oa Identifying Key Factors For Type Ii Diabetes Mellitus Prevention Interventions In Qatar

Background: Type II Diabetes Mellitus (DM) is one of the leading chronic diseases in Qatar as well as worldwide. However, the risk factors for DM in Qatar and their prevalence are not well understood. We conducted a case-control study with the specific aim of estimating, based on data from outpatients with DM in Qatar (cases) and inpatient/outpatient controls, the association between demographic/lifestyle factors and DM. We also estimated the contribution of these factors to the occurrence of DM cases among Qatari nationals and non-Qatari expatriate population. Methods: A total of 459 patients with DM from Hamad Medical Corporation Hospital (HMC) outpatient adult diabetes clinics and 342 control patients from various outpatient clinics and inpatient departments at HMC were identified using rigorous sampling methodologies and recruited between the years 2006 and 2008. The association between risk factors and DM was evaluated using bivariate and multivariate logistic regression analyses, and for the population at large and for only Qatari nationals. In addition to odds ratios (OR) and 95% confidence intervals (95% CI), we calculated the population attributable risk fractions for demographic and lifestyle factors in relation to DM. Results: Qatari nationality was the strongest risk factor for DM (adjusted OR=5.5; 95% CI=3.5-8.6), followed by higher monthly income (defined as ≥ 3000 riyals, OR=5.1; 95% CI=3.0-8.7), age > 65 years (OR=3.3; 95% CI=0.9-11.4), male gender (OR=2.9; 95% CI=1.8-4.8), obesity (body mass index ≥ 30, OR=2.2; 95% CI=1.5-3.2), no college education (OR=1.7; 95% CI=1.2-2.6), and no daily vigorous/moderate activity (OR=1.5; 95% CI=0.9-2.3). Among Qatari nationals, obesity was revealed as the main risk factor for DM (unadjusted OR=3.0; 95% CI=1.6-5.6) followed by no college education (OR=2.7; 95% CI=1.5-5.1), while consanguinity did not appear to play a major role in predicting DM (OR=1.5; 95% CI=0.8-2.8). Our findings further suggested that eliminating obesity and improving access to education could reduce DM cases by up to one third in the population at large (31.7% and 26.8%, respectively) and up to half (46.9% and 49.3%, respectively) among only Qatari nationals. Promoting physical activity may as well reduce the burden of DM by up to 9.4% in the population at large and up to 17.3% among Qatari nationals. Conclusions: Demographic and lifestyle factors were revealed as the main risk factors for the high DM levels observed in Qatar, with a contribution that appears to outweigh that of genetic risk factors. While further evaluation of these factors among the Qatari population (as opposed to the population at large) is important and of interest, these findings highlight the need to focus short-term DM interventions on addressing demographic and lifestyle risk factors to achieve substantial and timely declines in DM levels.