Diabetes National Diabetes Control Programme

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Presentation transcript:

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 10% ---- 8.3% 5.7% 2000 11.6% 6.1% Prevalence of Diabetes and IGT in Oman using 1999 WHO diagnostic criteria Survey Method used DM IGT IFG 1991 post glucose load, plasma 10% ---- fasting plasma glucose 8.3% 5.7% 2000 11.6% 6.1% DM: diabetes mellitus, IGT: Impaired glucose tolerance, IFG: Impaired fasting glucose

Total IFG + Diabetes (%) Prevalence of diabetes in males in the national health survey, 2000 Age Group Number examined IFG (%) Diabetes (%) Total IFG + Diabetes (%) 20-29 1176 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 26.2 32.8 All 2917 7.1 12.0 19.1

Total IFG + Diabetes (%) Prevalence of diabetes in females 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

Body Mass Index, overweight and obesity 1991 2000 Body mass index (kg/M²) M: 24.3 F: 26.3 M: 25.2 F: 25.8 Overweight (%) M: 28.8 F: 29.5 M: 32.1 F: 27.3 Obesity (%) M: 10.5 F: 25.1 M: 16.7 F: 23.8 Dhofar: 71%, Muscat and Dahirah: 50%

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).

Hospital Mortality 1989-1993

Diabetes Prevalence in GCC Ages 20+ years MOH, UAE, 2000 Abedlla et al, 1998 Al-Nuaim, 1997 Asfour et al, 1991

Diabetes Mellitus, GCC Estimates, 1995-2025 Source: The World Health Report, 1997, WHO

Prevalence 1991 vs 2000 Oman Criteria DM IGT IFG 1991 WHO (old) 10% 2-OGTT ------- WHO (new) 8.3% FPG 5.7% 2000 11.7% 6.1%

National Health Survey, Oman, 2000 Age & Diabetes National Health Survey, Oman, 2000

Fasting Blood Glucose for Diabetes Undiagnosed Diabetes in Oman 5786 5214 572 Total 5519 5139 No 267 75 192 Yes - + Do you have Diabetes Fasting Blood Glucose for Diabetes 380 National Health Survey, Oman, 2000

Trends of BMI by Gender (Oman) 1991 2000 Males 24.3 25.2 Females 26.3 25.8

Insulin Resistance Syndrome (Metabolic Syndrome) Central/abdominal obesity High TG Microalbuminuria Low HDL Metabolic Syndrome or INSULIN RESISTANCE HBP Endothelial dysfunction High FPG Atherosclerosis, cardiovascular disease

Oman 21% Atherosclerosis, cardiovascular disease Al-Lawati JA, Prevalence of the metabolic syndrome among Omani adults. Diabetes Care 2003;26(6):1781-5. Central/abdominal obesity 24.6% High TG 20.7% Microalbuminuria Low HDL 75.4% Oman 21% HBP 23.1% Endothelial dysfunction High FPG 18.1% Atherosclerosis, cardiovascular disease

Overweight in GCC

Obesity in GCC