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The rising burden of type 2 diabetes is a major concern in healthcare worldwide. This research aimed to analyze the global epidemiology of type 2 diabetes. We analyzed the incidence, prevalence, and burden of suffering of diabetes mellitus based on epidemiological data from the Global Burden of Disease (GBD) current dataset from the Institute of Health Metrics, Seattle. Global and regional trends from 1990 to 2017 of type 2 diabetes for all ages were compiled. Forecast estimates were obtained using the SPSS Time Series Modeler. In 2017, approximately 462 million individuals were affected by type 2 diabetes corresponding to 6.28% of the world’s population (4.4% of those aged 15–49 years, 15% of those aged 50–69, and 22% of those aged 70+), or a prevalence rate of 6059 cases per 100,000. Over 1 million deaths per year can be attributed to diabetes alone, making it the ninth leading cause of mortality. The burden of diabetes mellitus is rising globally, and at a much faster rate in developed regions, such as Western Europe. The gender distribution is equal, and the incidence peaks at around 55 years of age. Global prevalence of type 2 diabetes is projected to increase to 7079 individuals per 100,000 by 2030, reflecting a continued rise across all regions of the world. There are concerning trends of rising prevalence in lower-income countries. Urgent public health and clinical preventive measures are warranted.
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Journal of Epidemiology and Global Health
Vol . 0(0); Month (2019), pp. 0–0
DOI: https://doi.org/10.2991/jegh.k.191028.001; ISSN 2210-6006; eISSN 2210-6014
https://www.atlantis-press.com/journals/jegh
Research Article
Epidemiology of Type 2 Diabetes – Global Burden of
Disease and Forecasted Trends
Moien AB Khan1, Muhammad Jawad Hashim1,*, Jeff King1, Romona Devi Govender1, Halla Mustafa1, Juma Al Kaabi2
1Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
2Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
1. INTRODUCTION
Type 2 diabetes is recognized as a serious public health concern
with a considerable impact on human life and health expenditures.
Rapid economic development and urbanization have led to a rising
burden of diabetes in many parts of the world [1]. Diabetes affects
individuals’ functional capacities and quality of life, leading to sig-
nificant morbidity and premature mortality [2]. Recently, concerns
have been raised that more than one-third of the diabetes-related
deaths occur in people under the age of 60 [3]. Increased consump-
tion of unhealthy diets and sedentary lifestyles, resulting in high
Body Mass Index (BMI) and high fasting plasma glucose, have been
blamed for these trends [4]. In particular, persons with higher BMI
are more likely to have type 2 diabetes [5]. The aging of the human
population is another contributor, as diabetes tends to affect older
individuals [6]. The cost of diabetes care is at least 3.2 times greater
than the average per capita healthcare expenditure, rising to 9.4
times in presence of complications [7]. Control of blood glucose,
blood pressure, and other targets remains suboptimal for many
patients [8]. This has been partly attributed to the lack of awareness
and health promotion needed for diabetes control [9].
Unfortunately, the global epidemiology of diabetes has not been
re-evaluated since the availability of recent high-quality data [10].
We found no studies providing global forecasts for the intermediate
future, which would be a critical piece of information for health
policymakers.
This research project examines the latest dataset of the Global
Burden of Disease (GBD) to assess the burden of type 2 diabetes
worldwide. The aim is to study the current global epidemiology
of diabetes and highlight the current distribution of disease and
emerging epidemiologic trends.
2. MATERIALS AND METHODS
We analyzed descriptive epidemiological data from the GBD data-
set managed by the Institute of Health Metrics and Evaluation at
the University of Washington, Seattle [11]. The GBD dataset is
actively maintained and updated based on research data, epide-
miology studies, and governmental publications from more than
100,000 sources. As a systematic public health project, it carefully
builds models and statistical estimates for health loss due to illness,
injury, and risk factors based on empirical data. GBD produces
annual estimates of disease measures, such as prevalence, inci-
dence, deaths, and Disability-Adjusted Life Years (DALYs). DALYs
combine years of life lost due to premature death and years lived
with disability, and are a more accurate reflection of human suf-
fering resulting from a disease than prevalence or mortality alone.
ARTICLE INFO
Article History
Received 26 June 2019
Accepted 27 October 2019
Keywords
Diabetes mellitus type 2
epidemiology
disease pattern
prevalence
ABSTRACT
e rising burden of type 2 diabetes is a major concern in healthcare worldwide. is research aimed to analyze the global
epidemiology of type 2 diabetes. We analyzed the incidence, prevalence, and burden of suering of diabetes mellitus based on
epidemiological data from the Global Burden of Disease (GBD) current dataset from the Institute of Health Metrics, Seattle.
Global and regional trends from 1990 to 2017 of type 2 diabetes for all ages were compiled. Forecast estimates were obtained using
the SPSS Time Series Modeler. In 2017, approximately 462 million individuals were aected by type 2 diabetes corresponding
to 6.28% of the world’s population (4.4% of those aged 15–49 years, 15% of those aged 50–69, and 22% of those aged 70+), or a
prevalence rate of 6059 cases per 100,000. Over 1 million deaths per year can be attributed to diabetes alone, making it the ninth
leading cause of mortality. e burden of diabetes mellitus is rising globally, and at a much faster rate in developed regions, such
as Western Europe. e gender distribution is equal, although the incidence peaks at around 55 years of age. Global diabetes
prevalence is projected to increase to 7079 individuals per 100,000 by 2030. e burden of type 2 diabetes continues to rise
globally and in all regions of the world. ere are concerning trends of rising prevalence in lower-income countries. Urgent
public health and clinical preventive measures are warranted.
© 2019 Atlantis Press International B.V.
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
*Corresponding author. Email: jhashim@uaeu.ac.ae
In Press, Uncorrected Proof
2 M.AB. Khan et al. / Journal of Epidemiology and Global Health. In Press
We used the latest data refresh from GBD (the 2017 update). This
dataset includes annual figures from 1990 to 2017 for type 2 dia-
betes in all countries and regions. We selected four world regions
(Asia, Europe, America, and Africa) instead of other classification
schemes based on economic development. All data were directly
retrieved from GBD without any adjustments. Estimates were not
age adjusted for differences in underlying population age distribu-
tions. Thus, the rates for different countries represent the actual
burden on their respective health systems.
2.1. Statistical Data Analysis
Forecasting was conducted using IBM SPSS version 25 (IBM SPSS
Inc., 2019). The Time Series Modeler was used to develop a forecast
model using the Expert Modeler option without any events. None
of the observed values were marked as outliers.
3. RESULTS
Globally, an estimated 462 million individuals are affected by type 2
diabetes, corresponding to 6.28% of the world’s population (Table 1).
More than 1 million deaths were attributed to this condition in
2017 alone, ranking it as the ninth leading cause of mortality. This
is an alarming rise when compared with 1990, when type 2 diabetes
was ranked as the eighteenth leading cause of deaths. In terms of
human suffering (DALYs), diabetes ranks as the seventh leading
disease.
Tab le 1 | Disease burden of type 2 diabetes, 2017
Region Prevalence
(cases per 100,000)
Burden of suffering
(DALY per 100,000)
Global 6059 751
Europe 8529 842
Germany 9091 820
France 6843 564
Italy 9938 1083
Spain 8796 773
Netherlands 11,344 924
Switzerland 10,040 815
Sweden 10,448 877
Turkey 6483 889
Russia 6865 740
United Kingdom 8663 644
Asia 5961 729
China 6262 635
India 4770 663
Japan 6737 553
South Korea 8835 1044
Taiwan 10,012 1294
Saudi Arabia 7661 623
Iran 7000 851
Australia 5235 593
America 7060 1036
United States 8911 1046
Canada 7095 829
Brazil 4240 780
Africa 3916 537
South Africa 7360 1374
The prevalence of type 2 diabetes shows a distribution pattern that
matches socio-economic development (Figure 1). Developed
regions, such as Western Europe, show considerably higher
prevalence rates that continue to rise despite public health mea-
sures (Figure 2). The rate of increase does not appear to be slow-
ing down.
Remarkably, certain regions, such as Pacific Ocean island nations,
are sustaining the highest prevalence of disease. These countries
include Fiji (20,277 per 100,000), Mauritius (18,545), American
Samoa (18,312), and Kiribati (17,432). Southeast Asian countries,
such as Indonesia, Malaysia, Thailand, and Vietnam, have moved
up the ranks in the last two decades. Owing to their large popula-
tion sizes, China (88.5 million individuals with type 2 diabetes),
India (65.9 million), and the US (28.9 million) retain the top spots
as the countries with the greatest total number of individuals with
this condition.
Males show a slightly higher prevalence than females (6219 com-
pared with 5898 cases per 100,000), although this difference is
within the margin of uncertainty. The age of onset of new diagnosis
is also somewhat earlier among males and shows expected patterns
of rising prevalence with increasing age, whereas the incidence
peaks at 55–59 years (Figure 3). There appears to be no major shift
in the age distribution from 1990 to 2017.
Even though it afflicts individuals later in life, type 2 diabetes ranks
seventh among the leading causes of disability and years of life lost.
It has jumped ranks from nineteenth position in 1990, indicating
a global transition in disease patterns toward noncommunicable
diseases.
Statistical forecasting using a model based on the 1990–2017 data
showed that global diabetes prevalence could increase to 7079 per
100,000 by 2030 and 7862 by 2040. This estimate for 2040 is flanked
by an upper confidence limit of 9904 and a lower limit of 5821
per 100,000.
4. DISCUSSION
This study reports on the current trends in the global burden of
diabetes with emphasis on the burden of human suffering. The
high prevalence of type 2 diabetes worldwide continues to rise, and
there are no signs of it stabilizing. A concerning finding is the rap-
idly rising burden in lower-income countries. These findings have
implications for health policy planners, physicians, healthcare pro-
fessionals, and the public.
The burden of suffering due to diabetes, as measured by DALYs, is
increasing despite significant investment in clinical care and phar-
maceutical research. This increase is in excess of population growth
and aging. Notably, Western Europe has a rate of increase greater
than that of global and Asian averages. Even with the high levels
of clinical and public health expenditure, this region is losing the
battle against diabetes. One explanation might be non-modifiable
risk factors, such as age and family history [12]. However, factors
like a highly processed, calorie-dense western diet and a seden-
tary lifestyle may also be contributing. Developed countries like
Italy and the US endure the highest burdens of human suffering
(DALYs) due to diabetes. Advanced economies in Asia, such as South
Korea and Taiwan, are joining the ranks of these countries, based on
M.AB. Khan et al. / Journal of Epidemiology and Global Health. In Press 3
Figure 1 | Global distribution of diabetes mellitus type 2 prevalence. Note: Colors indicate prevalence rates per 100,000 population in 2017.
Figure 2 | Trends in the prevalence of type 2 diabetes. Note: Forecast
estimates using SPSS Time Series Modeler (Ljung Box Q, p = 0.16). Dotted
lines indicate upper and lower confidence limits.
GBD data. Thus, our findings support the correlation between
diabetes and economic development [13]. We speculate that our
current approach to diabetes management, which focuses on
expensive oral medications and insulin, is not working. Lowering
blood glucose levels is perhaps not sufficient by itself nor effective
in reducing all-cause mortality among these patients.
Prevention of new cases of diabetes appears to be not working
either, based on our findings from global data. Although research
is ongoing to reduce the progression from metabolic syndrome
and prediabetes to diabetes, most interventions being tried seem to
be unsuccessful in affecting the incidence. According to our data,
there is no evidence of a decrease in incidence. Alarmingly high
incidence rates recorded in island nations in the Pacific region are
an indication of the interaction between genetic predisposition and
the effect of rapid nutritional change on these indigenous popula-
tions. Meanwhile, the sheer number of individuals with diabetes
is testing health systems in China, India, and the US to the limit.
Rapid urbanization and its effects on diet and lifestyle has been
implicated [14]. These findings have direct implications for health
systems planning and resource allocation. Clearly, hospital- based
management and subspecialist care are not sustainable strate-
gies. Resource allocation in healthcare budgets for prevention of
diabetes needs to be comparable to expenditures on treatment.
Strengthening of primary care and community restructuring for
active lifestyles and healthy nutrition are perhaps more likely to be
cost effective [15]. Sadly, the rising tide of type 2 diabetes is out-
pacing preventive efforts by a wide margin [16].
The rising incidence of type 2 diabetes at earlier ages warrants
closer attention. Previous clinic-based studies have reported a
high number of young adults being diagnosed with type 2 dia-
betes, most of whom are obese [17]. There appears to be an age
gradient with early-onset type 2 diabetes patients (those younger
than 45) showing more obesity, dyslipidemia, smoking, seden-
tary lifestyles, and low-grade inflammation [18]. In our study,
although the incidence of diabetes in young adults has increased
over the past decades, the rise is across all ages. Thus, there
appears to be no clear indication that the age of onset of type 2
diabetes has shifted to younger age groups. In any case, rising life
expectancy in many countries will lead to a substantially greater
burden of diabetes in the elderly.
The main limitations of our study include reliance on secondary
data, which in turn is affected by the accuracy of measurement,
changes in case definition, and heterogeneity in study designs. Yet
as GBD evolves and matures, its estimation techniques have become
more accurate and reliable. These statistical estimates provide a
more complete and continuous picture of disease epidemiology than
4 M.AB. Khan et al. / Journal of Epidemiology and Global Health. In Press
relying on raw data from isolated studies [11]. Ultimately, the goal
is to guide decision making in clinical care and public health policy.
5. CONCLUSION
Type 2 diabetes continues to increase in prevalence, incidence, and
as a leading cause of human suffering and deaths. Despite signifi-
cant investments in clinical care, research, and public health inter-
ventions, there appears to be no sign of reduction in the rate of
increase. Certain regions of the world, such as Western Europe and
island states in the Pacific, are experiencing a disproportionately
high burden. This epidemic will require an urgent and unwavering
commitment to aggressive solutions at national levels with public
policies, public health funding, and economic incentives for local
communities to start diabetes prevention programs. Healthy eating
options need to be subsidized, and unhealthy foods need to be
taxed or otherwise disincentivized. Healthcare organizations and
individual healthcare providers from multiple disciplines (doctors,
nurses, pharmacists, dieticians, and diabetes educators) must be
given time and resources to collaborate as they educate and care
for individual and groups of patients. Unless urgent measures are
instituted to reduce unhealthy eating, sedentary lifestyles, rapid
urbanization, and other factors related to economic development,
the burden of diabetes is expected to continue rising.
CONFLICTS OF INTEREST
The authors declare they have no conflicts of interest.
AUTHOR CONTRIBUTIONS
M.K. contributed to writing the manuscript including the literature
review. M.J.H. designed the study/basic concept, wrote sections of
the manuscript, analyzed the data, and provided overall supervi-
sion of the study. J.K. wrote parts of the manuscripts, proofread,
and provided insights into the interpretation. R.D.G. revised the
manuscript and provided additional interpretation of results. H.M.
compiled data and wrote the table. J.A.K. revised and proofread the
manuscript and provided additional interpretation of results.
FUNDING
This study did not receive any external grants from government,
private or commercial sources.
ACKNOWLEDGMENT
We would like to thank the Institute of Health Metrics, Seattle for com-
piling global epidemiological statistics and allowing access to data.
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Non-communicable diseases (NCDs) have emerged as a leading global health concern, particularly in low- and middle-income countries This study aims to analyze the effect of demographic and metabolic risk factors, including body mass index (BMI), HbA1c, smoking, and high blood pressure, on the incidence and mortality of cardiovascular diseases (CVDs), metabolic disorders, and cancers. A prospective cohort study was conducted using data from the Iran Cohort Study (ICS), which followed participants from the 2016 STEPs survey. The cohort included 24,818 individuals, with data collected over three years through structured interviews and healthcare records. Statistical analyses were performed to calculate incidence rates, death rates, and rate ratios (RR) for NCDs based on demographic and risk factors. Males exhibited a higher incidence rate of CVDs (RR 1.22, 95% CI 1.05–1.44), while females showed a higher incidence of cancers (males: RR 0.61, 95% CI 0.41–0.89). Individuals with diabetes had a markedly increased incidence rate of CVDs (RR 4.92, 95% CI 3.88–6.24) and metabolic disorders (RR 28.59, 95% CI 13.52–60.43). Hypertension was associated with a heightened incidence rate across all investigated NCDs, while obesity significantly correlated with increased incidences of CVDs (RR 1.92, 95% CI 1.56–2.38) and cancers (RR 1.78, 95% CI 1.13–2.82). Notably, smoking was linked to increased mortality from CVDs (RR 1.63, 95% CI 1.23–2.17). Modifiable risk factors like smoking, high blood pressure, and high BMI, and non-modifiable risk factors like age and sex have significant effect on the burden of NCDs in Iran.
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The rising prevalence of diabetes mellitus (DM) is a serious global health concern. The world is experiencing type 2 diabetes epidemics and prevalence differs by gender, regions, and level of socioeconomic development. Type 2 diabetes mellitus (T2DM) in men increased at a faster rate and numbers are continuing to rise in some regions of the world. This study aimed to estimate the prevalence of T2DM among men in the Middle East countries. Seventy-four research articles were identified through search engines including Web of Science, Medline, PubMed, EMBASE, Scopus, and Ovid databases by using keywords “epidemiology,” “prevalence,” “diabetes mellitus,” and individual names of the Middle East states. Finally, 17 studies were included for the assessment of prevalence of T2DM among men in the Middle East. In the Middle East, high prevalence of T2DM among men was identified in Bahrain (33.60%), Saudi Arabia (29.10%), United Arab Emirates (UAE; 25.83%), and Kuwait (25.40%), whereas low prevalence was reported in Iran (9.90%) and Yemen (9.80%). The random pooled prevalence in the Gulf Cooperation Council (GCC) states was (24.0%) compared to non-GCC states (16.0%), and in both GCC and non-GCC countries combined, it was 19%. The prevalence was significantly associated with the gross domestic product of these states (p = .0005). Despite different socioeconomic and cultural settings in the Middle East, the rising T2DM prevalence among men was identified in Bahrain, Saudi Arabia, UAE, and Kuwait. These states must incorporate future diabetes defensive strategies targeting the Middle East population to minimize the burden of DM from the region.
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This study examined correlations of historical changes in diet and physical inactivity with the rise of noncommunicable diseases (NCDs) in Kenya. Historical data on diet, wage jobs by industry, urbanization, gross domestic product (GDP), and morbidity due to NCDs were extracted from Kenya Statistical Abstracts, Food and Agriculture Organization (FAOSTAT), and the World Bank online database. These data were plotted and correlations between these factors and the incidence of different NCDs over time were evaluated. There was a rapid rise in the incidence of circulatory disease starting in 2001, and of hypertension and diabetes starting in 2008. The rise of these NCDs, especially hypertension and diabetes, was accompanied over the same period by a rise in per capita GDP and physical inactivity (as measured by increased urbanization and declining proportion of agricultural and forestry wage jobs); a rise in per capita supply of rice, wheat and its products, and cooking oils; and a decline in the per capita supply of maize and sugar. In conclusion, the positive correlations between indicators of dietary consumption and physical inactivity and rates of hypertension, circulatory disease, and diabetes suggest that the rapid rise of NCDs in Kenya may be, in part, due to changes in these modifiable factors.
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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.
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Background: Around 20-25 percent of the world's adult populations have the metabolic syndrome and they are twice as likely to die from heart attack or stroke compared with people without the syndrome. The World Health Organization proposed a definition for the metabolic syndrome in 1998 and later on NCEP ATPIII and IDF provided new definitions of this syndrome in 2001 and 2003 respectively. Very few studies have compared the different definitions to diagnose the metabolic syndrome in type two diabetics in India while as for Kashmir valley no such documented study has been carried out till date. Objective: To study the prevalence of metabolic syndrome in type 2 Kashmir diabetics and to find out the degree of agreement between three different criteria given by WHO, NCEPATPIII and IDF for diagnosis of metabolic syndrome. Materials and method: A cross sectional study was conducted in one of the two tertiary care hospitals of Kashmir, India. About 1000 patients were selected and their demographic, clinical and biochemical parameters were studied after obtaining informed consent from each patient. Results: Prevalance of metabolic syndrome was found to be highest(84.5%) while using WHO definition.Kappa statistic between WHO, ATP III and WHO, IDF definitions was 0.697 (95% CI 0.637-0.754) and 0.775 (95%CI 0.72-0.82) respectively while the degree of agreement between IDF and ATP III definitions was highest with kappa of 0.851 (95%CI 0.810-0.889). Conclusion: Our study warrants for interventions to prevent the progression towards this syndrome among type 2 diabetics as early as the diagnosis of diabetes is made.
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Background The prevalence of diabetes has steadily increased in Iran from the time of the first published nationally representative survey in 1999 and despite efforts and strategies to reduce disease burden. Objectives The aim of the present review was to describe the current status of diabetes care in Iran. Methods A selective review of the relevant literature, focusing on properly conducted studies, describing past and present diabetes care strategies, policies, and outcomes in Iran was performed. Findings The quality of diabetes care has gradually improved as suggested by a reduction in the proportion of undiagnosed patients and an increase in affordability of diabetes medications. The National Program for Prevention and Control of Diabetes has proven successful at identifying high-risk individuals, particularly in rural and remote-access areas. Unfortunately, the rising tide of diabetes is outpacing these efforts by a considerable margin. Conclusions Substantial opportunities and challenges in the areas of prevention, diagnosis, and management of diabetes exist in Iran that need to be addressed to further improve the quality of care and clinical outcomes.
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Diabetes mellitus substantially increases cardiovascular disease (CVD) risk. Among Saudi Arabian citizens with diabetes, little is known about the prevalence and control of other CVD risk factors. We extracted data from medical records of a random selection of 422 patients seen between 2008 and 2012 at two diabetic clinics in Riyadh, Saudi Arabia. We calculated the proportion of patients who had additional CVD risk factors: obesity (body mass index⩾30kg/m(2)), hypertension (BP⩾140/90mmHg), elevated cholesterol fractions, and multiple risk factors). Further, we calculated the proportion of patients meeting the American Diabetes Association's recommended care targets for each risk factor. Of 422 patients (mean age, 52years), half were women, 56% were obese, 45% had hypertension, and 77% had elevated LDL concentrations. In addition to diabetes, 70% had two or more CVD risk factors. Although 9% met both target HbA1c and BP values, only 3.5% had optimum HbA1c, BP, and lipid values. In Saudi Arabia's best diabetes clinics, most patients have poor control of their disease. This huge disease burden and related care gaps have important health and financial implications for the country. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
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The present study aims to determine the prevalence of self-reported sleep duration and sleep habits and their associated factors in patients with type 2 diabetes in Trinidad. This was a cross-sectional multicenter study. There were 291 patients with type 2 diabetes studied. Sleep habits were assessed using the Epworth Sleepiness Scale (ESS) and the National Health and Nutrition Examination Survey sleep disorder questionnaire. Demographic, anthropometric and biochemical data were also collected. The sample had a mean age of 58.8years; 66.7% were female. The mean BMI was 28.9kg/m(2). The prevalence of Excessive Daytime Sleepiness (EDS) was 11.3%. The prevalence of patients with short sleep (⩽6h) was 28.5%. The prevalence of patients with poor sleep was 63.9%. Poor sleep was associated with age, intensive anti-diabetic treatment and longer duration of diabetes. Short sleep was associated with intensive anti-diabetic treatment and BMI, while EDS was associated with increased BMI. In a sample of patients with type 2 diabetes, a high prevalence of self-reported sleep duration and unhealthy sleep habits was found. There needs to be an increased awareness of sleep conditions in adults with type 2 diabetes by doctors caring for these patients. Copyright © 2015. Published by Elsevier Ltd.
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Introduction Over 80% of cardiovascular deaths take place in low- and middle-income countries; most of these deaths are due to modifiable risk factors. The study aimed at estimating the prevalence and pattern of major cardiovascular risk factors in both men and women older than 18 years. Methods This is a cross-sectional study of cardiovascular risk factors among semi-urban dwellers in Ekiti State, south-western, Nigeria. 750 participants were drawn from 10 communities. The instrument used was the standard WHO STEPS (II) questionnaire, while blood samples were obtained for analysis. Results There were 750 participants with 529 (70.53%) females. The mean age of participants was 61.7 ± 18.50 years and participants’ ⩾65 years comprised 38.3%. There were 0.8%, 24.9% and 12.4%, who at the time of this study smoked cigarettes, consumed alcohol, and ate a high salt diet, respectively. The prevalence of hypertension, diabetes, generalized and abdominal obesity was 47.2%, 6.8%, 8.5% and 32.0%, respectively, with only 48.9% receiving hypertension treatment. Elevated total cholesterol, LDL-cholesterol, and low HDL was seen in 4.4%, 16.7% and 56.3% respectively. Conclusion High prevalence of cardiovascular risk factors call for an urgent need for more public health attention and reinforcement of primary preventive strategies to curb its menace.
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Aim: To examine the association between early onset of type 2 diabetes (DM) and clinical and behavioural risk factors for later diabetes complications. Methods: We conducted a cross-sectional study of 5115 persons with incident type 2 DM enrolled during 2010-2015 in the Danish Centre for Strategic Research in Type 2 Diabetes-cohort. We compared risk factors at time of diagnosis among those diagnosed at ≤45 years (early-onset) with diagnosis age 46-55, 56-65 (average-onset = reference), 66-75, and >75 years (late-onset). Prevalence ratios (PRs) were computed using Poisson regression. Results: Poor glucose control i.e. HbA1c≥75 mmol/mol (≥9.0%) in the early-, average-, and late-onset groups was observed in 12%, 7%, and 1% respectively [PR 1.70 (95% confidence intervals (CI) 1.27, 2.28) and PR 0.17 (95% CI 0.06, 0.45)]. A similar age gradient was observed for severe obesity [BMI>40 kg/m(2) : 19% vs. 8% vs. 2%; PR 2.41 (95% CI 1.83, 3.18) and 0.21 (95% CI 0.08, 0.57)], dyslipidemia [90% vs. 79% vs. 68%; PR 1.14 (95% CI 1.10, 1.19) and 0.86 (95% CI 0.79, 0.93)], and low-grade inflammation [CRP>3.0 mg/L: 53% vs. 38% vs. 26%; PR 1.41 (95% CI 1.12, 1.78) and 0.68 (95% CI 0.42, 1.11)]. Daily smoking was more frequent and meeting physical activity recommendations less likely in persons with early-onset type 2 DM. Conclusions: We found a clear age-gradient, with increasing prevalence of clinical and behavioural risk factors the younger the onset age of type 2 DM. Younger persons with early-onset type 2 DM need clinical awareness and support.
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Knowledge of diabetes among patients with the disease in the United Arab Emirates is essential for effective self-management. We assessed the level of diabetes-related knowledge among patients and compared it with that found in previous studies in the same city. A cross-sectional study, using an interviewer-administered questionnaire, was conducted at two clinics in Al Ain, United Arab Emirates. The Michigan Diabetes Knowledge Test, translated into Arabic, was used to assess knowledge of diabetes. Of 165 participants with diabetes, 130 (78.8%) were women. The mean knowledge score was low at 55% (6.6 out of a maximum possible score of 12, standard deviation 1.8). This is comparable to levels found in previous studies: 55.5% in 2001 and 68.2% in 2006. Misconceptions about the diabetic diet and blood testing were common. The level of diabetes-related knowledge has remained low since 2001. These results are of concern in view of the substantial investments made in diabetes care and health education in the region.