Diabetes • National Diabetes Control Programme • National Diabetes Control Committee with members from MOH and outside • National Policy for the control of diabetes • Regional diabetologists -
Jan 16, 2016
Diabetes
• National Diabetes Control Programme
• National Diabetes Control Committee
with members from MOH and outside
• National Policy for the control of
diabetes
• Regional diabetologists - focal
points
• Diabetes in primary care
• Mini diabetes clinics
• Standard guidelines
• Diabetes care team
• Diabetes registry:The total number of cases
reported till 2005 were 48,972 with 4,862
new cases diagnosed in the year 2005.
• World Diabetes Day
• Other health education
Diabetes
-Various surveys over the last decade have shown that ten percent of Omani adults suffer from diabetes and a similar proportion has impaired glucose tolerance.
-A survey conducted in 1991 showed a diabetes prevalence of 8.3% based on fasting blood glucose. A more recent National Health Survey (2000), has shown diabetes to have increased significantly to 11.6%.
National Health Survey, 2000
Total: 5856
IFG: 6.1%
IFG+diabetes: 17.8%
Survey Method used DM IGT IFG
1991 post glucose load, plasma
10% 10% ----
fasting plasma glucose
8.3% ---- 5.7%
2000 fasting plasma glucose
11.6% ---- 6.1%
Prevalence of Diabetes and IGT in Oman using 1999 WHO diagnostic criteria
DM: diabetes mellitus, IGT: Impaired glucose tolerance, IFG: Impaired fasting glucose
Age Group Number examined
IFG (%) Diabetes (%)
Total IFG + Diabetes
(%)
20-29 1176 4.2 4.2 8.4
30-39 540 10.2 9.1 19.3
40-49 390 10.3 19.0 29.3
50-59 352 9.4 23.3 32.7
60-69 261 6.1 17.6 23.7
70-79 137 6.6 24.8 31.4
80+ 61 6.6 26.2 32.8
All 2917 7.1 12.0 19.1
Prevalence of diabetes in males in the national health survey, 2000
Age Group Number examined
IFG (%) Diabetes (%)
Total IFG + Diabetes
(%)
20-29 1186 2.4 3.4 5.8
30-39 622 5.9 8.4 14.3
40-49 284 6.0 15.1 21.1
50-59 512 8.0 22.1 30.1
60-69 198 8.6 28.3 36.9
70-79 91 8.8 25.3 34.1
80+ 46 4.3 19.6 23.9
All 2939 5.1 11.4 16.5
Prevalence of diabetes in females in the national health survey, 2000
1991 2000
Body mass index (kg/M²)
M: 24.3F: 26.3
M: 25.2F: 25.8
Overweight (%)
M: 28.8F: 29.5
M: 32.1F: 27.3
Obesity (%) M: 10.5F: 25.1
M: 16.7F: 23.8
Dhofar: 71%, Muscat and Dahirah: 50%
Body Mass Index, overweight and obesity
Metabolic syndrome (IDF criteria)
•Central obesity (waist circumference 94 cm for men and 80 cm for women),
plus any 2 of the following 4 factors:
•Raised triglyceride (TG) levels 1.7 mmol/L, or specific treatment for this lipid abnormality
•Reduced high density lipoproteins (HDL) cholesterol: <1.03 mmol/L in men and <1.29 mmol/L in women, or specific treatment for these lipid abnormalities
•Raised systolic BP 130 or diastolic BP 85 mmHg, or treatment of previously diagnosed hypertension
•Raised fasting plasma glucose: FPG 5.6 mmol/L, or previously diagnosed type 2 diabetes
Prevalence of metabolic syndrome in Oman
Females: 40.0% (95% CI 35.6% to 44.3%)
Males: 18.4% (95% CI 14.5% to 22.3%)
(p-value for the gender difference <0.001).
0 500 1000 1500 2000 2500 3000 3500 4000
Nervous
Blood, Endocrine
GU
Digestive
Resp
Ill-defined
Infections
Inj+ Poison
Cancer
CVD
Hospital Mortality 1989-1993
Diabetes Prevalence in GCC
10.0%
14.0%15.0%
18.0%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
20.0%
Oman KSA Kuwait UAE
Prevalence
Ages 20+ years
Al-Nuaim, 1997
Asfour et al, 1991
Abedlla et al, 1998
MOH, UAE, 2000
Diabetes Mellitus, GCC Estimates, 1995-2025
2961 59
34
10984
237217
75
260
0
50
100
150
200
250
300
Bah Kw Om Qat UAE
Prevalence (000)
1995
2000
2025
Source: The World Health Report, 1997, WHO
Prevalence 1991 vs 2000Oman
Criteria DM IGT IFG
1991 WHO (old)
10%
2-OGTT
10% -------
1991 WHO (new)
8.3%
FPG
10% 5.7%
2000 WHO (new)
11.7%
FPG
------- 6.1%
Age & Diabetes
0
5
10
15
20
25
30
20-29 30-39 40-49 50-59 60-69 70-79 80+ All
MALESFemales
National Health Survey, Oman, 2000
57865214572Total
55195139No
26775192Yes
Total-+Do you have Diabetes
Fasting Blood Glucose for Diabetes
380
Undiagnosed Diabetes in Oman
National Health Survey, Oman, 2000
Trends of BMI by Gender (Oman)
1991 2000
Males 24.3 25.2
Females 26.3 25.8
Atherosclerosis, cardiovascular diseaseAtherosclerosis, cardiovascular disease
Central/abdominal obesity
High FPG
HBP
MicroalbuminuriaHigh TG
Metabolic Metabolic Syndrome Syndrome
ororINSULININSULIN
RESISTANCERESISTANCE
Endothelial dysfunction
Low HDL
Insulin Resistance Syndrome (Metabolic Syndrome)
Atherosclerosis, cardiovascular diseaseAtherosclerosis, cardiovascular disease
Central/abdominal obesity 24.6%
High FPG 18.1%
HBP 23.1%
MicroalbuminuriaHigh TG 20.7%
Oman 21%
Endothelial dysfunction
Low HDL 75.4%
Al-Lawati JA, Prevalence of the metabolic syndrome among Omani adults. Diabetes Care 2003;26(6):1781-5.
Overweight in GCC
36.135.2
28.7
32.1
27.126.9
32.3
29.5
0
5
10
15
20
25
30
35
40
Bahrain Kuwait KSA Oman
Male Female
Obesity in GCC
22
32.3
15.5 16.7
23.823.6
40.641.4
0
5
10
15
20
25
30
35
40
45
Bahrain Kuwait KSA Oman
Male Female