Abstract
Background: Diabetes is a growing public health problem in the MENA region with a significant impact on morbidity, mortality, and healthcare resources. Currently, the prevalence of type 2 diabetes (T2D) in the MENA region is estimated at 9.7 %.
Objective: To describe the epidemiology, principal causes, associated risk factors, cultural aspects, and challenges that contribute to the rapid rise in T2D in MENA.
Methods: Review of papers in PubMed and relevant gray literature.
Findings: The International Diabetes Federation (IDF) has identified the MENA region as having the highest prevalence of diabetes in the world. Approximately 37 million people have diabetes and this number is expected to rise dramatically. This increase may be attributed to multiple risk factors, including an increased prevalence of obesity, physical inactivity, and change in dietary patterns. In addition, there are factors unique to MENA that contribute to the diabetes epidemic. These include cultural factors and the increased prevalence of hepatitis C in few countries.
Conclusion: Prevention, early identification, and effective intervention are key components to effective T2D care in MENA. These strategies may reduce the expanding economic burden associated with T2D care.
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References
International Diabetes Federation. IDF diabetes. 7th ed. Brussels: International Diabetes Federation; 2015. http://www.diabetesatlas.org.
NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387(10027):1513–30.
Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY, Al-Harthi SS. Diabetes mellitus in saudi arabia. Saudi Med J. 2004;25:1603–10.
Habeb AM, Al-Magamsi MS, Halabi S, Eid IM, Shalaby S, Bakoush O. High incidence of childhood type 1 diabetes in Al-Madinah, North West Saudi Arabia (2004–2009). Pediatr Diabetes. 2011;12(8):676–81.
Al-rubeaan K. International journal of diabetes mellitus type 2 diabetes mellitus red zone. Int J Diabetes Mellitus. 2010;2:1–2.
Jain S, Saraf S. Type 2 diabetes mellitus—its global prevalence and therapeutic strategies. Diabetes Metab Syndr: Clin Res Rev. 2010;4:48–56.
Whiting DR, Guariguata L, Weil C, et al. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94:311–21.
Wang DD, Bakhotmah BA, Hu FB, Alzahrani HA. Prevalence and correlates of diabetic peripheral neuropathy in a saudi arabic population: a cross-sectional study. PLoS One. 2014;9(9):e106935.
El-Asrar AMA, Al-Rubeaan KA, Al-Amro SA, Kangave D, Moharram OA. Risk factors for diabetic retinopathy among Saudi diabetics. Int Ophthalmol. 1998;22(3):155–61.
Jbour AS, Jarrah NS, Radaideh AM, Shegem NS, Bader IM, Batieha AM, Ajlouni KM. Prevalence and predictors of diabetic foot syndrome in type 2 diabetes mellitus in Jordan. Saudi Med J. 2003;24(7):761–4.
El-Rufaie OE, Bener A, Ali TA, Abuzeid M. Psychiatric morbidity among type II diabetic patients: a controlled primary care survey. Prim Care Psychiatry. 1997;3:189–94.
AlQuaiz AM, Siddiqui AR, Qureshi RH, Fouda MA, AlMuneef MA, Habib FA, Turkistani IM. Women health in Saudi Arabia: a review of non-communicable diseases and their risk factors. Pak J Med Sci. 2014;30(2):422.
EL-Zanaty F, Way A. Egypt demographic and health survey 2008. Cairo: Ministry of Health, El-Zanaty and Associates, and Macro International; 2009. p. 431.
Population Council. http://www.popcouncil.org/uploads/pdfs/2010PGY_SYPEFinalReport_FrontMatter.pdf.
Ibrahim MM, Elamragy AA, Girgis H, et al. Cut off values of waist circumference & associated cardiovascular risk in Egyptians. BMC Cardiovasc Disord. 2011;11:53.
Herman WH, Ali MA, Aubert RE, et al. Diabetes mellitus in Egypt: risk factors and prevalence. Diabet Med. 1995;12(12):1126–31.
Mirmiran P, Sherafat-Kazemzadeh R, Jalali-Farahani S, Azizi F. Childhood obesity in the Middle East: a review/Revue sur l’obésité de l’enfant au Moyen-Orient. East Mediterr Health J. 2010;16(9):1009.
Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI, Qahwaji DM, Musaiger AO. Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr Phys Act. 2011;8(1):140.
Zadjali F, Al-Yahyaee S, Hassan MO, Albarwani S, Bayoumi RA. Association of adiponectin promoter variants with traits and clusters of metabolic syndrome in Arabs: family-based study. Gene. 2013;527(2):663–9.
Alkhateeb A, Al-Azzam S, Zyadine R, Abuarqoub D. Genetic association of adiponectin with type 2 diabetes in Jordanian Arab population. Gene. 2013;512(1):61–3.
Mtiraoui N, Ezzidi I, Turki A, Chaieb A, Mahjoub T, Almawi WY. Single-nucleotide polymorphisms and haplotypes in the adiponectin gene contribute to the genetic risk for type 2 diabetes in Tunisian Arabs. Diabetes Res Clin Pract. 2012;97(2):290–7.
Nemr R, Almawi AW, Echtay A, Sater MS, Daher HS, Almawi WY. Replication study of common variants in CDKAL1 and CDKN2A/2B genes associated with type 2 diabetes in Lebanese Arab population. Diabetes Res Clin Pract. 2012;95(2):e37–40.
Nemr R, Echtay A, Dashti EA, Almawi AW, Al-Busaidi AS, Keleshian SH, Irani-Hakime N, Almawi WY. Strong association of common variants in the IGF2BP2 gene with type 2 diabetes in Lebanese Arabs. Diabetes Res Clin Pract. 2012;96(2):225–9.
Al-Nozha MM, Al-Hazzaa HM, Arafah MR, Al-Khadra A, Al-Mazrou YY, Al-Maatouq MA, Khan NB, Al-Marzouki K, Al-Harthi SS, Abdullah M, Al-Shahid MS. Prevalence of physical activity and inactivity among Saudis aged 30–70 years. A population-based cross-sectional study. Saudi Med J. 2007;28(4):559–68.
Miller FD, Abu-Raddad LJ. Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt. Proc Natl Acad Sci U S A. 2010;107:14757–62.
Chehadeh W, Abdella N, Ben-Nakhi A, et al. Risk factors for the development of diabetes mellitus in chronic hepatitis C virus genotype 4 infection. J Gastroenterol Hepatol. 2009;24:42–8.
Chehadeh W, Kurien SS, Abdella N, et al. Hepatitis C virus infection in a population with high incidence of type 2 diabetes: impact on diabetes complications. J Infect Public Health. 2011;4:200–6.
Greca LF, Pinto LC, Rados DR, et al. Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection. Braz J Med Biol Res Rev Bras Pesqui Méd Biol Soc Bras BiofÃs … [et al]. 2012;45:284–90.
Huang JF, Yu ML, Huang CF, et al. The outcomes of glucose abnormalities in pre-diabetic chronic hepatitis C patients receiving peginterferon plus ribavirin therapy. Liver Int. 2012;32:962–9.
FAO/RNEA. Report of the workshop on implementation of the International Code of Conduct on the distribution and use of pesticides in the Near East, 16–21 Sept 1995, Cairo; 1995.
WRI. Pesticides and the immune system: the public health risks. Washington, DC: World Resources Institute; 1996.
Ambio O. Pesticide use, habits and health awareness among Egyptian farmers. Ann Occup Hyg. 1996;40(5):499–509.
Wessels D, Barr DB, Mendola P. Use of biomarkers to indicate exposure of children to organophosphate pesticides: implications for a longitudinal study of children’s environmental health. Environ Health Perspect. 2003;111(16):1939–46.
Mansour SA. Pesticide exposure—Egyptian scene. Toxicology. 2004;198(1–3):91–115.
El-Sebae AH, Zeid MA, Saleh MA. Status and environmental impact of toxaphene in the third world—a case study of African agriculture. Chemosphere. 1993;27(10):2063–72.
Raafat N, Abass MA, Salem HM. Malathion exposure and insulin resistance among a group of farmers in Al-Sharkia governorate. Clin Biochem. 2012;45:1591–5.
Lee DH, Steffes MW, Sjödin A, et al. Low dose organochlorine pesticides and polychlorinated biphenyls predict obesity, dyslipidemia, and insulin resistance among people free of diabetes. PLoS One. 2011;6(1), e15977.
Brunner EJ, Mosdøl A, Witte DR, Martikainen P, Stafford M, Shipley MJ, Marmot MG. Dietary patterns and 15-y risks of major coronary events, diabetes, and mortality. Am J Clin Nutr. 2008;87(5):1414–21.
Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012;344:e1454.
Fields J, Trivedi NJ, Horton E, et al. Vitamin D in the Persian Gulf: integrative physiology and socioeconomic factors. Curr Osteoporos Rep. 2011;9:243–50.
Musaiger AO. Overweight and obesity in the Arab countries: the need for action. Arab Cent Nutr. 2007;1:1–8.
Musaiger AO, Al-Ansari MS. Barriers to practicing physical activity in the Arab countries, in nutrition and physical activity in the arab countries of the near east. Musaiger AO and Meladi SS, (eds). FAO/Cairo Regional Office, Cairo, Egypt. 2000.
Khattab A, Javaid A, Iraqi G, Alzaabi A, Kheder AB, Koniski ML, Shahrour N, Taright S, Idrees M, Polatli M, Rashid N, El Hasnaoui A, BREATHE Study Group. Smoking habits in the Middle East and North Africa: results of the BREATHE study. Respir Med. 2012;106:S16–24.
Al-Maskari F, El-Sadig M, Al-Kaabi JM, Afandi B, Nagelkerke N, Yeatts KB. Knowledge, attitude and practices of diabetic patients in the United Arab Emirates. PLoS One. 2013;8(1):e52857.
Koura MR, Khairy AE, Abdel-Aal NM, et al. The role of primary health care in patient education for diabetes control. J Egypt Public Health Assoc. 2001;76(0013-2446 (Print)):241–64.
Shams ME, Barakat EA. Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt. Saudi Pharm J. 2010;18(4):225–32.
Al-Ahmadi H, Roland M. Quality of primary health care in Saudi Arabia: a comprehensive review. International J Qual Health Care. 2005;17(4):331.
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393.
Hajat C, Harrison O, Al Siksek Z. Diagnostic testing for diabetes using HbA1c in the Abu Dhabi population Weqaya: the Abu Dhabi cardiovascular screening program. Diabetes Care. 2011;34(11):2400–2.
Al-Lawati JA, Tuomilehto J. Diabetes risk score in Oman: a tool to identify prevalent type 2 diabetes among Arabs of the Middle East. Diabetes Res Clin Pract. 2007;77(3):438–44.
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Khan, Y., Hamdy, O. (2017). Type 2 Diabetes in the Middle East and North Africa (MENA). In: Dagogo-Jack, S. (eds) Diabetes Mellitus in Developing Countries and Underserved Communities. Springer, Cham. https://doi.org/10.1007/978-3-319-41559-8_4
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DOI: https://doi.org/10.1007/978-3-319-41559-8_4
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