1887
Volume 4 (2023) Number 2
  • EISSN: 2708-0463

Abstract

سجّل الشرق الأوسط أعلى معدل انتشار لداء السكري في العالم، في الوقت الذي فشلت فيه نفقات الرعاية الصحية في هذه الدول على مواكبة الزيادة السريعة في أعداد المرضى إلى أن وصل إلى حد الوباء. ولفهم الأسباب الرئيسة لانتشار داء السكري وعوامل خطورته في هذه الدول، جاءت هذه الدراسة لمراجعة ورصد ما نُشر من البحوث الوبائية لداء السكري باستخدام محركات البحث العلمية وقواعد البيانات (PubMed, Embase and Ovid) لكشف حقيقة هذا الوباء، ومن ثمّ إبراز حجم المشكلة وأسباب الانتشار ودور عوامل الخطورة المختلفة. ولقد اعتمدت على الدراسات الوبائية المحكمة، والممثلة للتركيبة السكانية لكل دولة، مع استخدام طرق التشخيص المعتمدة عالمياً. وكشفت نتائج هذه الدراسة أن معدل انتشار داء السكري في الدول العربية هو 15.2% للذكور والإناث، بينما شكَّلت حالات اختلال تحمل الجلوكوز ما نسبته 13.3% للذكور و13.5% للإناث. وكانت نسب الانتشار أعلى في دول الخليج العربي، تليها منطقة العراق والشام، ثم تأتي منطقة شمال إفريقيا في المرتبة الثالثة. أمّا عوامل الخطورة فيأتي في مقدمتها العمر فوق 45 سنة، ووجود تاريخ أسري للإصابة بداء السكري؛ حيث تتضاعف الاحتمالية في وجودهما معاً. أما عوامل الخطورة الأخرى فتأتي في مقدمتها السمنة، مع العلم أن العرق العربي من الأعراق الأكثر إصابةً بالسكري. وقد أظهرت الدارسة العلاقة الطردية بين الإصابة بداء السكري وزيادة استهلاك السعرات الحرارية وقلة النشاط البدني اليومي. وانتهت الدراسة إلى أن دول العالم العربي تتفوق على معظم دول العالم من حيث نسب انتشار داء السكري واختلال تحمل الجلوكوز، والسبب في ذلك يعود إلى تغير نمط الحياة الذي انعكس كذلك على انتشار السمنة. لذلك فإن على هذه الدول اتخاذ الإجراءات السريعة للمكافحة الأولية لهذا الوباء، على أن تشمل جميع طبقات المجتمع، وخصوصاً الأطفال واليافعين؛ لاتخاذ نمط حياة صحي ومكافحة السمنة للحد من انتشار داء السكري.

Countries of the Middle East and North Africa region (MENA) have the highest rate of diabetes cases in the world, while their healthcare expenditures have failed to keep pace with the rapid increase in the number of patients until it has reached an epidemic phase. This study aimed to understand the main reasons behind the high diabetes prevalence and the related risk factors in these countries. The study was carried out by reviewing published epidemiological studies about diabetes in MENA region using PubMed, Embase, and Ovid scientific database engines. The collected studies were analyzed to assess the size of the problem and the risk factors behind the spread of this disease in the region. The results of this study confirmed that the prevalence rate of diabetes mellitus in 22 Arab countries was 15.2% for males and females, while the prevalence of impaired glucose tolerance disorder was 13.3% for males and 13.5% for females. The highest level of diabetes prevalence was in the Gulf Cooperation Council states, followed by Iraq and Sham countries, then the countries of North Africa. The most important risk factors are being over 45 years old and having a family history of diabetes, having both of them combined will double the risk of diabetes. Modifiable risk factors include obesity and smoking, which also increase the risk of diabetes to more than double. The study also showed a direct association of diabetes with increased calorie consumption and lack of daily physical activity. The paper concluded that these countries are ahead of most countries worldwide in terms of diabetes prevalence and impaired glucose tolerance, due to changes in lifestyle reflected in the high incidence of obesity. Therefore, countries of MENA region must urgently initiate primary prevention programs, targeting all gender and age groups, especially children and adolescents, to reach an adequate healthy lifestyle in order to combat obesity and diabetes prevalence.

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2023-10-31
2024-11-12
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References

  1. IDF diabetes atlas: year 2021. 10th ed [Internet]. Available from: www.diabetesatlas.org
  2. World Bank. Census reports from national statistical offices: World Bank. n.d. https://data.albankaldawli.org/indicator/SP.POP.TOTL?locations=SA تقارير التعداد السكاني من مكاتب الإحصاءات الوطنية: البنك الدولي.
  3. Alsmadi O, Thareja G, Alkayal F, Rajagopalan R, John SE, Hebbar P, et al. Genetic substructure of Kuwaiti population reveals migration history. PLoS ONE. 2013 Sep 16; 8:(9):e74913.
    [Google Scholar]
  4. Food and Agriculture Organization of the United Nations (FAO). World Food and Agriculture – statistical yearbook 2022. Rome: FAO; 2022. Available from: https://doi.org/10.4060/cc2211en
  5. Garaulet M, Gómez-Abellán P, Alburquerque-Béjar JJ, Lee Y-C, Ordovás JM, Scheer FA. Timing of food intake predicts weight loss effectiveness. International Journal of Obesity. 2013 Apr; 37:(4):604–611.
    [Google Scholar]
  6. Boutayeba A, Boutayeba W, Lamlilia MEN, Boutayebb S. Estimation of the direct cost of diabetes in the Arab region. Mediterranean Journal of Nutrition and Metabolism. 2014 Jan 1: 7:(1);21–32.
    [Google Scholar]
  7. Moradinazar M, Babakhani M, Rostami R, Shakiba M, Moradi A, Shakiba E. Epidemiological status of type 2 diabetes mellitus in the Middle East and North Africa, 1990–2019. Easter Mediterranean Health Journal. 2022; 28:(7):478–488.
    [Google Scholar]
  8. American Diabete Association. Classification and diagnosis of diabetes: Standards of medical care in diabetes 2021. Diabetes Care. 2021; 44:(Suppl. 1):S15–S33.
  9. El-Kebbi IM, Bidikian NH, Hneiny L, Nasrallah MP. Epidemiology of type 2 diabetes in the Middle East and North Africa: Challenges and call for action. World Journal of Diabetes. 2021 Sep 15; 12:(9):1401–1425.
    [Google Scholar]
  10. Abuyassin B, Laher I. Diabetes epidemic sweeping the Arab world. World Journal of Diabetes. 2016 Apr 25; 7:(8):165–174.
    [Google Scholar]
  11. Meiloud G, Arfa I, Kefi R, Abdelhamid I, Veten F, Lasram K, et al.. Type 2 diabetes in Mauritania: Prevalence of the undiagnosed diabetes, influence of family history and maternal effect. Primary Care Diabetes. 2013 April; 7:(1):19–24.
    [Google Scholar]
  12. Khan R, Siddiqui AA, Alshammary F, Shaikh S, Amin J, Rathore HA. Diabetes in the Arab World, InHandbook Healthcare in the Arab World. 2021 Aug 11 (pp. 1029-1051). Cham: Springer International Publishing.
    [Google Scholar]
  13. Al-Rubeaan K., Al-Manaa HA, Khoja TA, Ahmad NA, Al-Sharqawi AH, Siddiqui K, et al. Epidemiology of abnormal glucose metabolism in a country facing its epidemic: SAUDI-DM study. Journal of diabetes. 2015 Sep; 7:(5):622–632.
    [Google Scholar]
  14. Badran M, Laher I. Type II diabetes mellitus in Arabic-speaking countries. International Journal of Endocrinology. 2012; Article ID 902873, 11 pages.
    [Google Scholar]
  15. Al-Rubeaan K, Al-Manaa H, Khoja T, Ahmad N, Al-Sharqawi A, Siddiqui K, et al. The Saudi abnormal glucose metabolism and diabetes impact study (SAUDI-DM). Annals of Saudi Medicine. 2014 Nov–Dec; 34:(6):465–475.
    [Google Scholar]
  16. Majeed A, El-Sayed AA, Khoja T, Alshamsan R, Millett C, Rawaf S. Diabetes in the Middle-East and North Africa: An update. Diabetes Research and Clinical Practice. 2014 Feb; 103:(2):218–222.
    [Google Scholar]
  17. Hegazi R, El-Gamal M, Abdel-Hady N, Hamdy O. Epidemiology of and risk factors for type 2 diabetes in Egypt. Annals of Global Health. 2015 Nov 1; 81:(6):814–820.
    [Google Scholar]
  18. Kautzky-Willer A, Harreiter J, Pacini G. Sex and gender differences in risk, pathophysiology and complications of type 2 diabetes mellitus. Endocrine Reviews. 2016 Jun; 37:(3):278–316.
    [Google Scholar]
  19. Al-Rubeaan K. Type 2 diabetes mellitus red zone. International Journal of Diabetes Mellitus. 2010 April; 1:(2):1–2.
    [Google Scholar]
  20. World Health Population Review. Arab countries / Arab league countries 2023. https://worldpopulationreview.com/country-rankings/arab-countries [Accessed March 2023].
  21. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice. 2019 Nov 1;157:107843.
    [Google Scholar]
  22. Trichopoulou A, Martínez-González MA, Tong TYN, Forouhi NG, Khandelwal S, Prabhakaran D, et al. Definitions and potential health benefits of the Mediterranean diet: Views from experts round the world. BMC Medicine. 2014 Dec; 12:(1):2–16.
    [Google Scholar]
  23. Golzarand M, Mirmiran P, Jessri M, Toolabi K, Mojarrad M, Azizi F. Dietary trends in the Middle East and North Africa: An ecological study (1961 to 2007). Public Health Nutrition. 15:(10), 1835–1844.
    [Google Scholar]
  24. Pan XR, Hu YH, Li GW, Liu PA, Bennett PH, Howard BV. Impaired glucose tolerance and its relationship to ECG-indicated coronary heart disease and risk factors among Chinese. Da Qing IGT and diabetes study. Diabetes Care. 1993 Jan 1; 16:(1):150–156. doi:10.2337/diacare.16.1.150.
    [Google Scholar]
  25. Hamoudi R, Sharif-Askari NS, Sharif-Askari FS, Abusnana S, Aljaibeji H, Taneera J, et al. Prediabetes and diabetes prevalence and risk factors comparison between ethnic groups in the United Arab Emirates. Scientific Reports. 2019;9:17437. https://doi.org/10.1038/s41598-019-53505-7
    [Google Scholar]
  26. Lindström J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, et al. The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003 Dec 1; 26:(12):3230–3236.
    [Google Scholar]
  27. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002; 346:(6):393–403.
    [Google Scholar]
  28. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine. 2001;344:1343–1350.
    [Google Scholar]
  29. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and diabetes study. Diabetes Care. 1997 Apr; 20:(4):537–544.
    [Google Scholar]
  30. O’Connell JM, Manson SM. Understanding the economic costs of diabetes and prediabetes and what we may learn about reducing the health and economic burden of these conditions. Diabetes Care. 2019 Sep 1; 42:(9):1609–1611.
    [Google Scholar]
  31. Khan R, Siddiqui AA, Alshammary F, Shaikh S, Amin J, Rathore HA. Diabetes in the Arab world. Handbook of healthcare in the Arab world. Springer. 2021.
    [Google Scholar]
  32. Tadmouri GO, Nair P, Obeid T, Al Ali MT, Al Khaja N, Hamamy HA. Consanguinity and reproductive health among Arabs. Reproductive Health. 2009 Dec 6; 6:(1):1–9.
    [Google Scholar]
  33. Elmadhoun WM, Noor SK, Ibrahim AA, Bushara SO, Ahmed MH. Prevalence of diabetes mellitus and its risk factors in urban communities of north Sudan: Population-based study. Journal of Diabetes. 2016 Nov; 8:(6):839–846.
    [Google Scholar]
  34. Alebshehy R, Shuaib NM, Mbako JD, Barffo D, Nuotol RK. Determinant analysis of obesity among adult females in Egypt. The Egyptian Journal of Hospital Medicine. 2016;:662–669.
    [Google Scholar]
  35. Badran M, Laher I. Obesity in Arabic-speaking countries. Journal of Obesity, 2011;Article ID 686430, 9 pages.
    [Google Scholar]
  36. Al-Rubeaan K. National surveillance for type 1, type 2 diabete and prediabetes among children and adolescents: A population-based study (SAUDI-DM). Journal of Epidemiology and Community Health. 2015 Nov 1; 69:(11):1045–1051.
    [Google Scholar]
  37. Moghames P, Hammami P, Hwalla N, Yazbeck N, Shoaib H, Nasreddine L, et al. Validity and reliability of a food frequency questionnaire to estimate dietary intake among Lebanese children. Nutrition Journal. 2015;15:Article number: 4.
    [Google Scholar]
  38. Lafta RK, Kadhim MJ. Childhood obesity in Iraq: Prevalence and possible risk factors. Annals of Saudi Medicine. 2005 Sep; 25:(5):389–393.
    [Google Scholar]
  39. Aboul-Enein BH, Bernstein J, Neary AC. Dietary transition and obesity in selected Arabic speaking countries: A review of the current evidence. Eastern Mediterranean Health Journal. 2016; 22:(10):763–770.
    [Google Scholar]
  40. Proctor MH, Moore LL, Gao D, Cupples LA, Bradlee ML, Hood MY, et al. Television viewing and change in body fat from preschool to early adolescence: The Framingham children's study. International Journal of Obesity. 2003 Jul; 27:(7):827–833.
    [Google Scholar]
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