Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar

https://doi.org/10.1016/j.diabres.2009.02.003Get rights and content

Abstract

Objective

The objective of the study was to determine the prevalence of diagnosed and undiagnosed diabetes, pre-diabetes and to identify the associated risk factors in the sample of adult Qatari population.

Design

This was a cross-sectional study.

Setting

The survey was carried out in urban and semi-urban primary health care centers.

Subjects and methods

The survey was conducted from January 2007 to July 2008 among Qatari nationals above 20 years of age. Of the 1434 subjects who were approached to participate in the study, 1117 (77.9%) gave their consent. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. DM was defined according to the WHO expert group. Pre diabetes status was based on the presence of impaired fasting glucose or impaired glucose tolerance.

Results

The overall prevalence of diabetes mellitus among adult Qatari population was high (16.7%) with diagnosed DM (10.7%) and newly diagnosed DM (5.9%). The impaired glucose tolerance (IGT) was diagnosed in 12.5%, while impaired fasting glucose was in 1.3% with a total of (13.8%). The proportion of DM was higher in Qatari women (53.2%) than in Qatari men (46.8%) and it peaked in the age group 40–49 years (31.2%). The age-specific prevalence of total DM and IGT increased with age. Risk factors were significantly higher in diabetic adult Qatari population: central obesity (p < 0.001), hypertension (p < 0.001), triglyceride (p < 0.001), HDL (p = 0.003), metabolic syndrome (p < 0.001), heart diseases (p < 0.001). Smoking habits and family history of DM were the major contributors for diabetes disease. The central obesity was associated with higher prevalence of DM and IFG among Qatari men and women.

Conclusion

The present study has found a moderately high prevalence of diabetes mellitus in the adult Qatari population. High proportion of pre-diabetes in Qatari adults will increase the prevalence of DM in the next few years. Smoking habits and family history of DM were the major contributors for DM. Early diagnosis of DM is of major importance to reduce the risk of these diabetes-related conditions.

Introduction

Diabetes mellitus is recognized as a global major public health problem. Diabetes is one of the main contributors to ill health and premature mortality worldwide [1]. It has been projected that the number of diabetic patients will rise from an estimated 135 million in 1995 to 300 million in 2025 [2]. Also, it is estimated that diabetes mellitus accounts currently for 5.2% of all deaths worldwide [3]. Diabetes mellitus can affect individuals’ health through involvement of several body systems. Inevitably, diabetes and its complications will emerge as one of the major threats to future public health resources throughout the world at a huge economic and social cost, particularly in a developing country.

Over the last century, there has been rapid socio-economic development in many countries resulting in a move from a traditional to a modern way of life. The changes in diet and lifestyle habits combined with increased longevity have formed the basis for dramatic increases in the prevalence of type 2 diabetes mellitus in both developed and developing countries. The prevalence of diabetes varies widely among populations according to race, life style and urbanization [4]. The state of Qatar is a rapidly developing country with a change that influenced the lifestyle of the people towards urbanization, particularly over the recent decades. These rapid changes happened in Qatar highlights the importance of conducting a study on diabetes mellitus and associated risk factors. The possible causes of this ‘diabetic epidemic’ are population growth, longer survival, urbanization, low physical activity, obesity, excessive energy intake and other factors.

It has been reported that the number of people with type 2 diabetes mellitus is increasing worldwide and many of these individuals remain unidentified [5]. Undiagnosed type 2 diabetes and impaired glucose regulation are reported to have substantial clinical importance. Undiagnosed diabetes may also impose substantial public health implications because these subjects remain untreated and at risk for complications [6]. Although numerous studies have documented worldwide increases in diagnosed and undiagnosed diabetes mellitus, no population based study has been conducted in Qatar to estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) among Qatari population. Hence, this study was undertaken to determine the prevalence of diagnosed and undiagnosed diabetes, pre-diabetes and to identify the associated risk factors in the sample of adult Qatari population.

Section snippets

Subjects and methods

This is a cross-sectional study which was conducted among the adult Qatari population in the age group 20–59 years of age over a period from January 2007 to July 2008. The study was approved by the Hamad Medical Corporation prior to commencing data collection. Each participant was provided with brief information about the study and was assured of strict confidentiality. Of the 1434 subjects who were approached to participate in the study, 1117 (77.9%) gave their consent. Only participants who

Results

Table 1 shows the socio-demographic characteristics of diabetic and non-diabetic studied subjects. The mean ± SD age of diabetic versus non-diabetic subjects was (44.4 ± 9.4 and 38.9 ± 9.5 respectively; p < 0.001). The proportion of diagnosed diabetic subjects was particularly high in the age group 50–59 (32.8%), followed by 40–49 (31.2%), then 30–39 (30.1%). The proportion of DM was higher in Qatari women (53.2%) than in Qatari men (46.8%). There was a significant association between diabetic and

Discussion

Diabetes mellitus is a major public health problem, causing significant morbidity and mortality. The present study provides the first representative; population based estimates of the prevalence of diagnosed and undiagnosed diabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) among adult Qatari population. It was reported that the Asia pacific region is considered to be on the verge of an emerging diabetes epidemic [9]. The overall prevalence of diabetes mellitus was

Limitations

As the recruitment of subjects is from primary health care centres, there may be a possibility that this sample is biased. They were more likely to be an unwell subset of the population because they were seeking medical attention. Therefore, the selected subjects may not be a totally representative sample.

Conclusion

The present study has found a moderately high prevalence of diabetes mellitus in the adult Qatari population. The age-specific prevalence of known and new diabetes mellitus increased progressively with age. The substantial proportion of diabetic patients unaware of having DM shows that the awareness and the screening program in our population is not efficient to detect this silent killer. High proportion of pre-diabetes in Qatari adults will increase the prevalence of DM in the future. This

Conflict of interest

The authors state that they have no conflict of interest.

Acknowledgements

The project was supported and funded by the Diabetic Association and Qatar Foundation for generous support and help while this project conducted. We also, would like to thank Hamad Medical Corporation for their approval this study (HMC Research Protocol Nos. 275 and 325).

References (26)

  • H. Saadi et al.

    Prevalence of diabetes mellitus and its complications in a population-based sample in Al Ain, UAE

    Diab. Res. Clin. Pract.

    (2007)
  • A. Sekikawa et al.

    Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in a rural area of Japan, The Funagata Diabetes Study

    J. Diabetes Complications

    (2000)
  • World Health Organization, the prevention of diabetes and its complications, WHO Report, 2006, Available from...
  • H. King et al.

    Global burden of diabetes 1995–2025: prevalence, numerical estimates and projections

    Diabetes Care

    (1998)
  • D. Yach et al.

    Epidemiology and economic consequences of the global epidemics of obesity and diabetes

    Nat. Med.

    (2006)
  • H.L. Shi et al.

    Prevalence of DM and associated risk factors in an adult urban population in Shangai

    Diabetes Metab.

    (1998)
  • S. Wild et al.

    Global prevalence of diabetes: estimates for the year 2000 and projection for 2030

    Diabetes Care

    (2004)
  • L.V. Franse et al.

    Type 2 diabetes in older well-functioning people: who is undiagnosed? Data from the Health, Aging and Body composition study

    Diabetes Care

    (2001)
  • K.G. Alberti et al.

    Metabolic syndrome—a new world-wide definition: a consensus statement from the International Diabetes Federation

    Diabetes Med.

    (2006)
  • World Health Organization, Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications, Report...
  • A.F. Amos et al.

    The rising global burden of diabetes and its complications: estimates and projections to the year 2010

    Diabetes Med.

    (1997)
  • J.A. Al-Lawati et al.

    Increasing prevalence of DM in Oman

    Diabetes Med.

    (2002)
  • R.R. Hamdeh

    Non-communicable diseases among the Bahraini population: a review

    East Mediterr. Health J.

    (2000)
  • Cited by (139)

    View all citing articles on Scopus
    View full text