Prevalence of diabetes mellitus and its complications in a population-based sample in Al Ain, United Arab Emirates
Introduction
Health problems associated with diabetes mellitus (DM) are a growing source of concern in the United Arab Emirates (UAE). First established as a nation in 1971, the UAE has progressed rapidly from a subsistence agrarian economy emphasizing animal husbandry and date production to a diversified economy producing oil and oil based products, commerce and tourism. These rapid changes had an enormous impact on the UAE society such as improved education and rising affluence. This has been associated with decreased levels of activity and increasing consumption of calories leading to obesity and associated high rates of type 2 DM in this population [1], [2], [3], [4]. A prevalence survey, performed in 1989–1990 on adults in the UAE [1] found an overall prevalence of DM of 6%. A more recent survey (1999–2000) suggests a much higher prevalence of over 20% [2] making the prevalence of DM in the UAE the second highest in the world after Narau [5].
We are not aware of any more recent surveys on the prevalence of DM in the UAE. Our objectives were to determine the current prevalence of DM in a sample of UAE citizens residing in the city of Al Ain and survey complications in subjects with diagnosed and undiagnosed DM. We also wanted to assess the degree of metabolic control in subjects with diagnosed DM. This study may provide important information for planning of services and determining the effectiveness of population-based interventions.
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Sampling
The study was designed to enroll 100 subjects with DM (diagnosed and undiagnosed) in order to be able to estimate the prevalence of any complication that occurs in 50% of subjects with DM with accuracy (coefficient of variation) of 10%, i.e. with a standard error of 0.05. On the basis of previous studies, showing a prevalence rate of DM in the adult population of 25% [2], we estimated a required total sample size of 400 subjects.
In order to draw a random sample from the population of UAE
Prevalence of diabetes
Of the 575 houses surveyed between December 2005 and November 2006, 452 were occupied and household heads provided information. There were 2455 adults living in these houses and DM status was available on 2396 (1176 men and 1220 women), out of which 245 (10.2%) subjects (9.4% of men and 11.1% of women) were reported to have DM (Table 1). Using the 30–64 years olds only, as suggested by King and Rewers [16], we obtained Segi standardized prevalence rate of reported diabetes of 20.6% (17.7% in
Discussion
We found that the prevalence of known DM in this random sample of UAE citizens living in Al Ain was 10.2%. This rate is very similar to the rate of 10.4% reported by a survey of health status conducted in the Emirate of Abu Dhabi in 2001 [3]. We also found that almost one-third of parous women had history of gestational DM, consistent with previous finding [17]. In subjects who underwent testing, the age-standardized rates for DM (diagnosed and undiagnosed) and pre-diabetes were 29.0 and 24.2%,
Conclusion
Our results confirm the previously reported high prevalence of diabetes in the UAE. Micro- and macro-vascular complications were highly prevalent among patients with diagnosed DM and a significant proportion of subjects had these complications at the time of first diagnosis. Metabolic control was suboptimal in most subjects with diagnosed DM. Greater efforts are urgently needed to properly screen and diagnose DM early in order to prevent long-term complications. Patient-education,
Acknowledgments
We are grateful for Drs. Tariq Jabir and Latifa Al Ketbi from Primary Health Care for their support of this study, Mrs. Hala Shehouri for data collection, Mr. Awad Al Essa for data entry and Ms. Lina Sejaan and Mr. Javed Yasin for their technical assistance.
Supported by a research grant from UAE University and UAE Red Crescent.
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