Volume 1 number 1 Summer 2003
Special issue for the abstracts of the 7th Pan Arab Conference on Diabetes
PACD7 , 25 – 28 March 2003 Cairo

Abstract Number : 82
Type 2 Diabetes Mellitus in the Arab Countries.

Ibrahim S. Salti MD, Ph.D., FRCPC, FACP, Division of Endocrinologyand Metabolism, American University of Beirut, Lebanon

As in many parts of the developing world, the Arab Countries have recently witnessed a major increase in the prevalence of type 2 diabetes. This trend was clearly demonstrated in several epidemiological surveys conducted in the past decade. As expected, the prevalence begins to rise after the age of 35 years, and reaches maximal levels above the age of 65 years. Taking Lebanon as an example, the prevalence in relation to age was as follows:

30-39 y: 0.7 %
40-49 y: 6.9 %
50-59 y: 16.5%
60-64 y: 23.7%
> 65 y: 29.4 %
Total: 13.1 %

The same trends were seen in the majority of Arab Countries, although in some, the increase is being seen even at a younger age than 35 years.
The factors contributing to the rising prevalence are probably multi-factorial. The most important appear to be the changes in the style of life as a result of socio-economic changes. In urban communities, the prevalence is distinctly higher than in rural communities. Within the urban communities, the prevalence was higher in lower socio-economic and low educational status individuals, than those with a higher socio-economic status or educational level As in many parts of the world, in most surveys, a clear relationship was found between body mass index and waist-hip circumference ratio and the prevalence of type 2 diabetes or impaired glucose tolerance.

The contribution of genetic factors is less clear. In the Lebanese study, the impact of a positive family history of diabetes was clear. However, there was no statistically significant impact of consanguinity.

As in many other epidemiological surveys, the co-existence of major cardiovascular risk factors was significantly higher in diabetics compared to non-diabetics. This was especially true of systolic and diastolic hypertension, hyper-triglyceridemia, low serum HDL-cholesterol, but not of LDL-cholesterol. This adds to the potential seriousness of the impact of the diabetes epidemic in this part of world, on the cardiovascular mortality and morbidity outcomes 

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