Prevalence and clinical characteristics of diabetes mellitus in Lebanon: a national survey

Background: Diabetes mellitus in all its forms has been rapidly increasing worldwide, especially in the Eastern Mediterranean Region. Aims: This national study aimed to assess the prevalence and clinical aspects of diabetes mellitus in Lebanon with special focus on type 1 (T1DM). Methods: A national multistage, random household sample survey was conducted, using face-to-face interviews with 1 questionnaire per household. A total of 4500 households were selected from all areas based on a pre-existing sampling frame of the Lebanese population. Results: The prevalence of previously diagnosed diabetes mellitus in the surveyed population of 17 832 persons (mean age 36 years)was 7.95%. The prevalence of T1DM in particular was estimated at 0.1%, or almost 1% of all detected cases of diabetes mellitus. Most persons with diabetes mellitus reported obtaining their usual care from endocrinologists rather than primary healthcare physicians. Delayed performance of haemoglobin A1c test was reported in 25% of 1418 patients. Hypoglycaemic episodes recently occurred in 30% of patients; of whom, at least one third required medical attention, including hospital admission. Diagnosed complications were reported in 22% of cases, with retinopathy being the most common. Conclusions: Prevalence of T1DM in this population was lower than international estimates. Diabetes mellitus management appears to be deficient, based on delays in standard control testing, hypoglycaemic episodes and diabetes mellitus-related complications. Coordination of diabetic care management should be devolved to primary healthcare physicians, who can keep track of the need for referral to various types of diabetes mellitus care

Association of ABO blood group in Iraqis with hypercholesterolaemia, hypertension and diabetes mellitus

There is strong evidence to suggest that there is an association between ABO blood group and certain diseases. This study in Baghdad, Iraq investigated the possible association of diabetes mellitus, hypercholesterolaemia and hypertension with ABO type. The data were derived from 920 patients with diabetes mellitus, hypertension and hypercholesterolaemia attending hospitals, clinics and laboratories in Baghdad, and 200 healthy control individuals. Analysing the data by blood group showed that the levels of total cholesterol, glucose and systolic/diastolic blood pressure were all significantly higher in male and female patients in blood group O than other groups, with a decreasing trend from group A to B then AB. Similar trends by blood group were seen for the healthy controls although the differences were less marked

Risk factors for hypertension among the adult Moroccan population

This study used data from the Moroccan national survey in 2000 to identify the principle risk factors for hypertension in a representative sample of the population age 20+ years. The risk of hypertension increased steadily with age and was higher among rural residents [OR = 1.42] and those with diabetes [OR = 1.72]. The risk increased with increased body mass index, waist size and hypercholesterolaemia. The risk of hypertension decreased by 36% and 46% respectively for those who walked 30-60 min and > 60 min daily. Consumption of fish and fresh fruits 1+ times per week was associated with a lower risk. Among those with hypertension, only 21.9% were previously diagnosed and 8.8% were under medical treatment

Relation between hypercholesterolaemia and vascular endothelial microinflammation

We investigated the correlation between hypercholesterolaemia and oxidative stress and P-selectin and interleukin-6 [IL-6] as markers for endothelial status. We studied 40 Egyptian adults with asymptomatic hypercholesterolaemia and 20 age- and sex-matched controls. Lipid peroxidation was significantly higher [P < 0.001] in the study group and positively correlated with cholesterol [P < 0.001] and low-density lipoprotein [LDL] [P < 0.002]. Glutathione peroxidase activity was also significantly higher [P < 0.001] with positive correlation with cholesterol [P < 0.001] and LDL [P < 0.001]. Markers for endothelial cell function were significantly higher in the study group [P < 0.001] with a positive correlation with cholesterol [P < 0.001] and LDL [P < 0.001]. Hypercholesterolaemia causes endothelial microinflammation, and P-selectin and IL-6 may also be risk factors for cardiovascular disease

Prevalence of physical inactivity in Saudi Arabia: a brief review

Major lifestyle changes in recent years in Saudi Arabia may be leading to physical inactivity and a low level of physical fitness. This paper reviews the current literature about physical inactivity in the Saudi Arabian population and discusses its implications for health. Available data from a small number of studies suggests a high prevalence [43.3%-99.5%] of physical inactivity among Saudi children and adults alike. Furthermore, the proportion of Saudi children and adults who are at risk due to inactivity is much higher than for any other coronary heart disease risk factor. It is recommended that a national policy encouraging activity in daily life be established and more studies are carried out to address physical activity patterns with representative samples of the Saudi Arabian population

Some risk factors for hypertension in the United Arab Emirates

A case-control study evaluated the relationship between hypertension and socioeconomic and lifestyle factors in Al-Ain city.The survey included 426 hypertensive adults aged 20-65 years attending urban and semi-urban clinics and a randomly selected sample of 436 normotensive controls. Hypertension among cases was higher for men, age 40-49 years, non-UAE nationals, urban living, currently married, having children, illiterate, administrative/professional job, living in traditional house and low income. There were significant differences between cases and controls with regard to obesity, raised cholesterol level, low physical activity and family history of heart disease, kidney disease or diabetes. Multivariate logistic regression analysis revealed that obesity, medium/high income, history of diabetes, low physical activity and having 3+ children were significantly associated with hypertension

Hyperhomocysteinaemia, hyperlipidaemia and risk of venous thromboembolism in Shiraz

To assess the risk of venous thromboembolism [VTE] associated with hyperhomocysteinaemia [hyper-Hcy] and hyperlipidaemia, we performed a case-control study. Fasting total homocysteine [Hcy], triglyceride and cholesterol levels were assessed in 43 patients with VTE and 43 controls. Mean Hcy level was significantly higher in the test group. Odds ratio [OR] for VTE in patients with hyper-Hcy was 2.7, with the association stronger in women and those under 50. The OR for those with both hypertriglyceridaemia and hypercholesterolaemia was significantly greater in those under 50. Increased risk for venous thrombosis was found among those under 50 having both lipid abnormalities

Clustering of cardiovascular risk factors among Omani adults

To determine the distribution and correlates of clustering of cardiovascular disease [CVD] risk factors, data from the Oman National Health Survey, 2000 were analysed. Based on demographic data [blood pressure, fasting blood glucose, serum cholesterol, weight, height, waist and hip measurements], 5660 subjects were grouped according to how many of four CVD risk factors [hypertension, high cholesterol, diabetes, overweight/obesity] they had. We found that 72% of subjects had less than one risk factor and 2% had all four. Older age exacerbated risk, while living in rural areas or being single was protective. Metabolic cardiovascular syndrome is a public health problem in Oman. Increasing awareness in healthcare providers and the wider population by comprehensive dissemination of the survey results is crucial

Distribution and correlates of total impaired fasting glucose in Oman

To determine the distribution and correlates of total impaired fasting glucose in Oman, we conducted a cross-sectional survey of 1968 households with 7011 eligible residents in 2000. During face-to-face interviews, demographic data, blood pressure, fasting blood glucose, serum cholesterol, weight, height and waist and hip measurements were obtained. Of 5788 subjects tested for total impaired fasting glucose [response rate: 83%], crude prevalence was 17.3% and age-adjusted prevalence was 20.3%. Associated factors in bivariate analysis were older age, male gender, lower education, hypercholesterolaemia, being married, obesity, abnormal waist to hip ratio and hypertension. Total impaired fasting glucose is a significant public health problem in Oman. Increasing the awareness of health care providers and community through health education is crucial

Clustering of cardiovascular risk factors among obese urban schoolchildren in Sousse, Tunisia

Against a background of increasing obesity among Tunisians, we conducted a transversal survey of 1569 children aged 13-19 years selected by multistage cluster sampling to evaluate the prevalence of obesity and clustering of cardiovascular risk factors among obese schoolchildren in the urban area of Sousse. Obese children were found to have higher blood pressure, higher triglyceride levels and lower high-density lipoprotein cholesterol levels than children of normal weight. In both genders, the mean height and weight across all age groups was significantly higher in urban than in rural children. Our study indicates that obesity and the adverse effects of being over the ideal body weight are no longer limited to industrialized countries

Primary prevention of acute coronary events through the adoption of a Mediterranean-style diet

We evaluated the role of a Mediterranean-style diet in preventing acute coronary syndromes [ACS]. Data from CARDIO2000, a multi-centre retrospective case-control study investigating the association between ACS and demographic, nutritional, lifestyle and medical risk factors were used. We studied 661 patients hospitalized for a first ACS event and 661 matched controls without clinical suspicion of cardiovascular disease. The Mediterranean diet significantly reduced [by 16%] the risk of developing ACS. The association remained significant in the presence of hypertension, hypercholesterolaemia, sedentary lifestyle, diabetes mellitus or a combination of two of these cardiovascular risk factors. Our findings illustrate the importance of the Mediterranean diet in the primary prevention of acute coronary events

Diabetes mellitus in an urban Palestinian population: prevalence and associated factors

We investigated the prevalence of diabetes and associated factors in a cross-sectional survey of an urban Palestinian population of 492 men and women aged 30-65 years. The oral glucose tolerance test was used to diagnose diabetes and impaired glucose tolerance. World Health Organization-recommended survey protocols were followed. Diabetes was found in 12.0% of the survey population [including 9.4% previously diagnosed], and impaired glucose tolerance in 5.9%. Logistic regression analysis controlling for age and sex revealed body mass index, waist-to-hip ratio and family history of diabetes to be significantly independently associated with diabetes

Study of cardiovascular disease risk factors among urban schoolchildren in Sousse, Tunisia

To assess the risk to Tunisian children of cardiovascular diseases [CVD], we undertook an epidemiological survey of 1569 urban schoolchildren from Sousse. Prevalence rates for the following CVD risk factors were determined: hypertension, hypercholesterolaemia and other lipid disorders, obesity and tobacco consumption. Hypertension and hypertriglyceridaemia showed no statistically significant difference by sex. Hypercholesterolaemia, high levels of low-density lipoprotein cholesterol and obesity were all significantly higher for girls than boys. Smoking was significantly higher among boys. The relatively low CVD risk factor profile of Tunisian schoolchildren should be encouraged in adulthood and a school heart health programme should be established