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