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