, 09 Dec 2025 00:00:00 +0100

Background: Noise-induced hearing loss (NIHL) stands as a significant health challenge that is both common and preventable. It calls for a profound understanding of exposure patterns, commitment to ear protection, and the influence of demographic factors. This cross-sectional study sets out to explore these elements among a varied group of participants.

Methodology: A cross-sectional study engaged 252 individuals who provided demographic details and completed a structured questionnaire evaluating their noise exposure frequency, compliance with ear protection during various activities, and demographic variables. Data analysis utilized descriptive statistics, chi-square tests, and analysis of variance (ANOVA).

Results: The demographic analysis revealed a notable representation of females 172 (68.3%) and diverse occupational backgrounds. Participants aged 20-30 years constituted the majority with 169 individuals (67.1%). Exposure frequency demonstrated variations across different scenarios, with a substantial percentage reporting never being exposed to loud noises. Adherence to ear protection varied, with low utilization reported in certain activities. The relationship between adherence and demographics indicate gender, age, marital status, and occupation-related differences.

Conclusion: The study provides valuable insights into the demographic factors influencing noise exposure and adherence to ear protection. The observed patterns align with existing literature on NIHL, emphasizing the need for targeted interventions and educational campaigns to promote consistent hearing protection behaviors. Understanding demographic influences on hearing health is crucial for tailoring interventions and mitigating the risk of noise-induced hearing loss across diverse populations. The findings contribute to public health initiatives and workplace safety programs aimed at fostering a culture of proactive hearing health.

A cross-sectional study of impaired awareness of hypoglycemia and its risk factors among people living with type 1 diabetes in western region, Saudi Arabia

Abdulmajeed Algethami, Shumukh AlThomali, Maram A. Alameen, Hutaf S. Almutairi — Tue, 09 Dec 2025 00:00:00 +0100

Background: One of the most prevalent endocrine metabolic diseases affecting children and adolescents worldwide is type 1 diabetes mellitus (T1DM), it frequently has severe acute and long-term effects. The prevalence of impaired awareness of hypoglycemia (IAH) is notably high among T1D patients in Saudi Arabia. This study aimed to determine the prevalence of IAH and identify the associated risk factors in individuals with Type 1 diabetes.

Methodology: A cross-sectional observational study was conducted through an online survey distributed across the Western region of Saudi Arabia between July and October 2024. The study utilized the Clarke Hypoglycemia Awareness Survey.

Results: Data from 382 T1D patients were analyzed, revealing a prevalence of IAH of 75.1% in the Western region of Saudi Arabia. Younger adults, particularly those aged 25–54, reported more frequent moderate and severe hypoglycemic episodes. Female participants exhibited a higher prevalence of reduced awareness (72.1%). Patients with higher educational attainment demonstrated poorer awareness of hypoglycemic symptoms. However, this finding was not statistically significant (p ≥ 0.05).

Conclusion: The high prevalence of impaired awareness of hypoglycemia (IAH) among T1D patients in Saudi Arabia’s Western region underscores the urgent need for improved patient education and awareness programs on hypoglycemia and effective self-management strategies, especially for newly diagnosed individuals. Addressing key factors, such as the duration of diabetes and the importance of tailored educational interventions, is crucial to reducing the risks associated with IAH.