Search Results (3,547)

Background/Objectives: Social determinants of health, including income, age, education, and gender, have been proposed to shape diabetes self-care capacity, yet their joint associations within Saudi Arabian primary healthcare populations remain poorly delineated. Anchored within the World Health Organization’s Commission on Social Determinants of Health framework and the Social Ecological Model, this study examined both the unadjusted and, via multivariable regression, adjusted associations of four sociodemographic factors with diabetes self-care management and health literacy among adults in southern Riyadh. Methods: A cross-sectional correlational design was employed with 92 adults with type 2 diabetes recruited from primary healthcare centers in southern Riyadh. Data were collected using the Arabic HLS-Q12 (health literacy) and SDSCA-Arabic (self-care management). Non-parametric Spearman rank-order correlations were conducted to examine bivariate associations. Multivariable linear regression was subsequently performed to estimate adjusted associations for each sociodemographic variable. Bivariate analyses were conducted using IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA), while multivariable linear regression analyses were performed using Python version 3.12 with the statsmodels package. Results: Income level showed significant, moderate positive unadjusted correlations with both self-care management (rs = 0.40, 95% CI [0.21, 0.56], p < 0.01) and health literacy (rs = 0.41, 95% CI [0.22, 0.57], p < 0.01). Age showed the strongest negative unadjusted correlation with self-care management (rs = −0.49, 95% CI [−0.63, −0.31], p < 0.01) and a significant negative correlation with health literacy (rs = −0.36, 95% CI [−0.53, −0.17], p < 0.01). Educational attainment was significantly associated with both self-care management (rs = 0.29, 95% CI [0.09, 0.47], p < 0.01) and health literacy (rs = 0.26, 95% CI [0.06, 0.44], p < 0.05). Gender did not reach statistical significance for either outcome. A multivariable model adjusting for all four sociodemographic variables confirmed that income and age remained independently associated with both outcomes, whereas education and gender did not. These findings do not establish independent or causal effects from the bivariate correlations alone; the adjusted results are reported separately below. Conclusions: Income and age were independently associated with both diabetes self-care and health literacy after multivariable adjustment, whereas education and gender were not. Findings support equity-focused nursing interventions and age-responsive diabetes education attentive to the social patterning of self-care disparities in southern Riyadh. Full article

Chronic pain continues to be a major global health burden and is frequently refractory to conventional pharmacologic and conservative therapies. Spinal cord stimulation (SCS) has emerged as an important neuromodulatory treatment for selected patients with chronic neuropathic and mixed pain syndromes. Since its introduction in the 1960s, SCS has evolved from paresthesia-based tonic stimulation into more adaptive and personalized neuromodulation. This review summarizes the current evidence regarding the mechanisms, clinical applications, technological advances, and future directions of SCS therapy. Mechanistically, SCS modulates nociceptive transmission through dorsal column and dorsal horn pathways, inhibitory neurotransmitter systems, wide-dynamic-range neuronal activity, and supraspinal pain-processing networks. Technological advances have expanded available stimulation paradigms, including burst stimulation, high-frequency stimulation, closed-loop evoked compound action potential-controlled systems, and differential target multiplexed stimulation. These approaches aim to improve analgesic durability, reduce the burden of paresthesia, and address mechanisms such as neuroinflammation and neural habituation. Clinically, SCS is used for conditions including failed back surgery syndrome, complex regional pain syndrome, painful diabetic neuropathy, ischemic limb pain, and emerging non-traditional pain states. However, outcomes remain variable and are influenced by psychological readiness, pain phenotype, anatomic factors, trial response, neurophysiologic markers, and patient engagement. Complications such as lead migration, infection, implantable pulse generator malfunction, and loss of efficacy remain important considerations. Future progress in SCS will likely depend on artificial intelligence, remote monitoring, biomarker-guided programming, and integration with multidisciplinary chronic pain care. Full article

Diabetes mellitus and periodontitis are bidirectionally associated chronic disorders linked through metabolic dysregulation, host inflammation, microbial dysbiosis, and impaired tissue remodeling. This review summarizes clinical, molecular, cellular, genomic, epigenomic, transcriptomic, and microbial evidence concerning the mechanisms underlying this relationship and their potential translational relevance. Chronic hyperglycemia is associated with advanced glycation end product signaling through the receptor for advanced glycation end products, mitogen-activated protein kinase/nuclear factor-κB activation, reactive oxygen species production, oxidative stress, and NLR family pyrin domain-containing 3 inflammasome activation, which may contribute to enhanced cytokine responses and periodontal tissue injury. Diabetes is also associated with altered neutrophil and macrophage function, increased T helper 17/interleukin-17 signaling, and an elevated receptor activator of nuclear factor-κB ligand/osteoprotegerin ratio, thereby favoring osteoclastogenesis and alveolar bone loss. Conversely, periodontal inflammation and microbial products may contribute to systemic low-grade inflammation, insulin resistance, and metabolic dysregulation. Multi-omics studies have identified shared susceptibility loci, regulatory networks, and disease-associated cell states, although their causal and clinical significance remains incompletely defined. These findings suggest potential roles for integrated medical–dental care, glycemic screening in dental settings, periodontal inflammation control, host-modulatory therapies, and regenerative biomaterials. Further longitudinal and experimental studies are needed to determine their clinical applicability. Full article

Background: Achieving remission of type 2 diabetes mellitus (T2DM) after bariatric surgery represents a critical opportunity to reduce long-term diabetes-related complications, including cardiovascular disease, nephropathy, neuropathy, and retinopathy. However, remission rates vary widely across patients, and identifying modifiable clinical and behavioral determinants remains essential for optimizing integrated metabolic care. Objectives: In the current study, we aimed to (1) classify type 2 diabetes mellitus (T2DM) remission status after bariatric surgery through clinical, anthropometric, and behavioral variables at follow-up; (2) identify the main model-based determinants of remission status and explainable machine learning using the preoperative model for baseline risk stratification with surgical candidates. Methods: We performed a retrospective cross-sectional study on 233 patients with T2DM who had bariatric surgery at a tertiary referral center. We made use of two analytical frameworks: a full-feature approach to identify the current remission status in a cross-sectional manner and a preoperative approach to make a temporal classification of the baseline for the first time. We trained and internally assessed 14 machine learning and deep learning classifiers. We evaluated model interpretability using SHAP. Results: In the full-feature cross-sectional classification, the Bottleneck Network performed best (ROC AUC = 0.889). SHAP data identified percentage weight regain, pre- and post-surgical body mass index, HbA1c, and oral hypoglycemic agent use as the dominant model-associated factors. In the restricted preoperative setting, the Extra Trees model achieved an AUC of 0.707, which is a lower level but still represents good baseline risk stratification performance. Conclusions: The findings indicate that remission status after bariatric surgery is both clinical as well as behavioral, but the post-operative or contemporaneously assessed variables should be looked at as classification (as opposed to prediction) models. The preoperative model may be able to be used in risk stratification, but clinical validation and prospective evaluation should be made prior to clinical implementation. Full article

Background/Objectives: The objectives of this study were to compare emotional well-being, depressive symptoms, and psychiatric medication use between adults with and without diabetes in Spain and to identify sex-specific factors associated with these outcomes among individuals with diabetes. Methods: A population-based matched study was conducted using data from the 2023 Spanish National Health Survey (SNHS 2023). Adults aged ≥35 years with physician-diagnosed diabetes were individually matched (1:1) to controls without diabetes according to sex, exact age, and autonomous community of residence. Low emotional well-being (WHO-5 score < 50), clinically relevant depressive symptoms (PHQ-8 ≥ 10), and psychiatric medication use were assessed. Conditional logistic regression and sex-specific multivariable logistic regression models were fitted. Results: The study included 3710 participants (1855 with diabetes and 1855 matched controls without diabetes). The prevalence of low emotional well-being was significantly higher among participants with diabetes than among matched controls in both men (16.4% vs. 11.6%; p = 0.004) and women (28.8% vs. 21.6%; p < 0.001). Likewise, clinically relevant depressive symptoms were more frequent among individuals with diabetes (men: 32.7% vs. 24.9%, p < 0.001; women: 54.4% vs. 40.2%, p < 0.001), as was psychiatric medication use (men: 20.5% vs. 15.2%, p = 0.005; women: 39.5% vs. 30.2%, p < 0.001). After full adjustment, diabetes remained independently associated with low emotional well-being (men: aOR 1.48, 95% CI 1.03–2.13; women: aOR 1.43, 95% CI 1.14–1.78), depressive symptoms (men: aOR 1.31, 95% CI 1.02–1.69; women: aOR 1.38, 95% CI 1.08–1.77), and psychiatric medication use (men: aOR 1.34, 95% CI 1.02–1.75; women: aOR 1.35, 95% CI 1.06–1.73). Poor social support, physical inactivity, and several chronic comorbidities emerged as the factors most consistently associated with adverse mental health outcomes among individuals with diabetes. Conclusions: Adults with diabetes in Spain experience a substantially greater burden of adverse mental health than matched individuals without diabetes. Integrating routine mental health assessment and psychosocial support into diabetes care may help improve both psychological well-being and disease management. Full article

Patients with chronic liver disease are systematically excluded from acute myocardial infarction (AMI) trials, and prior real-world data rely on administrative coding alone. Whether ICD-coded liver disease and laboratory-defined liver fibrosis identify the same patients, and whether they predict the same outcomes, is unknown. We conducted a single-center retrospective cohort study of 1037 consecutive adults admitted with AMI (ICD-10 I21.x) to a tertiary New York center between November 2022 and December 2024. The primary exposure was ICD-defined advanced liver disease (cirrhosis, hepatic failure, or portal hypertension/decompensation; n = 102). The secondary, lab-based exposure was the Fibrosis-4 (FIB-4) index calculated from earliest admission AST, ALT, and platelet count (computable in 1031 patients, 99.4%), stratified as low (<1.45), indeterminate (1.45–3.25), or advanced (>3.25). Co-primary outcomes were invasive management (diagnostic angiography, percutaneous coronary intervention, or coronary artery bypass grafting) and in-hospital mortality. Multivariable logistic regression adjusted for age, sex, diabetes, chronic kidney disease, heart failure, and ST-elevation; the trend across FIB-4 tiers was assessed with the Cochran–Armitage test. Denominators throughout (including the 168/909 occult-fibrosis estimate) use the full exposure group as denominator under a missing-as-not-exposed convention; the four no-LD and two advanced-LD patients with missing FIB-4 are counted as non-advanced fibrosis for this calculation. Patients with ICD-defined advanced liver disease received invasive management less often (12.7% vs. 50.4%; adjusted odds ratio [aOR] 0.17, 95% CI 0.09–0.32) and died in hospital more often (43.1% vs. 7.9%; aOR 8.22, 95% CI 5.02–13.46) than patients without coded liver disease. Outcomes worsened monotonically across FIB-4 tiers (mortality 4.4% → 9.2% → 27.5%; invasive management 55.2% → 45.6% → 33.5%; both p < 0.001 by Cochran–Armitage trend test). Critically, 168 of 909 patients with no coded liver disease (18.5%) had FIB-4 > 3.25, representing a substantial population of unrecognized advanced fibrosis missed by clinical coding. Coded liver disease identifies a small, severely affected subgroup with markedly lower rates of invasive management and 6- to 8-fold higher mortality after AMI. Routine FIB-4 calculation, a free, three-variable lab score, identifies a much larger population with occult advanced fibrosis and graded excess risk that ICD codes miss entirely. Pending prospective validation, FIB-4 may serve as a low-cost adjunct to bedside risk stratification in AMI care. Full article

Background: Necrotizing fasciitis complicating diabetic foot infection requires rapid source control and is associated with substantial morbidity. A topical desiccating agent (TDA) may assist debridement by dehydrating necrotic tissue and potentially disrupting biofilm, but comparative clinical evidence is limited. Methods: We conducted a retrospective, single-center cohort study of 87 patients who underwent emergency surgery for diabetic foot-related necrotizing fasciitis between July 2023 and February 2026. Nineteen patients received a single application of TDA at the index operation in addition to standard care, and 68 received standard care without TDA. Treatment allocation was non-random and occurred in routine clinical practice. The primary outcome was the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score at Day 7. The primary analysis used linear regression adjusted for baseline LRINEC score and baseline septic status, with heteroskedasticity-consistent type 3 (HC3) standard errors. LRINEC was treated as a laboratory-based surrogate rather than as a validated treatment-response measure. C-reactive protein (CRP), white blood cell count, and glucose at Day 0 and Day 7 were summarized descriptively. Secondary clinical outcomes were 30-day major amputation and all-cause mortality. Results: The mean LRINEC score decreased from 8.58 to 2.95 in the TDA group and from 7.51 to 5.51 in the control group. The mean change was −5.63 in the TDA group and −2.00 in the control group, an unadjusted between-group difference of −3.63 points (95% confidence interval [CI], −4.83 to −2.43; p < 0.001). Baseline sepsis was more frequent in the TDA group than in the control group (89.5% vs. 51.5%). After adjustment for baseline LRINEC score and septic status, TDA exposure was associated with a 3.01-point lower Day-7 LRINEC score (95% CI, −4.00 to −2.02; p < 0.001). At Day 7, 18 of 19 TDA-treated patients (94.7%) and 34 of 68 controls (50.0%) had an LRINEC score below 6; this threshold analysis was exploratory. CRP, white blood cell count, and glucose decreased descriptively in both groups, with numerically larger reductions in the TDA group. No major amputations or deaths occurred within 30 days in either group. No TDA-related adverse event was documented in the retrospective clinical records. Conclusions: Adjunctive TDA use was associated with a lower Day-7 LRINEC score and a greater reduction from baseline. Because treatment was not randomized, baseline severity differed between groups, LRINEC is not a validated longitudinal treatment-response measure, and assessment of clinical outcomes was limited, the findings should be interpreted as exploratory associations and confirmed in prospective multicenter studies. Full article

Aging is the strongest risk factor for chronic diseases such as cardiovascular diseases, cancer, diabetes, and neurodegenerative disorders. Advances in geroscience indicate that pharmacological modulation of conserved molecular pathways may extend healthspan and delay multimorbidity. A structured narrative review of the PubMed, Scopus, and Web of Science literature published between January 2010 and May 2026 was conducted, with seminal earlier studies retained where relevant. The review focused on molecular pathways implicated in aging, pharmacological interventions targeting these pathways, and their preclinical and clinical evaluation. Particular emphasis was placed on translational evidence, including human biomarker studies and randomized clinical trials, and on the distinction between biomarker modulation and clinically meaningful outcomes. Repurposed drugs such as metformin and rapamycin have among the most extensive preclinical and translational evidence, although clinical evidence for broadly applicable geroprotection remains limited. Statins, SGLT2 inhibitors, GLP-1 receptor agonists, and menopausal hormone therapy have established disease-specific or cardiometabolic benefits that may have indirect relevance to geroprotection, but direct effects on biological aging and healthspan remain unproven. Other candidates, including senolytics, NAD⁺ precursors, taurine, and epigenetic reprogramming approaches, are at different stages of translational development, with evidence ranging from promising preclinical findings to early human studies. Across interventions, a substantial gap remains between mechanistic plausibility and clinically validated geroprotection. Geroprotective pharmacology represents a promising but incompletely validated approach to extending healthspan. Major uncertainties include the absence of universally accepted biomarkers and clinical endpoints of biological aging, heterogeneity in treatment response, optimal timing and duration of interventions, and long-term safety. Future research should prioritize adequately powered randomized clinical trials integrating standardized measures of biological aging with clinically meaningful outcomes, alongside biomarker-guided patient selection, appropriate treatment timing, and careful assessment of long-term safety. The future of geroprotective medicine will depend not only on identifying additional pharmacological targets, but on demonstrating that their modulation produces durable and clinically meaningful benefits in humans. Full article

Diabetes mellitus continues to impose a substantial global health burden, underscoring the need for therapeutic systems capable of achieving precise, adaptive, and patient-friendly glycemic control. Conventional diabetes treatments, including repeated insulin injections and oral hypoglycemic agents, are often constrained by non-physiological drug release, poor adherence, systemic side effects, and the persistent risk of hypoglycemia. In this context, glucose-responsive nanomedicine has emerged as a promising platform for next-generation diabetes therapy by enabling self-regulated and glucose-triggered delivery of insulin and other antidiabetic agents. This review highlights recent advances in glucose-responsive nanomedicine, focusing on the principal sensing mechanisms, including glucose oxidase-based, phenylboronic acid-based, and lectin-mediated systems, as well as the nanoscale carriers engineered to support them, such as polymeric nanoparticles, nanogels, micelles, liposomes, and hybrid nanostructures. These smart platforms offer significant potential to improve drug stability, enhance targeting efficiency, reduce dosing frequency, and more closely mimic endogenous insulin secretion. The review further examines their emerging role in precision diabetes care, particularly in combination with continuous glucose monitoring technologies, wearable devices, and closed-loop therapeutic systems. Despite notable progress at the preclinical level, important barriers to clinical translation remain, including challenges related to biocompatibility, long-term safety, reproducibility, scalable manufacturing, and regulatory approval. Collectively, glucose-responsive nanomedicine represents a rapidly advancing and clinically relevant field with the potential to redefine diabetes management through intelligent and personalized therapeutic strategies. This review provides a focused overview of current developments, key translational challenges, and future directions toward clinical implementation. Full article

Background/Objectives: Type 2 diabetes (T2D) is a major risk factor for cardiovascular disease and chronic kidney disease (CKD), yet the extent of longitudinal CKD screening in routine clinical practice remains unclear. This study aimed to assess long-term cardiorenal outcomes and CKD screening practices in patients with T2D managed across primary care and endocrinology settings, evaluating the feasibility of risk stratification in real-world practice. Methods: We conducted a retrospective cohort study using anonymized data from the Telotrón database (2.2 million patients). Adults with T2D attended across primary and endocrinology care were followed from 1 January 2018 to 31 December 2022. Frequency of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) measurements, and cumulative proportion of kidney and cardiovascular events, hospitalizations, and mortality were assessed. Results: Among 13,600 individuals, 31.1% experienced a kidney event and 18.6% a cardiovascular event over 5 years. All-cause hospitalization occurred in 24.9% and 16.1% died. First occurrence of an abnormal eGFR or UACR measurement occurred in 37.0% of participants without baseline CKD, and 45.4% with baseline CKD showed progression. Annual monitoring was limited, with 39.1% and 16.6% undergoing at least one yearly assessment, and 2.9 and 1.5 mean number of measurements per patient for eGFR and UACR, respectively. Conclusions: Despite receiving endocrinology care, kidney disease progression and cardiovascular events remain a major concern in T2D, and yet suboptimal albuminuria and eGFR assessment limit early detection and risk stratification, thereby hindering risk-directed management. Full article

Catheter ablation is the cornerstone of rhythm control in atrial fibrillation (AF), yet recurrence remains common, and obesity is among the most consistently implicated modifiable risk factors. Weight reduction and metabolic pharmacotherapy are increasingly used in the periprocedural period, but whether they act through a shared pathway has not been systematically examined. This narrative review compares the two approaches and asks whether metabolic agents confer protection beyond weight loss itself. Three observations argue that they do not act identically. First, the benefit of weight reduction is dose-dependent yet contingent on delivery: a structured, physician-led risk-factor program reduced 12-month arrhythmia recurrence (risk ratio 0.53), whereas nurse-led care that improved guideline adherence without structured delivery did not alter the primary endpoint. Second, sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been associated with reduced recurrence across BMI strata despite producing only modest weight loss; notably, a randomized trial in patients without cardiovascular or metabolic comorbidity showed no additional benefit, whereas benefit was observed in patients with type 2 diabetes and heart failure. Third, glucagon-like peptide-1 receptor agonists (GLP-1RA) achieve greater weight loss but yield inconsistent recurrence data, and Mendelian randomization suggests their cardiometabolic benefit is largely BMI-mediated, whereas that of SGLT2i is weight-independent. Together, these observations are consistent with a working hypothesis of two partly distinct atrial substrates—an obesity-related substrate responsive to weight reduction, and a metabolic-inflammatory substrate that may respond to SGLT2i predominantly when metabolic comorbidity is present. This framework is hypothesis-generating: it rests on indirect, cross-study comparisons and has not been tested by formal mediation analysis. If confirmed, it would imply that the two interventions are complementary rather than interchangeable. Full article

Background: Memantine, an uncompetitive and voltage-dependent N-methyl-D-aspartate (NMDA) receptor antagonist, is clinically established for moderate-to-severe Alzheimer’s disease. Its pharmacodynamic profile, low-to-moderate affinity, rapid open-channel block, and strong voltage dependency allows selective inhibition of pathological NMDA overactivation while preserving physiological neurotransmission. Increasing evidence shows that these same mechanistic principles operate in the peripheral nervous system, where NMDA receptors contribute to excitotoxicity, oxidative stress, neuroinflammation, and maladaptive nociceptive signaling. Purpose: To synthesize emerging preclinical and clinical evidence demonstrating memantine’s modulatory and neuroprotective actions in peripheral neurons and glia and to outline implications for drug repurposing across neurology, pain medicine, oncology, supportive care, and ophthalmology. Methodology: A narrative integration of mechanistic studies, in vivo preclinical models, and heterogeneous clinical trials evaluating memantine’s effects on peripheral sensory neurons, autonomic neurons, Schwann cells, retinal ganglion cells, and neuromuscular junction physiology. Evidence was examined across conditions involving excitotoxicity, oxidative injury, mitochondrial dysfunction, apoptotic signaling, neuroinflammation, and neuropathic pain amplification. Results: Memantine consistently attenuates peripheral excitotoxic calcium influx, suppresses NOX-2–mediated ROS generation, stabilizes mitochondrial membrane potential, modulates Bax/Bcl-2 signaling, and reduces neuroinflammatory cytokine activity. It also inhibits dorsal horn wind-up selectively under neuropathic conditions. These convergent mechanisms yield protective effects across chemotherapy-induced peripheral neuropathy (CIPN), diabetic neuropathy, traumatic nerve injury, phantom limb pain, retinal ganglion cell excitotoxicity, and organophosphate-induced neuromuscular toxicity. Clinical evidence includes improved multimodal neuropathy outcomes in diabetic neuropathy when combined with gabapentin, reduced phantom limb pain prevalence and intensity at six months, and a five-fold reduction in post-mastectomy neuropathic pain with pre-emptive administration. Conclusions: Memantine should be conceptually reframed as a system-wide neuroprotective agent with substantial translational potential beyond the CNS. Priorities for future development include NR2B-selective peripheral NMDA antagonists, peripherally restricted formulations, single-cell transcriptomic mapping of peripheral NMDA receptor subtypes, and adequately powered PNS-specific randomized trials. Full article

Glucagon-like peptide (GLP)-1 receptor agonists (GLP-1RAs) (including medications that contain GLP-1 and other RAs), hereafter referred to as GLP-1 medicines, have significantly advanced the management of metabolic disease and weight management. Obesity is highly prevalent among cancer survivors at the time of diagnosis, and cancer treatments are associated with subsequent changes in weight, either gain or loss. Research has shown that obesity can adversely affect cancer treatment outcomes and survivorship, leading researchers to investigate the potential integration of GLP-1 medicines into oncology care. There is growing interest in understanding the effects of GLP-1 medicines on weight loss and cancer-related outcomes among individuals with obesity who are taking anticancer therapies, as well as individuals treated for cancer in the past who are long-term survivors. This review examines the literature to characterize what is known about GLP-1 medicine use among cancer survivors. The current literature, though limited and largely retrospective, suggests that GLP-1 medicines may contribute to weight loss among cancer survivors, with outcomes varying by cancer stage and type of anticancer therapy. It is important for healthcare providers to consider the potential negative impact of these GLP-1 medications on their patients, especially those with cancer cachexia or sarcopenic obesity, as well as those undergoing anticancer treatments that often lead to weight loss. While there is preclinical evidence suggesting that there are weight-loss independent effects that may be beneficial to individuals with cancer, use of GLP-1 medicines in patients of normal weight for reasons other than treatment of type 2 diabetes should be initiated with caution. On the positive side, these agents may help mitigate therapy-related toxicities, such as cardiotoxicity, with the potential to enhance survivorship outcomes. Unfortunately, there is a notable lack of well-designed randomized controlled trials evaluating the effects of GLP-1 medicines on weight loss, clinical endpoints, and cancer-related outcomes. Advancing the field requires a focus on elucidating the interactions between GLP-1 medicines and anticancer therapies, particularly their impact on treatment efficacy, nutritional status, and overall patient outcomes, both during treatment and in the long term. Full article

Background: Diabetes mellitus is a major public health concern in Saudi Arabia, affecting approximately 18.3% of adults. Although over 95% of people in the Qassim region own smartphones, limited information exists regarding how and why patients with diabetes utilize digital health technologies. Objective: This study employed an extended Technology Acceptance Model (TAM) incorporating trust, privacy concerns, and self-efficacy to investigate the factors influencing digital health technology adoption among patients with diabetes in Qassim Unaizah, Saudi Arabia. Methods: A cross-sectional study was conducted from November 2025 to January 2026 following institutional review board approval. The quantitative phase utilized a structured survey (n = 203) measuring TAM constructs via validated 5-point Likert scales. Descriptive statistics, Pearson correlations, and one-way ANOVA were performed. Qualitative themes were derived from open ended responses to contextualize quantitative findings. Results: Most participants were male (62.6%), with a mean age of 47.2 years (SD ± 13.1). Smartphone ownership was nearly universal (99.5%), and 82.8% used blood glucose tracking applications. All TAM constructs exhibited significant positive correlations with behavioural intention (p < 0.001): attitude (r = 0.450), perceived usefulness (r = 0.438), self-efficacy (r = 0.394), trust (r = 0.379), ease of use (r = 0.340), and privacy concern (r = 0.309). Mean scores indicated strong acceptance: perceived usefulness (4.31, SD ± 0.39), behavioural intention (4.21, SD ± 0.44), and attitude (4.17, SD ± 0.42). Daily usage was reported by 63.1% of participants, 81.8% expressed satisfaction, and 63.1% reported that digital tools greatly improved their diabetes management. Privacy concerns were notably low (mean 1.70, SD ± 0.89, reverse-coded; Cronbach’s α = 0.921). Supplementary qualitative content analysis of optional open-ended comments (n = 40 respondents) identified six recurring topics: clinical utility, digital literacy, trust, data security awareness, patient empowerment, and social support. Conclusions: Patients with diabetes in Qassim Unaizah demonstrate substantial digital health adoption, predominantly driven by perceived usefulness, positive attitudes, and self-efficacy. The extended TAM effectively explains adoption within this Saudi Arabian context. Findings support interventions emphasizing clinical benefits, user friendly design, and trust building to optimize digital health utilization in diabetes care. Full article