• Volume 9 – No 5 – July-Sep 2016
    Vol 0 No No 5 (2016)
    Type 2 diabetes (T2D) is one of the major and exacer- bating health problems worldwide; T2D is predicted to affect 490 million in 2030 (Zhang, et al., 2010). Strong genetic in uences and many polymorphisms have been reproducibly associated with T2D.Insulin resistance in muscle, liver, and adipose tissues is a primary charac- teristic of most patients with T2D; as such, these tissues become resistant to endogenous and exogenous insulin. The interaction of insulin with target tissues is mediated by insulin receptor (INSR), a glycoprotein implicated in directing insulin to target cells and initiating cell responses to insulin, (Gold ne, 1987 Herder and Roden, 2011, Voight, et al., 2010). High-mobility group A1 (HMGA1) is an architectural transcription factor involved in numerous biological functions in the nucleus, including regulation of DNA replication, transcription, recombination, and repair; among these functions, transcriptional regulation of gene expression is considered as the most important. After HMGA1 binds to DNA, HMGA1 can be polymerized with other transcription factors, forming an “enhanceo- some†to regulate gene transcription; thus, gene expres- sions are positively or negatively regulated(Bustin and Reeves, 1996). Studies on humans and knockout mice have suggested that HMGA1 is involved in to T2D patho- genesis through the regulation of INSR gene expres- sion; INSR gene expression is decreased by functional HMGA1 gene variants. HMGA1-de cient patients have been biologically investigated because of their clinical value. However, whether HMGA1 single gene deletion- or mutation-induced insulin resistance is the underlying cause of T2D remains unknown, (Foti, et al., 2005). Low- frequency insertion polymorphism IVS5-13insC (c.136- 14_136-13insC) has been identi ed and associated with insulin resistance and T2D among individuals of white European ancestry and Chinese populations, (Chiefari, et al., 2011 Liu, et al., 2012)
  • Volume 9 – No 4 – Oct-Dec 2016
    Vol 0 No No 4 (2016)
    Not long ago, the World Bank supported the extension of role of private health insurance in many developing countries. As a result, some employers in these coun- tries provide health insurance as a tool to attract profes- sional workers. Saudi Arabia attracts a large number of additional expatriates, both skilled and unskilled, in the hope of seeking employment for  nancial security. Lit- erature suggests that expatriates have increased health risks related to leaving their home countries, (Sekhri and Savedoff 2005, Sommers et al 2012 and Baicker, 2013). Of late, there has been a resurgence in the role of pri- vate health insurance companies in providing better ser- vices to their clients, as in most high and middle income countries they are now required to provide supplemen- tary or complementary coverage to primarily, social or national health insurance systems, with the exception of the United States, (Bassett and Kane 2007, Thomson et al 2009, Levy and Janke 2016, Alkhamis et al 2014, Alkhamis 2016 and Sa 2016). In a time when global disease burden is immense, health insurance provides valuable risk coverage against expenditure caused by any unforeseen medical emer- gencies. Having health insurance is important for sev- eral reasons, though these may vary in both developed and developing economies. It is the poor and most vul- nerable who are at greatest risk owing to lack of protec- tion against the impoverishing effects of illness. People who are uninsured are more likely to have worse health outcomes, delayed access to care and are more likely to receive less medical care than the insured ones. Health care providers do not care about the uninsured people due to  nancial implications (Bassett and Kane, 2007and Thomson et al 2009). The role of private health insurance in access to healthcare varies among developing and developed countries, and has been deliberated in different sur- roundings (Thomson et al 2009; Schoen et al 2010. Dor- herty 2011, Berkhout and Oostingh, 2008; Drechsler and Jütting 2005; Islam 2007 and Smith, 2007). Saudi Arabia shares characteristics of both high and low-income countries as recently Alkhamis (2012) and Alkhamis et al (2014) have reported. It has attempted to seriously reform its private healthcare system and reduce expatriate access to government resources through the provision of Compulsory Employment Based Health Insurance (CEBHI). CEBHI was announced in 1999; however, it could not be implemented until 2006, when it was carried out in phases according to company size, similar to the plan used for implementing compulsory healthcare in Korea (Jeong and Niki, 2012). Consequently, by November 2008, all companies had to provide health insurance to their employees regardless
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