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Objective This study aimed to report on the trends in incidence and prevalence rates of diabetes mellitus in Saudi Arabia over the last 25 years (1990–2015). Design A descriptive review. Methods A systematic search was conducted for English-language, peer reviewed publications of any research design via Medline, EBSCO, PubMed and Scopus from 1990 to 2015. Of 106 articles retrieved, after removal of duplicates and quality appraisal, 8 studies were included in the review and synthesised based on study characteristics, design and findings. Findings Studies originated from Saudi Arabia and applied a variety of research designs and tools to diagnosis diabetes. Of the 8 included studies; three reported type 1 diabetes and five on type 2 diabetes. Overall, findings indicated that the incidence and prevalence rate of diabetes is rising particularly among females, older children/adolescent and in urban areas. Conclusion Further development are required to assess the health intervention, polices, guidelines, self-management programs in Saudi Arabia.
Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An
Abdulellah Alotaibi
, Lin Perry
, Leila Gholizadeh
, Ali Al-Ganmi
Faculty of Applied Medical Science, Shaqra University, Saudi Arabia
Faculty of Health, University of Technology Sydney (UTS), Australia
South Eastern Sydney Local Health District, Australia
Faculty of Health, University of Baghdad, Iraq
article info
Article history:
Received 20 May 2017
Received in revised form 26 July 2017
Accepted 2 October 2017
Available online 7 October 2017
Diabetes mellitus
Saudi Arabia
Objective: This study aimed to report on the trends in incidence and prevalence rates of diabetes mellitus
in Saudi Arabia over the last 25 years (1990–2015).
Design: A descriptive review.
Methods: A systematic search was conducted for English-language, peer reviewed publications of any
research design via Medline, EBSCO, PubMed and Scopus from 1990 to 2015. Of 106 articles retrieved,
after removal of duplicates and quality appraisal, 8 studies were included in the review and synthesised
based on study characteristics, design and findings.
Findings: Studies originated from Saudi Arabia and applied a variety of research designs and tools to
diagnosis diabetes. Of the 8 included studies; three reported type 1 diabetes and five on type 2 diabetes.
Overall, findings indicated that the incidence and prevalence rate of diabetes is rising particularly among
females, older children/adolescent and in urban areas.
Conclusion: Further development are required to assess the health intervention, polices, guidelines, self-
management programs in Saudi Arabia.
Ó2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. This is an open access article under the
CC BY-NC-ND license (
1. Introduction . . . ...................................................................................................... 212
2. Methods . . . . . . ...................................................................................................... 212
2.1. Review design . . . . . . . . . .......................... ............................................................... 212
2.2. Search strategy . . . . . . . . ................................ ......................................................... 212
2.3. Quality appraisal . . . . . . . ................................................................ ......................... 212
2.4. Data extraction . . . . . . . . .................... ..................................................................... 213
2.5. Data synthesis . . . . . . . . . ...................................................... ................................... 213
3. Findings . . . . . . ...................................................................................................... 213
3.1. Type 1 diabetes . . . . . . . . ...................................................... ................................... 213
3.2. Type 2 diabetes . . . . . . . . ...................................................... ................................... 214
4. Discussion. . . . . ...................................................................................................... 216
4.1. Limitations of this review ................ ......................................................................... 217
5. Conclusion . . . . ...................................................................................................... 217
References . . . . ...................................................................................................... 217
2210-6006/Ó2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.
This is an open access article under the CC BY-NC-ND license (
Peer review under responsibility of Ministry of Health, Saudi Arabia.
Corresponding author at: Faculty of Health, University of Technology Sydney (UTS), Australia.
E-mail addresses:, (A. Alotaibi), (L. Perry),
(L. Gholizadeh), (A. Al-Ganmi).
Journal of Epidemiology and Global Health 7 (2017) 211–218
Contents lists available at ScienceDirect
Journal of Epidemiology and Global Health
journal homepage:
1. Introduction
Diabetes Mellitus (DM) is a growing global health concern. In
2000, diabetes affected an estimated 171 million people world-
wide; by 2011 this had increased to more than 366 million and
numbers are expected to exceed 552 million by 2030 [1].DMisa
metabolic disease of multiple aetiologies, characterised by hyper-
glycaemia resulting from defects in insulin secretion, insulin action
or both, and associated with disturbance of carbohydrate, fat and
protein metabolism [2]. The three commonest types of diabetes
are Type 1 Diabetes Mellitus (T1DM), Type 2 Diabetes Mellitus
(T2DM) and Gestational Diabetes Mellitus (GDM) [3].
The highest prevalence of diabetes overall is anticipated to
occur in the Middle East and North Africa due to rapid economic
development, urbanisation and changes in lifestyle patterns in
the region [1]. The Kingdom of Saudi Arabia (KSA) is not excluded
from this global epidemic [4] and diabetes is the most challenging
health problem facing this country [5]. According to a report by the
Saudi Arabian Ministry of Health, approximately 0.9 million people
were diagnosed with diabetes in 1992, but this figure rose to 2.5
million people in 2010, representing a 2.7 times increase in the
incidence rates in less than two decades. In 2015, 4660 patients
with diabetes attended the family and medical clinics across Saudi
Arabia [6]. This increasing burden of diabetes is due to various fac-
tors, including a rising obesity rate and an aging population [7].
Patients with diabetes commonly experience other associated
chronic conditions, resulting in serious complications [3]. For
example, the incidence of end stage renal disease is higher among
patients with diabetes [8] and accounts for between 24% and 51%
of those receiving renal replacement therapy [9]. Compared to
the general population, patients with diabetes are two to four
times more likely to develop cardiovascular disease, and two to
five times more likely to die from this disease [10]. In addition to
its impact on individuals, diabetes places a significant burden on
healthcare services and the community as a whole [11]. Globally,
diabetes accounted for 11% of the total healthcare expenditure in
2011; in Saudi Arabia, the annual cost of diabetes has been esti-
mated at more than $0.87 billion [12].
It is essential to understand the epidemiology of diabetes in
order to identify public health priorities, to generate policy initia-
tives and evaluate the effect of services in reducing the individual
and social burden of diabetes [13]. Although prevalence estimates
by countries and regions are provided by the International Dia-
betes Federation, there are substantial variations in time trends
as these estimates are based on imputation [14]. To date, no sys-
tematic review has been reported on the incidence and prevalence
of diabetes in Saudi Arabia. Considering the major socio-economic
changes that have occurred in this country during the past few
decades, and their marked impact on the lifestyles, eating habits
and physical activities of the people of this region, along with the
aging of the population, this is an important omission [12]. This
review has therefore been conducted to report the trends in inci-
dence and prevalence rates of diabetes mellitus in Saudi Arabia
between 1990 and 2015.
2. Methods
2.1. Review design
This review employed a descriptive design to review and anal-
yse studies reporting the incidence and prevalence rates of dia-
betes in Saudi Arabia. This approach is also referred to as
correlational or observational design and is commonly used to
obtain information about naturally occurring health states [15].
This descriptive study followed the Joanna Briggs Institute (JBI)
(2014) protocol for the review of prevalence and incidence studies,
including search strategy, quality appraisal, data extraction and
synthesis, results, discussion and conclusion.
2.2. Search strategy
A systematic literature search was performed to identify publi-
cations reporting the incidence and prevalence rates of diabetes in
Saudi Arabia. Included publications focused specifically on studies
describing the incidence and prevalence rates in relation to either a
diagnosis of diabetes, or explicit blood glucose-level criteria for
diagnosis of diabetes. Studies considering type 1 or type 2 diabetes,
or both, were included as these account for over 90% of all diabetes
[16]. Medical Subject Heading terms (MeSH) were used, including
prevalence, incidence, diabetes mellitus, and Saudi Arabia. Syno-
nyms for the identified concepts were generated including, ‘‘epi-
demiology” and ‘‘trend”; ‘‘type 1 diabetes” and ‘‘type 2 diabetes”.
These concepts were combined using Boolean Operators (AND,
OR). Four academic databases (Medline, EBSCO, PubMed and Sco-
pus) were searched for relevant literature. The search was limited
to English language papers published between 1990 and 2015.
Papers published in languages other than English, and publication
types other than primary studies (such as systematic reviews and
meta-analyses, discussion papers, conference abstracts and disser-
tations) were excluded. In total, 106 citations of potential rele-
vance were identified (Table 1). Initial screening of titles and
abstracts revealed that 90% of these retrieved studies did not meet
the review inclusion criteria, with 16 papers retained for full-text
evaluation. Full text screening for relevance resulted in the exclu-
sion of five further papers. Two articles were added from the refer-
ence lists of the reviewed articles and Google scholar.
2.3. Quality appraisal
These 13 articles were critically appraised for quality using the
JBI Critical Appraisal Checklist for studies reporting prevalence
data [15]. All papers were evaluated on the basis of data relevance
and methodological rigor, and papers that met a minimum of five
of the nine criteria (see column headings, Tables 2 and 3) were
included. The process resulted in the exclusion of four papers
(Table 2;Fig. 1). The remaining nine studies employed appropriate
quantitative designs for incidence and prevalence studies (Table 3).
Table 1
Search terms, database and search output.
Search No Search Terms Medline results EBSCO results PubMed results Scopus results Total
S 1 Prevalence or epidemiology or trend 579,280 1,061,711 2,656,747 2,749,216 7,046,954
S 2 Incidence 229851 249,619 2355894 1,014,650 3,850,014
S 3 Diabetes mellitus 495873 258,094 564756 699,008 2,017,731
S 4 Saudi Arabia 9627 59,039 44900 34,024 147,590
S 5 S1and S2 and S3 and S4 with limits: date (1990–2015), Peer Reviewed,
Human, Journal Article and English Language)
12 15 61 18 106
212 A. Alotaibi et al. / Journal of Epidemiology and Global Health 7 (2017) 211–218
2.4. Data extraction
Data were extracted using a specifically designed data extrac-
tion table (Table 4), and examined, compared, discussed and
agreed with all authors. Data were analysed descriptively, compar-
ing and contrasting results across studies, taking into consideration
the differences in date of study, sampling technique and sample
size, age, setting, methods and type of diabetes.
2.5. Data synthesis
Multiple sources of heterogeneity (research region and site,
types of diabetes and age groups) were observed across the
included studies. The heterogeneity was explored qualitatively by
comparing the characteristics of the included studies. Studies were
grouped according to the type of diabetes (Table 5).
3. Findings
Of the nine included studies, two examined incidence rates
[17,18], four reported the prevalence rates of T1DM among chil-
dren and adolescents [19–22], while six studies reported the
prevalence rate of T2DM among adults [19,21–25]. These studies
included only Saudi nationals, with sample sizes ranging from
419 to 45,682. Four studies were conducted nationwide
[20,21,24,25], one study was conducted in Dhahran (Eastern
region) [17]; one recruited across the entire Eastern province
[23], and one each were conducted in Riyadh (Central region)
[19], Jeddah (Western region) [22] and Al-Madina (Western region)
[18]. Four were conducted using random sampling techniques, two
used convenience sampling, one used multistage stratified cluster
sampling and the remaining two did not report the sampling tech-
nique used. The research settings of three studies were tertiary
hospitals [17,18,22], two were set in primary health centres
[19,24], three in households [20,21,25] and one was conducted in
a range of settings including governmental public hospitals and
primary health centres [21,23]. The reported prevalence and inci-
dence rates of diabetes varied widely across different geographical
areas (Tables 4 and 5).
3.1. Type 1 diabetes
Two studies reported the incidence rates of T1DM between
1990 and 2009 in Dhahran, Eastern KSA [17] and in Al Madina,
North West KSA [18]. The samples in these two studies were chil-
dren and adolescents from 0 to 14 years old. The cumulative inci-
dence rates of T1DM among these children and adolescents were
very similar, at 27.52 per 100,000 and 26.7 per 100,000, respec-
tively (Table 4). In the Dhahran study, an increasing trend in child-
hood and adolescence incidence rate of T1DM between 1990 and
2007 was observed (Fig. 2). The incidence rates of T1DM doubled
among children in less than two decades, from 18.05 per 100,000
Table 2
JBI critical appraisal checklist applied for excluded studied reporting incidence and prevalence data.
Author Name/Year Sample was
size was
and the
factors/ subgroups/
identified and
identified using
Abou-Gamel et al.
No No No Unclear Yes Yes Unclear Unclear Unclear
Al-Orf (2012) No Unclear No Unclear Yes Yes Yes No Unclear
Alsenany and Al
Saif (2015)
Yes No No Unclear Yes Unclear Unclear Unclear Yes
Karim et al.,
Yes No Yes No No Unclear Unclear Unclear Unclear
Table 3
JBI critical appraisal checklist applied for included studies reporting incidence and prevalence data.
Sample was
size was
subjects and
the setting
Confounding factors/
differences identified
and accounted?
identified using
et al. [17]
Yes No Yes Yes Yes No Yes Unclear No
et al. [23]
Yes Yes Yes Yes Yes Yes Yes Yes Yes
et al. [19]
Yes Yes Yes Yes Yes Yes Yes Yes Yes
et al. [20]
Yes Yes Yes Yes Yes No Unclear Unclear Unclear
et al. [24]
Yes Yes Yes Yes Yes Yes Yes Yes Unclear
et al. [22]
Yes No Yes Yes Yes Unclear Yes Yes Yes
et al.
Yes Yes Yes Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes Yes Yes Yes
Habeb et al.
No No No Yes Yes Yes Yes Yes Yes
A. Alotaibi et al. / Journal of Epidemiology and Global Health 7 (2017) 211–218 213
children between 1990 and 1998 to 36.99 per 100,000 children
between 1999 and 2007, indicating an average annual increase in
incidence of 16.8% [17]. In Al-Madina, no significant increase was
observed in the overall annual incidence rate between 2004 and
2009 in Al-Madina[18]; children aged 0 to 4 years had an esti-
mated incidence rate of 17.1 per 100,000, while children aged 5
to 9 and 10 to 12 years had incidence rates of 30.9 and 46.5 per
100,000, respectively. Children aged 5 to 9, and 10 to 12 years
had 1.8 and 2.7 times greater risk of developing T1DM than chil-
dren aged 0 to 4 years [18].
A nationwide study reported the prevalence of T1DM among
children and adolescents aged up to 19 years at 109.5 per
100,000 between 2001 and 2007 [20]. The prevalence rate was
highest among adolescents aged 13 to 16 years (at 243 per
100,000) and lowest among children aged 5 to 6 years at 100 per
100,000 [20]. Another nationwide study found the prevalence of
T1DM between ages 13 and 18 years, at (0.46%), higher than
amongst those who aged under 12 years at (0.37%) between 2007
and 2009 [21]. In addition, two studies conducted in Riyadh [19]
and Jeddah [22] found that the prevalence rates of diabetes at
younger ages between 7–17 and 12–19 years respectively, were
higher in female than male populations.
In terms of gender, the incidence of T1DM was significantly
higher among females (at 31.17 per 100,000) than males (at
24.07 per 100,000) in Dhahran, KSA between 1990 and 2007
[17]. In females the highest incidence rate was reported for those
aged 7–11 years and for males similar rates were reported for
those aged 8–12 years [17]. Females had significantly higher inci-
dence rates than males (at 33.0 per 100,000 compared to 22.2
per 100,000 respectively) in Al-Madina between 2004 and 2009
[18]. A nationwide study found that prevalence was higher among
females than males between 2007 and 2009. [21].
The highest prevalence rate (at 126 per 100,000) was recorded
in the central region where the capital city of Riyadh is located and
the environment is mostly urban; the lowest prevalence rate (at 48
per 100,000) was reported in the eastern region of KSA, which is
predominantly rural [20]. Between 2007 and 2009, the majority
(77.2%) of cases of T1DM was documented in urban rather than
rural areas (at 22.7%) [21].
3.2. Type 2 diabetes
Prevalence rates of T2DM were reported in six studies, three of
which were nationwide [21,24,25]. Of the remainder, one study
was conducted in Riyadh [19], one in Jeddah [22] and one in the
Eastern province [23]. All these studies reported prevalence rates
of T2DM in different years between 1995 and 2011 and included
only Saudi nationals aged between 7 and 80 years (Table 4). The
Fig. 1. Flowchart of study selection.
214 A. Alotaibi et al. / Journal of Epidemiology and Global Health 7 (2017) 211–218
studies demonstrated varying prevalence rates in different geo-
graphical regions in the country, ranging from 18.2% (in 2004–
2005) in the study conducted in the Eastern province [23] to
31.6% in 2011 in the study conducted in Riyadh [19], nationwide
prevalence rate increased from 23.7% between 1995 and 2000 to
25.4% between 2007 and 2009 [24,25]. When plotted figuratively,
these six studies indicate a clear trend of overall increasing
prevalence of T2DM with time (Fig. 3). Four studies reported
Table 4
Summary table of included studies.
(Date of
Date of study Sample
Age Type of
Sampling technique Setting (urban /
Incidence /
prevalence per
100,000 or%
Male Female
et al. [17]
1990–2007 438 <15 years T1DM
Not reported Dhahran, Eastern
KSA (urban)
24.07 31.17 27.52
et al. [20]
2001–2007 45, 682 0–19 years T1DM
Multi-stage stratified
random sampling
Nationwide (rural
& urban)
Self-report 56.9 52.6 109.5
Habeb et al.
2004–2009 419 0–12 years T1DM
Not reported Al-Madinah
Self-report 22.2 33.0 27.6
et al. [23]
2004–2005 197,
30 years T2DM
Convenience sampling
(approached participantsin
their workplaces, major
public places, malls and
other venues)
Eastern Province
(urban & rural)
15.9% 18.6% 18.2%
et al. [19]
2011 9, 149 7–80 years T2DM
Cluster random sampling Riyadh (Unknown) FPG
34.7% 28.6% 31.6%
et al. [24]
1995–2000 16, 917 30–70
2 stage, stratified cluster
(urban & rural)
26.2% 21.5 23.7%
et al. [22]
2009 6, 024 12–70
Convenience sampling
(patients attending a
primary care clinic)
Jeddah (King
Fahad Armed
Forces Hospital.)
Self-report 34.1% 27.6% 30.0%
et al.
2007–2009 18, 034 30 years T2DM
Random sampling Nationwide
(urban & rural)
29.1% 21.9% 25.4%
2007–2009 23,523 0– 18
Multistage stratified cluster
(urban & rural)
Type 1 Diabetes Mellitus.
Type 2 Diabetes Mellitus.
Fasting Plasma Glucose.
Capillary Fasting Blood Glucose.
Casual Capillary Blood Glucose.
Table 5
General characteristics of included studies.
Central region East region West region Nationwide
Country regions 1 study 2 study 2 studies 4 studies
Al-Daghri et al. [19] Abduljabbar et al. [17],
Al-Baghli et al. [23]
Habeb et al. [18], Alqurashi et al. [22] Al-Herbish et al. [20], Al-Rubeaan [21],
Al-Nozha et al. [24], Al-Rubeaan et al. [25]
Type of diabetes Type 1 diabetes Type 2 diabetes Both types
4 studies 6 studies 4 studies
Abduljabbar et al. [17] Al-Daghri et al. [19] Al-Daghri et al. [19], Al-Rubeaan [21]
Habeb et al. [18] Al-Rubeaan [21]
Al-Herbish et al. [20] Alqurashi et al. [22] Alqurashi et al. [22], Al-Nozha et al. [24]
Al-Rubeaan [21] Al-Baghli et al. [23]
Al-Nozha et al. [24]
Al-Rubeaan et al. [25]
Age groups Children/ adolescent Adult
4 studies 6 studies
Abduljabbar et al. [17] Al-Daghri et al. [19]
Habeb et al. [18] Al-Rubeaan [21]
Al-Herbish et al. [20] Alqurashi et al. [22]
Al-Rubeaan [21] Al-Baghli et al. [23]
Al-Nozha et al. [24]
Al-Rubeaan et al. [25]
Research setting Tertiary hospital Primary healthcare center (PHCC) Nursing home and households
4 studies 3 studies 3 studies
Abduljabbar et al. [17] Al-Daghri et al. [19] Al-Herbish et al. [20]
Habeb et al. [18] Al-Baghli et al. [23] Al-Rubeaan [21]
Alqurashi et al. [22] Al-Nozha et al. [24] Al-Rubeaan et al. [25]
Al-Baghli et al. [23]
A. Alotaibi et al. / Journal of Epidemiology and Global Health 7 (2017) 211–218 215
significantly higher prevalence rates for T2DM in males than in
females; one regional study from the Eastern province [23] and
two nationwide studies, conducted between 2004 and 2005 [25]
and between 2007 and 2009 [21] reported significantly higher
prevalence rates for T2DM among females than males but these
studies recruited by convenience and multistage stratified cluster
rather than random sampling. Of the studies, which recruited using
probability sampling (and for one of the two studies that used con-
venience sampling), there was an increasing prevalence of T2DM
for both genders between 1995 and 2011, with higher prevalence
rates among males than females (Fig. 3). Furthermore, T2DM was
reportedly more prevalent among people in urban areas (at 25.5%
compared to 19.5%) than in rural areas, and prevalence rates were
highest in the northern region (at 27.9%) and lowest in the south-
ern region (at 18.2%) between 1995 and 2000 [24].
Between 2007 and 2009, prevalence rates amongst those with
monthly incomes less than 4000 Saudi Riyal (SR; approx. 1067
USD) were higher among those in urban areas (27.2%) than those
in rural areas (25.7%) [21]. However, no significant difference
was reported in prevalence rates of urban and rural residents with
monthly incomes of 8000SR (approx.. 2134 USD) and higher [25];
at a certain level of wealth, affluence appears to overcome the
influence of residential area. Other differences noted included the
mean age of diagnosis of the disease, reported as 53.4 years for
females and 57.5 years for males [22]. In geographical terms,
T2DM was most prevalent in the northern regions and least in
the southern regions between 1995 and 2000 [24]. In terms of
socio-demographic characteristics, in the Eastern Province the
prevalence of T2DM was higher in individuals who were widowed
(39.1%), unemployed (31.9%), and uneducated (32.3%) between
2004 and 2005 [23].
4. Discussion
The findings of this review indicate that diabetes mellitus is a
growing health problem in Saudi Arabia. The findings broadly
reflect high incidence rates of T1DM across the country, with rates
rising particularly amongst children. One study conducted in the
western region showed no increase in T1DM for the 5-year period
between 2004 and 2009, but this may be due to the study’s
limitation of including children only up to age 12 years [18]. Other
studies indicate a significant increase in incidence rates of T1DM
amongst groups older than 12 years [17,20]. This review’s findings
concur with and expand on those of a report by the Saudi Arabian
Ministry of Health [17] as well as the latest report of the Interna-
tional Diabetes Federation (2015). The findings are also broadly
consistent with epidemiological studies from several areas of Asia,
Europe and North America, where the annual growth rates for
T1DM have been reported at 4.0%, 3.2% and 5.3% respectively
ote: Adapted from Abduljabbar et .al (2010) [17] and Habeb et .al (2011) [18]
Dhahran (East Region)
Al Madinah (West Region)
Fig. 2. Incidence rate of T1DM between 1990 and 2009 in Saudi Arabia.
ote: Adapted from Al-Daghri et al. [19];Alqurashi et al. [22];Al-Baghli et al. [23]; Al-Nozha et al. [24];
Al-Rubeaan [21]
1995-2000 2004-2005 2007-2009 2009 2011
Fig. 3. Prevalence rate of T2DM between 1995 and 2011 in Saudi Arabia.
216 A. Alotaibi et al. / Journal of Epidemiology and Global Health 7 (2017) 211–218
[26]. The latest report by the International Diabetes Federation
cites 16,100 children aged 0–14 living with T1DM in Saudi Arabia,
with an incidence of 31.4 new cases per 100,000 population [1].
The national incidence rate is higher than the incidence rates in
Dhahran [17] and Al-Medina [18], reported in this review at 27.5
per 100,000 and 26.7 per 100,000, respectively. This implies an
increase in new cases of T1DM in the country. Overall, studies
included in this review recorded a higher incidence of T1DM
among females than males. The International Diabetes Federation
reported that the highest incidence rate of diabetes should be
expected among females rather than males by 2030 [1]. The reason
for this is uncertain; gender differences are often related environ-
ment and culture, whilst genetic factors are generally assumed to
play a major role in the development of T1DM [27].
Contradiction of this reported higher incidence among females,
Cucca et al. [28] found a greater prevalence among males. This
seems to derive from the higher incidence rates of T1DM reported
amongst males of European populations, which is not the case in
non-European countries like Saudi Arabia [29]. Regardless of the
gender distribution, the high rates of T1DM among children in
Saudi Arabia are likely to increase burden on the country’s health-
care systems, as T1DM is implicated in the development of a wide
range of end-organ complications. It has recently has also been
associated with the development of obesity and overweight in
early adulthood [30], which are independent risk factors for health
problems such as cardiovascular disease and cancers. As with
T1DM, a steady rise was also noted in the prevalence rates of
T2DM especially during the years 2004–2005 and up to 2011,
affecting both genders. This finding is widely supported by a num-
ber of research studies conducted in Saudi Arabia and other Ara-
bian countries [31]. An alarming increase from 10.6% in 1989 to
32.1% in 2009 was documented in a systematic study conducted
in Saudi Arabia, although some of those included in the review
were non-Saudis [31]. Increased obesity, the popularity of fast
foods, smoking, and sedentary lifestyles may explain recent
increases in the prevalence of T2DM; the incidence of obesity, for
instance, has been reported to be as high as 75% among females liv-
ing in Saudi Arabia [32]. The higher prevalence of diabetes in urban
rather than rural areas, where lifestyle changes are more promi-
nent, lends support to the link between diabetes and life style risk
factors. However, whilst affluence was clearly influential, so was
poverty, in the Eastern province at least, and at higher incomes
the link with urban living was lost [23].
Prevalence rates of T2DM were found to be higher among males
than females although the age of onset was reported as earlier
among females than males (at 53.4 years and 57.5 years) [22]. This
finding is contrary to a study of Saudi adult patients at a primary
healthcare centre, which reported a higher incidence among
females (58%) than males (42%), but this discrepancy may be
related to the well-recognised greater willingness of females than
males to consult healthcare practitioners. In addition, females are
also reported as more willing than males to adhere to diabetes
daily management (e.g. restricted diet, monitoring blood-glucose,
taking medication and regular foot-care) [33]. These findings call
for prompt attention by the Ministry of Health especially because
the heaviest burden of diabetes (of both type 1 and type 2) is its
potential to progress to serious complications [34]. Awareness
campaigns are viewed as the best option to at least initiate recog-
nition of the need to modify unhealthy lifestyles, but recent cam-
paigns launched in Saudi Arabia have not been successful so far
[31]. Government-supported interventions are required to provide
programs aimed at both preventing the development of diabetes
and promoting self-care and management of the disease. The find-
ings of this review highlight the importance of introducing mea-
sures into the Saudi healthcare system to update the knowledge
and skills of all healthcare professionals involved with diabetes
management to provide high quality diabetes care [31]. This is par-
ticularly important given the knowledge deficits reported in the
nursing workforce both internationally and in Saudi Arabia [35,36].
4.1. Limitations of this review
Several limitations must be noted. First, this review was limited
to T1DM and T2DM; it did not include the prevalence and inci-
dence rates of gestational diabetes mellitus or childhood/adoles-
cent onset of T2DM. Future reviews should consider each of
these types of diabetes. Second, differences in assessment and
diagnosis methods for diabetes have resulted in changed diagnosis
criteria over time and heterogeneous methods and criteria were
observed over time, across regions, and for different types of dia-
betes in the studies, resulting in some lack of statistical precision.
5. Conclusion
This is the first comprehensive review of the incidence and
prevalence rates of T1DM and T2DM in Saudi Arabia. These were
found to be high and rising, particularly among women. Females
had higher incidence rates of T1DM among children and adoles-
cents than males, and older age groups of children and adolescents
had higher incidence rates of T1DM than younger age groups. The
incidence rate of T1DM was higher in the central region of the
country. Greater prevalence of T2DM was reported among those
living in urban than rural areas, but there were socio-economic
as well as geographical predisposing factors. This review recom-
mends that urgent attention is paid to develop, support and imple-
ment health interventions, guidelines and policies nationwide, to
assist in the prevention, diagnosis, management and promotion
of self-management of diabetes. For the future, well-designed epi-
demiological studies are required to allow for more accurate and
regular monitoring of the incidence and prevalence rates of dia-
betes across Saudi Arabia.
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... In men, one million were diabetic, 583,000 were on medication for diabetes, and 230,000 had uncontrolled diabetes. For women, 720,000 were diabetic, 367,000 were on medication, and 167,000 had uncontrolled diabetes [4,5]. ...
... At present, it is considered the most prevalent disease in the KSA [3]. According to a study conducted in the KSA, the overall prevalence of UTIs in diabetic patients was 25.3%, 7.2%, and 41.1% in males and females, respectively [4,5]. The current study employed a representative sample of diabetic patients (Table 1). ...
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Urinary tract infections (UTIs) are one of the most common long-term complications of diabetes mellitus (DM). Additionally, various factors, such as socio-demographics, type of DM, fasting blood glucose, regular diabetes monitoring, comorbid chronic diseases, HbA1c, body mass index (BMI), and duration of DM, are also thought to predispose individuals to developing UTIs more frequently when they have DM. This research aims to evaluate the risk factors for UTIs and their prevalence among people with DM in Saudi Arabia (KSA). This cross-sectional study was conducted among 440 adults with type 1, type 2, and gestational DM. The participants had to be at least 18 years old, of both genders, and had been suffering from DM for any period of time. A self-administered questionnaire was utilized to collect data on demographic characteristics, such as sex, age, height, weight, material state, education level, income, and clinical profiles of DM and UTI. The crude (COR) and adjusted odds ratios (AOR) were calculated using logistic regression in the IBM SPSS software. The incidence of types 1 and 2 DM and gestational diabetes reached 34.1, 60.9, and 5%, respectively. Most of the participants had first-degree relatives with DM (65.9%). UTI was common in 39.3% of participants. A chi-squared statistical analysis revealed that the frequency of UTI varied depending (χ2 = 5.176, P = 0.023) on the type of DM. Burning urination and abdominal pain were the most common symptoms. The CORs for sex, marital status, hypertension, and BMI were significant (P < 0.05) and had values of 2.68 (95% CI = 1.78–4.02), 0.57 (95% CI = 0.36–0.92), 1.97 (95% CI = 1.14–3.43), and 2.83 (95% CI = 1.19–2.99), respectively. According to the adjusted model, only sex influenced the occurrence of UTIs. The AOR for sex was 3.45 (95% CI = 2.08–5.69). Based on this study, the authorities related to the health of DM patients can use its findings to guide awareness programs and clinical preparedness.
... Regarding the incidence of DM, Saudi Arabia is ranked second among gulf countries and seventh in the world, with an estimated 3.4 million of its population suffering from it. The latest estimate has shown that nearly 24.4% of adults in Saudi Arabia suffer from DM [10]. Between 1990 and 2015, the incidence of type 2 diabetes mellitus (T2DM) in Saudi Arabia ranged from 18.5% to 31.6% depending on the region [11]. ...
... Measuring glucose levels in the blood is still one of the best ways to predict who will develop diabetes. Therefore, in the medical field, glucose biosensors have been used to help predict diabetes [10]. Nanoscale materials, such as GNPs, CNTs, magnetic nanoparticles, Pt nanoparticles, quantum dots, and others, affect glucose sensor performance. ...
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Diabetes mellitus is linked to both short-term and long-term health problems. Therefore, its detection at a very basic stage is of utmost importance. Research institutes and medical organizations are increasingly using cost-effective biosensors to monitor human biological processes and provide precise health diagnoses. Biosensors aid in accurate diabetes diagnosis and monitoring for efficient treatment and management. Recent attention to nanotechnology in the fast-evolving area of biosensing has facilitated the advancement of new sensors and sensing processes and improved the performance and sensitivity of current biosensors. Nanotechnology biosensors detect disease and track therapy response. Clinically efficient biosensors are user-friendly, efficient, cheap, and scalable in nanomaterial-based production processes and thus can transform diabetes outcomes. This article is more focused on biosensors and their substantial medical applications. The highlights of the article consist of the different types of biosensing units, the role of biosensors in diabetes, the evolution of glucose sensors, and printed biosensors and biosensing systems. Later on, we were engrossed in the glucose sensors based on biofluids, employing minimally invasive, invasive, and noninvasive technologies to find out the impact of nanotechnology on the biosensors to produce a novel device as a nano-biosensor. In this approach, this article documents major advances in nanotechnology-based biosensors for medical applications, as well as the hurdles they must overcome in clinical practice.
... Statistics show that, as of 2017, the number of people living with type 2 diabetes worldwide has reached a frightening 462 million, accounting for 6.28% of the world's population, and more than one million people lose their lives each year due to diabetes alone, making it the ninth leading cause of death in the world. What is even more worrisome is that scientists predict that the prevalence of type 2 diabetes will continue to rise in the coming years and that the age of death will gradually increase at younger age [62,63]. As a global disease, there is an urgent need for more effective and accessible treatment and prevention options for type 2 diabetes. ...
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Each person’s body is host to a large number and variety of gut microbiota, which has been described as the second genome and plays an important role in the body’s metabolic process and is closely related to health. It is common knowledge that proper physical activity and the right diet structure can keep us healthy, and in recent years, researchers have found that this boost to health may be related to the gut microbiota. Past studies have reported that physical activity and diet can modulate the compositional structure of the gut microbiota and further influence the production of key metabolites of the gut microbiota, which can be an effective way to improve body metabolism and prevent and treat related metabolic diseases. In this review, we outline the role of physical activity and diet in regulating gut microbiota and the key role that gut microbiota plays in improving metabolic disorders. In addition, we highlight the regulation of gut microbiota through appropriate physical exercise and diet to improve body metabolism and prevent metabolic diseases, aiming to promote public health and provide a new approach to treating such diseases.
... 5 In addition, ageing, greater urbanization, genetics, and an obesogenic profile are the primary causes of diabetes. 7 People with a family history of diabetes, for example, have a 25% increased chance of inheriting type 2 diabetes from their parents. 8 Similarly, monozygotic twins are 90% more likely than heterozygotic twins to acquire T2DM later in life. ...
Background: Diabetic foot ulcers (DFUs) are a life-threatening ailment caused by diabetes. Several growth factors, as well as their various combinations, have shown promising effect in aiding diabetic foot ulcer. However, contradictory or paradoxical results are often available, and debates about this issue are ongoing. Therefore, a comprehensive meta-analysis was performed to compare the efficacy and safety of epidermal growth factor (EGF) and placebo in healing diabetic foot ulcers. Methods: The database search included relevant English literature from Cochrane Library, PubMed, Google Scholar, Elsevier, and EMBASE that was published between 2009 and 2021. Inclusion criteria included type 1 and 2 diabetic patients with foot wounds focusing on complete healing rate. Exclusion criteria included combined therapy, non-human studies, reviews, and protocols. To assess the quality of each study, biases regarding random sequence generation, allocation concealment, participant and personnel blinding, outcome assessment blinding and incomplete outcome data were thoroughly identified. Results: Eight randomized control trials comprising 620 patients (337 in EGF group, 283 in placebo group), were included in this meta-analysis. EGF achieved a significantly higher complete healing rate than placebo after four weeks of treatment, with relative risk (RR): 3.04 (0.50, 18.44) and heterogeneity (Chi ² = 6.46, df = 2 (P = 0.04) I ² = 69 %). Notably, the healing frequency in the placebo group was 17%, whereas the healing frequency in the epidermal growth factor group was 34%. Likewise, after eight weeks of treatment, the relative risk and heterogeneity were RR: 2.59 (1.42, 4.72) and (Chi ² =7.92, df= 4 (p= 0.09): I ² = 49%), respectively. Moreover, the risk ratio at 12 weeks was RR: 1.01 (0.42, 2.46), and heterogeneity was (Chi ² =8.55, df= 2 (p= 0.01): I ² = 77%). Conclusions: Our findings indicate that EGF significantly promotes wound healing, and could be recommended as an effective and safe treatment for DFUs.
... In 2010, the prevalence of DM globally was 171 million which is projected to increase by 2030 to 552 million. [1,2] According to the world health organization (WHO), Saudi Arabia is ranked second in the Middle East and seventh in the world in terms of the highest rate of diabetes growth. [3] Locally, 7 million people, which represents 20% of the population, have diabetes, and approximately 3 million have pre-diabetes. ...
Objective: Diabetes mellitus represents a major burden globally and locally. Some diabetic patients may resort to the use of herbal medicine as another approach to control their blood glucose levels. This study aims to assess the prevalence and the perception of diabetic patients toward the usage of herbs in treating diabetes. Methods: A cross‑sectional survey was conducted in a specialized polyclinic of the primary health care center in the National Guard hospital located in Jeddah. The questionnaire was interviewer‑administered and a total of 196 diabetic patients were interviewed. Results: Of 196 patients interviewed, most (59.7%) have used herbs to treat diabetes. Cinnamon, garlic, fenugreek, and moringa were the most common herbs used by diabetic patients. Many herbal users (49.9%) reported that herbs can play a role in decreasing blood glucose levels and (48%) of herbal users prefer the use of herbs over conventional medicine in treating diabetes. Most diabetic patients (37.3%) gained their knowledge about herbs through media and the experiences of other diabetic patients and we found that the reason to use herbs the majority was to reap the benefits of the herbs (48.7%) or because of herbs on controlling diabetes and reducing diabetic complications (30.7%). Conclusion: This study concluded that herbs are commonly used among diabetic patients and the majority of patients perceive herbs as a cofactor in controlling diabetes
... The sample size [13,24] calculated was adjusted (with finite population correction) and estimated to be approximately 400. The response rate was 324 participants (81% response rate), who were subsequently analyzed and included in the study. ...
... Diabetes is an important chronic condition that contributes to more than 1 million deaths per annum and is considered to be the ninth leading cause of mortality [1]. About one-third of diabetes-related deaths affect people younger than 60 years [2]. An unhealthy diet and sedentary lifestyle contribute to increased body mass index (BMI) [3], and people with a high BMI are more likely to develop type 2 diabetes [4] and obstructive sleep apnea (OSA) [5]. ...
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This study aimed to obtain a comprehensive view of the risk of developing diabetes in patients with obstructive sleep apnea (OSA) and to compare this risk between patients receiving continuous positive airway pressure (CPAP) therapy versus upper airway surgery (UAS). We used local and the global-scale federated data research network TriNetX to obtain access to electronic medical records, including those for patients diagnosed with OSA, from health-care organizations (HCOs) worldwide. Using propensity score matching and the score-matched analyses of data for 5 years of follow-up, we found that patients who had undergone UAS had a lower risk of developing diabetes than those who used CPAP (risk ratio 0.415, 95% confidence interval (CI) 0.349–0.493). The risk for newly diagnosed diabetes patients showed a similar pattern (hazard ratio 0.382; 95% CI 0.317–0.459). Both therapies seem to protect against diabetes (Risk 0.081 after UAS vs. 0.195 after CPAP). Analysis of the large data sets collected from HCOs in Europe and globally lead us to conclude that, in patients with OSA, UAS can prevent the development of diabetes better than CPAP. Graphical Abstract
50 days of free access to our article: Diabetes is one of the 21st-century major health concerns, considered the sixth leading cause of death, and expected to rise to more than 642 million people by 2040. Three types of diabetes exist, differing in their etiology: Type 1 (T1DM) and 2 Diabetes Mellitus (T2DM), and Gestational DM. Despite the availability of insulin and oral antidiabetics-based treatments, all types have been associated with acute and chronic complications and undesired side effects derived from drug therapies. Phyto-therapy has attracted many researchers to explore various natural sources to find new compounds for treating the disease. Different phyto-molecules, ranging from polyphenols to alkaloids, have shown potential antidiabetic activity with a lower side effects profile. However, the intrinsic variability of natural sources makes them complex raw materials composed of various molecules with different physicochemical properties, especially in terms of chemical structure, solubility, and stability. Moreover, oral administration is affected by enzymatic digestion and hepatic first-pass metabolism, which limit their bioavailability and thus, their therapeutic effect. In order to solve this issue, phyto-drug delivery systems (phyto-DDS) based on phytosomes, liposomes, polymeric nanoparticles, solid lipid nanoparticles (SLNs), nanocrystals, and self-emulsifying drug delivery systems (SEDDS) have been developed to improve the physicochemical properties of the phytoconstituents and to provide protection in the gastric environment. Therefore, this review presents the phyto-DDS potential to transport phyto-components and successfully contribute to significant pharmacokinetic, bioavailability and therapeutic activity improvement in diabetes treatment.
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Diabetic foot is one of the significant complications of diabetes mellitus, associated with a high risk of morbidity and mortality. Patients' knowledge of, and willingness to practice, good footcare are essential and may decrease these risks. This study was conducted to assess adult diabetic patients' knowledge of footcare and willingness to put their knowledge into practice. A cross‐sectional observational study was conducted on adult diabetic patients in the central area of the Jazan Region using patients' responses to a questionnaire. Descriptive statistics were calculated for study variables, and the Pearson chi‐squared test was used to compare categorical data. A total of 410 diabetic patients were included in this study. The mean age of the participants was 56.7 years. The mean duration of their diabetes mellitus (DM) to date was 9.2 years, and 63% had complications of diabetes. For the questionnaire, 56% of the patients gave incorrect responses to the knowledge of the footcare section and 81% to the willingness to practice footcare section. Highly educated patients have better knowledge and practice of diabetic footcare than those who are less educated (77% vs. 23%, p < 0.05), (37% vs. 20%, p < 0.05), respectively. A statistically significant difference exists between patients with good and poor knowledge scores. This study demonstrates that the knowledge and practice of footcare among DM patients are poor. Therefore, appropriate patient information programs are needed to increase patients' understanding of their illness and how to manage it. The current study investigates diabetic patients' awareness and practice of proper DM footcare, an aspect of DM therapy that has long been overlooked. This study found that DM patients in the central Jazan Region had low awareness and practice of optimal footcare.
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Diabetes mellitus (DM) is a serious global health issue which significantly impacts public health and socioeconomic development. Exploring how the community perceives the causes of deaths and their associated risk factors is crucial for public health. This study combines verbal autopsy (VA) with the Type 2 Diabetes Mellitus (T2DM) register to explore community perceptions of causes of death and associated influential factors in the western region of Saudi Arabia. 302 VA interviews were conducted with relatives or caregivers of deceased who died between 2017 and 2021 based on T2DM medical register from Alnoor Specialist Hospital in Makkah city, Saudi Arabia. Cause-specific mortality fractions (CSMFs) obtained from the VA using the InterVA-5 model were utilized to assess community perception. We used a multivariable logistic regression model to determine factors influencing community perceptions of causes of death. Lin's CCC with 95% CI was used to analyze the concordance for the CSMFs from verbal autopsy causes of death (VACoD) as a presumed reference standard and family-reported causes of death (FRCoD). The outcomes of this study demonstrate a generally broad spectrum of community perceived mortalities, with some critical misconceptions based on the type of death and the deceased's background and characteristics, with an overall CCC of 0.60 (95% CI: 0.20-1.00; p=003). The study findings demonstrate that community perception is weak if the deceased was male compared to female (aOR: 0.52; 95% CI: 0.26 –1.03) and if the deceased was >=80 years compared to 34–59 years (aOR: 0.48; 95% CI: 0.16-1.38), but it significantly improves among married compared to single (aOR: 2.13; 95% CI: 1.02 –4.42). The Saudi community perception of causes of death with reported type 2 diabetes was relatively plausible but varied substantially based on the type of death, sex, age >=80 years, and other vital events like marital status. Higher or lower community perception is attributed to how people may perceive risk factors associated with the causes of death, which can guide public health planning and interventional programs. The study findings further emphasize the need to employ robust and standardized VA methods within the routine medical services for a systemized assessment of families' reported causes of death.
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BACKGROUND AND OBJECTIVES Because there is no recent update on the state of diabetes and its concomitant complications in Saudi Arabia, we undertook a study of the prevalence of health complications in patients with type 2 diabetes mellitus admitted to our institution. METHODS We conducted a retrospective review of medical records of adult Saudi patients with type 2 diabetes who were seen in clinics or admitted to the Security Forces Hospital, Riyadh, Saudi Arabia, between January 1989 and January 2004. RESULTS Of 1952 patients, 943 (48.3%) were males. For the whole study population the mean age at enrollment was 58.4±14.2 years, the mean age at onset of diabetes was 48.1±12.8 years, the mean duration of diabetes was 10.4±7.5 years, and the mean duration of follow-up was 7.9±4.6 years. Nephropathy was the most prevalent complication, occurring in 626 patients (32.1%). Acute coronary syndrome occurred in 451 (23.1%), cataracts in 447 (22.9%), retinopathy in 326 (16.7%), and myocardial infarction in 279 (14.3%), Doubling of serum creatinine was seen in 250 (12.8%) and 79 (4.0%) went into dialysis. Hypertension was present in 1524 (78.1%) and dyslipidemia in 764 (39.1%). Overall mortality was 8.2%. Multiple complications were frequent. Males had higher prevalence of complications than females (P<.05). Mortality was significantly higher in males 92 (9.8%) than females 69 (6.8%) (P=.024). The prevalence of complications significantly increased with duration of diabetes and age (P<.05). CONCLUSION Among Saudis, the prevalence of concomitant diabetic complications is high, with cardiovascular and renal complications the most frequent. Many patients had multiple complications. Early and frequent screenings in the patients with type 2 diabetes are desirable to identify patients at high risk for concomitant complications and to prevent disabilities.
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Diabetes mellitus (DM) is a major public health problem worldwide, and it is a known risk factor for coronary artery disease (CAD). New recommendations for the diagnosis of diabetes have changed the epidemiology of DM. Therefore, we designed this study with the objective to determine the prevalence of DM among Saudis of both sexes, between the ages of 30-70-years in rural as well as urban communities. This work is part of a major national project: Coronary Artery Disease in Saudis study (CADISS) that is designed to look at CAD and its risk factors in Saudi population. This study is a community-based national epidemiological health survey, conducted by examining Saudi subjects in the age group of 30-70-years of selected households over a 5-year period between 1995 and 2000. Data were obtained from history, fasting plasma glucose levels, and body mass index. The data were analyzed to classify individuals as diabetic, impaired fasting glucose and normal, using 1997 American Diabetes Association (ADA) criteria, which was adopted by the World Health Organization (WHO) in 1998, to provide prevalence of DM in the Kingdom of Saudi Arabia (KSA). A total of 17232 Saudi subjects were selected in the study, and 16917 participated (98.2% response rate). Four thousand and four subjects (23.7%), out of 16917 were diagnosed to have DM. Thus, the overall prevalence of DM obtained from this study is 23.7% in KSA. The prevalence in males and females were 26.2% and 21.5% (p<0.00001). The calculated age-adjusted prevalence for Saudi population for the year 2000 is 21.9%. Diabetes mellitus was more prevalent among Saudis living in urban areas of 25.5% compared to rural Saudis of 19.5% (p<0.00001). Despite the readily available access to healthcare facilities in KSA, a large number of diabetics 1116 (27.9%) were unaware of having DM. The overall prevalence of DM in adults in KSA is 23.7%. A national prevention program at community level targeting high risk groups should be implemented sooner to prevent DM. We further recommend a longitudinal study to demonstrate the importance of modifying risk factors for the development of DM and reducing its prevalence in KSA.
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Purpose: To explore how perceptions of self-efficacy, health locus of control and outcome expectancy impact the adherence of adults with type 2 diabetes mellitus in Saudi Arabiato self-care activities. Methods: A descriptive correlation design was used to analyse self-report questionnaires completed by a convenience sample of Arabic-speaking individuals (n = 30) with type 2 diabetes mellitus from King Abdulaziz Medical City in Riyadh. Results: More than half (53%) of participants reported high self-efficacy, and the majority (77%) valued health and believed that effective diabetes management was important. Although the vast majority (93%) of participants believed that their doctor influenced their diabetes management, 90% and 80% also acknowledged themselves and God, respectively, as the health locus of control. Participants who perceived that they or their doctors were in control of their health condition were more likely to adhere to self-care activities, such as follow a specific diet and perform foot care (p
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Background: Accurate estimates of the burden of diabetes are essential for future planning and evaluation of services. In Ireland, there is no diabetes register and prevalence estimates vary. The aim of this review was to systematically identify and review studies reporting the prevalence of diabetes and complications among adults in Ireland between 1998 and 2015 and to examine trends in prevalence over time. Methods: A systematic literature search was carried out using PubMed and Embase. Diabetes prevalence estimates were pooled by random-effects meta-analysis. Poisson regression was carried out using data from four nationally representative studies to calculate prevalence rates of doctor diagnosed diabetes between 1998 and 2015 and was also used to assess whether the rate of doctor diagnosed diabetes changed over time. Results: Fifteen studies (eight diabetes prevalence and seven complication prevalence) were eligible for inclusion. In adults aged 18 years and over, the national prevalence of doctor diagnosed diabetes significantly increased from 2.2 % in 1998 to 5.2 % in 2015 (p trend ≤ 0.001). The prevalence of diabetes complications ranged widely depending on study population and methodology used (6.5-25.2 % retinopathy; 3.2-32.0 % neuropathy; 2.5-5.2 % nephropathy). Conclusions: Between 1998 and 2015, there was a significant increase in the prevalence of doctor diagnosed diabetes among adults in Ireland. Trends in microvascular and macrovascular complications prevalence could not be examined due to heterogeneity between studies and the limited availability of data. Reliable baseline data are needed to monitor improvements in care over time at a national level. A comprehensive national diabetes register is urgently needed in Ireland.
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End-stage renal disease (ESRD) in diabetes is a life threatening complication resulting in a poor prognosis for patients as well as high medical costs. The aims of this systematic review were (1) to evaluate the incidence of ESRD due to all causes and due to diabetic nephropathy in the diabetic population and differences between incidences of ESRD with respect to sex, ethnicity, age and regions, (2) to compare incidence rates in the diabetic and non-diabetic population, and (3) to investigate time trends. The systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in the biomedical databases until January 3rd 2015; thirty-two studies were included. Among patients with incident type 1 diabetes the 30-year cumulative incidence ranged from 3.3% to 7.8%. Among patients with prevalent diabetes, incidence rates of ESRD due to all causes ranged from 132.0 to 167.0 per 100,000 person-years, whereas incidence rates of ESRD due to diabetic nephropathy varied from 38.4 to 804.0 per 100,000 person-years. The incidence of ESRD in the diabetic population was higher compared to the non-diabetic population, and relative risks varied from 6.2 in the white population to 62.0 among Native Americans. The results regarding time trends were inconsistent. The review conducted demonstrates the considerable variation of incidences of ESRD among the diabetic population. Consistent findings included an excess risk when comparing the diabetic to the non-diabetic population and ethnic differences. We recommend that newly designed studies should use standardized methods for the determination of ESRD and population at risk.
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[Purpose] This study analyzed type 2 diabetes and its role in complications among adult Saudi patients. [Subjects] Patients attending four primary health care centers in Jeddah were enrolled. [Methods] A cross-sectional design study among Saudi patients attending Ministry of Health primary health care centers in Jeddah was selected for use by the Primary Health Care administration. Patients were interviewed with structured questionnaires to determine the presence of diabetes and risk factors using questions about the history of any disease. [Results] Diabetes mellitus was present in 234 subjects during the data collection period (March-June 2014). Mean patient age was 58 years; diabetes prevalence was 42% in males and 58% in females. The mean age for diabetes onset in males and females was 34 and 39 years, respectively. There was a higher incidence of obesity (75%) associated with a sedentary lifestyle (body mass index ≥25) in females (N= 96; 40%) compared with males (N= 87; 36%). In this study, >44% of individuals aged 55 or older had severe to uncontrolled diabetes with long-term complications. The age-adjusted incidence of hypertension and coronary heart disease was 38% and 24%, respectively, showing a clear incidence of diabetes associated with cardiovascular disease in Saudi Arabia. [Conclusion] This study found that a multifactorial approach to managing diabetes complication risks is needed.
Background: With the worldwide increase in the incidence and prevalence of diabetes, there has been an increase in the scope and scale of nursing care and education required for patients with diabetes. The high prevalence of diabetes in Saudi Arabia makes this a particular priority for this country. Aim: The aim of this study was to examine nurses' perceived and actual knowledge of diabetes and its care and management in Saudi Arabia. Methods: A convenience sample of 423 nurses working in Prince Sultan Medical Military City in Saudi Arabia was surveyed in this descriptive, cross-sectional study. Perceived knowledge was assessed using the Diabetes Self-Report Tool, while the Diabetes Basic Knowledge Tool was used to assess the actual knowledge of participants. Results: The nurses generally had a positive view of their diabetes knowledge, with a mean score (SD) of 46.9 (6.1) (of maximum 60) for the Diabetes Self-Report Tool. Their actual knowledge scores ranged from 2 to 35 with a mean (SD) score of 25.4 (6.2) (of maximum of 49). Nurses' perceived and actual knowledge of diabetes varied according to their demographic and practice details. Perceived competency, current provision of diabetes care, education level and attendance at any diabetes education programs predicted perceived knowledge; these factors, with gender predicted, with actual diabetes knowledge scores. Conclusion: In this multi-ethnic workforce, findings indicated a significant gap between participants' perceived and actual knowledge. Factors predictive of high levels of knowledge provide pointers to ways to improve diabetes knowledge amongst nurses.
Objective: The aim of this study was to identify, critically appraise and synthesise evidence of nurses' knowledge of diabetes and identify factors that function as barriers to nurses' acquisition of diabetes knowledge. Design: An integrative review Methods: A systematic search was conducted for English-language, peer reviewed publications of any research design via CINAHL, Medline, EMBASE, and Education Research Complete databases from 2004 to 2014. Of 374 articles retrieved, after removal of duplicates and quality appraisal, 25 studies were included in the review and synthesised based on study characteristics, design and findings. Findings: Studies originated from developed and developing countries and applied a variety of research designs and tools to assess nurses' knowledge of diabetes. Assessed aspects of diabetes care included knowledge of diabetes medications (12 studies), nutrition (7), blood glucose monitoring (7), diabetes complications (6), and pathology, symptoms and diabetes management (9). Factors/barriers affecting nurses' acquisition of diabetes knowledge were identified (11). Overall, findings indicated wide-spread serious and sustained deficiencies in nurses' knowledge of diabetes and diabetes care. Conclusion: With nurses demonstrating significant and long-standing knowledge deficits in many aspects of diabetes care, strategies are urgently required to overcome the identified barriers to knowledge acquisition.