1. Dr. Abdulraziaq Al-Madani Diabetes Complications in the Gulf Countries

2. Diabetes Mellitus an Epidemic Disease in the Gulf Countries Epidemiological Data Diabetes Mellitus Prevalence Kuwait 14.8 Bahrain 11.0 UAE 15.7 Qatar 15.0 Saudi Arabia 12.3 Oman 10.0

3. Diabetes Mellitus an Epidemic Disease in the Gulf Countries Epidemiological Data Impaired Glucose Tolerance Prevalence Kuwait 12.8 Bahrain 11.0 UAE 13.2 Qatar 11.0 Saudi Arabia 11.9 Oman 10.0

4. Prevalence of Diabetes Mellitus Prevalence: Diabetes prevalence in the adult population (>20 years) by year and region for developed and developing countries and world total. WHO report 2000. Diabetes Complications in the Gulf Countries

5. Number of diabetics Number of Diabetics: WHO data for the expected number of diabetic patients according to regions and years. WHO report 2000. Millions Diabetes Complications in the Gulf Countries

6. Diabetic Neuropathy Diabetic Retinopathy Diabetic Nephropathy Diabetic Vasculopathy 1 2 34 3 3 3 1 1 1 2 2 2

7. Nephropathy Prevalence of microvascular complications: Comparing data from Arab countries with data of the highest & lowest prevalence world wide in the year 2000. The major complications will be soon the highest in Arab countries due to the lack of prevention programs. WHO report 2000. Neuropathy Retinopathy Diabetes Complications in the Gulf Countries

8. Diabetic Neuropathy Diabetic Retinopathy Diabetic Nephropathy Diabetic Vasculopathy

9. Neuropathy Neuropathy: Number of persons with diabetic neuropathy in different countries and according to the time. WHO report 2000 Diabetes Complications in the Gulf Countries

10. NEUROPATHY WITH DURATION % Years Diabetes Care 1, 168-188 1978 IDDM NIDDM

11. Diabetes Complications in the Gulf Countries IDDMNIDDMTotal Population: No.168.0001.512.0001.680.000 %10%90%( 14% ) Duration: 10 years ( % )10%30% ( Number)16.800453.600 470.400 20 years ( % )30%80% ( Number)50.4001.209.600 1.260.000 30 years ( % )60%100% ( Number )100.8001.512.0001.680.000 Number of Neuropathic Saudi Diabetics

12. Diabetes Complications in the Gulf Countries Diabetic Neuropathy Diabetic Retinopathy Diabetic Nephropathy Diabetic Vasculopathy

13. Diabetes Complications in the Gulf Countries RETINOPATHY WITH DURATION % Years ADA 1993 Vital Statistic Any Retinopathy Proliferative Retinopathy

14. Diabetes Complications in the Gulf Countries BLINDNESS BY DURATION OF DIABETES % Years ADA 1993 Vital Statistic Age at diagnosis 20 years old Age at diagnosis 60 years old

15. Retinopathy Retinopathy: Number of persons with diabetic retinopathy in different countries and according to the time. WHO report 2000 Diabetes Complications in the Gulf Countries

16. Prevalence of Retinopathy in Saudi diabetic patients 31.5% IDDM42.5% NIDDM25.3% Risk factors for Retinopathy in Saudi diabetic patients  Duration > 10 years.  Presence of nephropathy.  Older than 60 years.  Poor diabetes control.  Use of insulin. Diabetes Complications in the Gulf Countries

17. Diabetic Neuropathy Diabetic Retinopathy Diabetic Nephropathy Diabetic Vasculopathy

18. Diabetes Complications in the Gulf Countries NEPHROPATHY WITH DURATION % Years NIDDM IDDM NovoCare 1995 Years N Engl J Med 1987, 317. 1390-1398 Rate/ 100 subjects/ year

19. Nephropathy Nephropathy: Number of persons with diabetic nephropathy in different countries and according to the time. WHO report 2000 Diabetes Complications in the Gulf Countries

20. ESRF in Saudi Arabia: Increase in the total cases. More increase in the diabetic ESRF. Slow transplantation program. % Diabetes Complications in the Gulf Countries

21. Dialysis in Riyadh Number of patients. Vs Number of units. Diabetes Complications in the Gulf Countries

22. Diabetic Neuropathy Diabetic Retinopathy Diabetic Nephropathy Diabetic Vasculopathy

23. 2000 Saudi diabetics ( Initial ) General Mortality in Saudi diabetic patients 2000 Diabetics attending Diabetic Center KSU. 70 % Diabetes Complications in the Gulf Countries

24. General mortality55 per 1000 per 5yrs 11 per 1000 per year Cardiac mortality8 per 1000 per year Cardiac Mortality70% Non-cardiac Mortality30% Cardiac Morbidity9.1% Cardiac Mortality in Saudi diabetic patients 2000 Saudi diabetics ( Initial ) Cardiac mortality8 per 1000 per year In Saudi Arabia12,000,000 Inhabitance 1,500,000 Diabetics Cardiac deaths in diabetics =8 X 1,500 = 12,000 per year Cardiac mortality8 per 1000 per year In Saudi Arabia12,000,000 Inhabitance 1,500,000 Diabetics Cardiac deaths in diabetics =8 X 1,500 = 12,000 per year Diabetes Complications in the Gulf Countries

25. Number of deaths: In millions for patients aged > 20 years estimated for the year 2000. Percentage of total deaths attributable to diabetes: 11.9%Baseline 3.5%Optimistic 3.8%Etiologic ~ 9%WHO WHO report 2000. 9 % Number of death Diabetes Complications in the Gulf Countries

26. Diabetes in the Gulf countries Diabetes is the leading cause forBlindness Diabetes is the leading cause forESRF Diabetes is the leading cause forIHD Diabetes is the leading cause forCVA Diabetes is the leading cause forAmputation Diabetes Complications in the Gulf Countries