Prevalence of pre-diabetes and associated risk factors in an adult Omani population

  • Mohammed A. Al-Shafaee
  • Kamlesh Bhargava
  • Yahya Mohammed Al-Farsi
  • Shirley Mcilvenny
  • Ahmed Al-Mandhari
  • Samir Al-Adawi
  • Abdullah Al Maniri
Original Article

Abstract

The Sultanate of Oman has experienced an epidemiological transition over the last 4 decades with rising tide of non-communicable disease such as type-2 diabetes. This study aims to estimate the prevalence of pre-diabetes and explore the associated demographic, clinical and biochemical risk factors among a semi-urban Omani population. A semi-urban satellite town, Bidbid, located about 30 km west of the capital, Muscat, was selected as the study setting. The targeted participants were Omani adults (18 to 60 years old) who had resided in Bidbid municipality for at least 6 months prior to enrollment in the study. Using multistage random sampling, 1,600 Bidbid residents were invited to participate in the study. The study protocol gathered data on the socio-demographic and clinical backgrounds of the participants. Participants’ impaired glucose tolerance (IGT) impaired fasting glucose (IFG) and cholesterol and triglyceride levels were then measured. The study surveyed 1,313 individuals (490 men and 823 women) out of 1,600 who had been invited to participate. The participation rate was higher among women than men (91.5% compared to 54.3%). A total of 459 individuals (35% of participants) were diagnosed as pre-diabetic by either the IGT or IFG test; 121 (9%) were pre-diabetic by virtue of both measurements. Male gender, advanced age and obesity were each independently associated with higher prevalence of pre-diabetes. Increased prevalence of pre-diabetes also correlated with the indices of hypercholesterolemia and dyslipidaemia. Pre-diabetes is a substantial health problem in Oman that may present a significant challenge to the national healthcare system in the near future. Customized interventions targeting groups with high risk of pre-diabetes, especially men, the elderly and the obese, are urgently needed.

Keywords

Diabetes Pre-diabetes Oman Prevalence Survey 

Abbreviations

BMI

Body mass index

CEA

Census enumeration area

FPG

Fasting plasma glucose

HDL

High-density lipoprotein

IFG

Impaired fasting glucose

IGT

Impaired glucose tolerance

LDL

Low-density lipoprotein

Notes

Acknowledgements

We are grateful to the men and women who volunteered as subjects for this research.

Conflicts of interest

None.

References

  1. 1.
    Zimmet P. The burden of type 2 diabetes: are we doing enough? Diabetes Metab. 2003;29:6S9–18.PubMedCrossRefGoogle Scholar
  2. 2.
    Yach D, Stuckler D, Brownell KD. Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nat Med. 2006;12:62–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Shi HL, Fang JC, Zhu XX. Prevalence of diabetes mellitus and associated risk factors in an adult urban population in Shanghai. Diabetes Metabol. 1998;24:539–42.Google Scholar
  4. 4.
    Chi PW, Cheng TYD, Shan PT, Hui LH, Shu LW. Increased mortality risks of pre-diabetes (impaired fasting glucose) in Taiwan. Diabetes Care. 2005;28:2756–61.CrossRefGoogle Scholar
  5. 5.
    Alberti KG, Zimmet P, Shaw J. Metabolic syndrome -a new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med. 2006;23:469–80.PubMedCrossRefGoogle Scholar
  6. 6.
    Bertram MY, Vos T. Quantifying the duration of pre-diabetes. Aust New Zeal J Publ Health. 2010;34:311–4.CrossRefGoogle Scholar
  7. 7.
    Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, Hsu RT, et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 2007;334:299–302.PubMedCrossRefGoogle Scholar
  8. 8.
    Henry P, Thomas F, Benetos A, Guize L. Impaired fasting glucose, blood pressure and cardiovascular disease mortality. Hypertension. 2002;40:458–63.PubMedCrossRefGoogle Scholar
  9. 9.
    Milman S, Crandall JP. Mechanisms of vascular complications in prediabetes. Med Clin North Am. 2011;95:309–25.PubMedCrossRefGoogle Scholar
  10. 10.
    Rerkpattanapipat P, D’Agostino Jr RB, Link KM, Shahar E, Lima JA, Bluemke DA, et al. Location of arterial stiffening differs in those with impaired fasting glucose versus diabetes: implications for left ventricular hypertrophy from the multi-ethnic study of atherosclerosis. Diabetes. 2009;58:946–53.PubMedCrossRefGoogle Scholar
  11. 11.
    Kilmer G, Hughes E, Zhang X, Elam-Evans L. Diabetes and prediabetes: screening and prevalence among adults with coronary heart disease. Am J Prev Med. 2011;40:159–65.PubMedCrossRefGoogle Scholar
  12. 12.
    Colagiuri S. Epidemiology of prediabetes. Med Clin North Am. 2011;95:299–307.PubMedCrossRefGoogle Scholar
  13. 13.
    Vendrame F, Gottlieb PA. Prediabetes: prediction and prevention trials. Endocrinol Metab Clin North Am. 2004;33:75–92.PubMedCrossRefGoogle Scholar
  14. 14.
    Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;7:393–403.Google Scholar
  15. 15.
    Ali HI, Baynouna LM, Bernsen RM. Barriers and facilitators of weight management: perspectives of Arab women at risk for type 2 diabetes. Health Soc Care Community. 2010;18:219–28.PubMedCrossRefGoogle Scholar
  16. 16.
    Abo-Zenah H, El-Benayan A, El Nahas AM. Prevalence of increased albumin excretion rate in young Saudi adults. Nephron Clin Pract. 2008;108:155–62.CrossRefGoogle Scholar
  17. 17.
    Khandekar R, Al Riyami A, Attiya M, Morsi M. Prevalence and determinants of blindness, low vision, deafness and major bone fractures among elderly Omani population of Nizwa Wilayat (Nizwa elderly population study-2005). Indian J Ophthalmol. 2010;58:313–20.PubMedCrossRefGoogle Scholar
  18. 18.
    Khandekar RB, Tirumurthy S, Al-Harby S, Moorthy NSD, Amir I. Diabetic retinopathy and ocular co-morbidities among persons with diabetes at Sumail hospital of Oman. Diabetes Technol Ther. 2009;11:675–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Barakat MN, Youssef RM. Prevalence of dysglycemia and other cardiovascular risk factors among the rural population of Oman. Saudi Med J. 2008;29:1824–6.PubMedGoogle Scholar
  20. 20.
    Weiss R, Dufour S, Taksali SE, Tamborlane WV, Petersen KF, Bonadonna RC, et al. Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet. 2003;362:951–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Al-Lawati JA, Al Riyami AM, Mohammed AJ, Jousilahti P. Increasing prevalence of diabetes mellitus in Oman. Diabet Med. 2002;19:954–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Chedid R, Gannagé-Yared MH, Khalifé S, Halaby G, Zoghbi F. Impact of different metabolic syndrome classifications on the metabolic syndrome prevalence in a young Middle Eastern population. Metab Clin Exp. 2009;58:746–52.PubMedCrossRefGoogle Scholar
  23. 23.
    Al-Lawati JA, Jousilahti P. Prevalence of metabolic syndrome in Oman using the International Diabetes Federation’s criteria. Saudi Med J. 2006;27:1925–6.PubMedGoogle Scholar
  24. 24.
    Al-Shafaee MA, Ganguly SS, Bhargava K, Duttagupta KK. Prevalence of metabolic syndrome among prediabetic Omani adults: a preliminary study. Metab Syndr Relat Disord. 2008;6:275–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Al-Shereiqi S. Non communicable diseases screening: starts in Oman. Community Health Dis Surveill News (Oman). 2008;17:1–5.Google Scholar
  26. 26.
    Nichols GA, Arondekar B, Herman WH. Complications of dysglycemia and medical costs associated with non-diabetic hyperglycemia. Am J Manag Care. 2008;14:791–8.Google Scholar
  27. 27.
    Albarwani S, Al-Hashmi K, Al-Abri M, Jaju D, Hassan MO. Effects of overweight and leisure-time activities on aerobic fitness in urban and rural adolescents. Metab Syndr Relat Disord. 2009;7:369–74.PubMedCrossRefGoogle Scholar
  28. 28.
    Al-Adawi S, Powell J. The influence of smoking on reward responsiveness and cognitive functions: a natural experiment. Addiction. 1997;92:1773–82.PubMedCrossRefGoogle Scholar
  29. 29.
    Ingelsson E, Schaefer EJ, Contois JH, McNamara JR, Sullivan L, Keyes MJ, et al. Clinical utility of different lipid measures for prediction of coronary heart disease in men and women. JAMA. 2007;298:776–85.PubMedCrossRefGoogle Scholar
  30. 30.
    Décary S, Dumont G, Lamarche B, Hogue JC, Tremblay AJ, Bergeron J, et al. Assessment of the validity of the frequently used lipid indices for predicting LDL peak particle diameter in a large cohort of 1955 normal and dyslipidemic subjects. Clin Biochem. 2010;43:401–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Al-Bahrani AI, Bakhiet CS, Bayoumi RA, Al-Yahyaee SA. A potential role of apolipoprotein B in the risk stratification of diabetic patients with dyslipidaemia. Diabetes Res Clin Pract. 2005;69:44–51.PubMedCrossRefGoogle Scholar
  32. 32.
    Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370:1929–38.PubMedCrossRefGoogle Scholar
  33. 33.
    World Health Organization. Preventing chronic diseases: a vital investment: WHO global report. Geneva: World Health Organization; 2005.Google Scholar
  34. 34.
    Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53.PubMedCrossRefGoogle Scholar
  35. 35.
    Soliman AT, Al-Salmi IS, Asfour MG. Epidemiology of childhood insulin-dependent diabetes mellitus in the Sultanate of Oman. Diabet Med. 1996;13:582–6.PubMedCrossRefGoogle Scholar
  36. 36.
    Al-Lawati JA, Mabry R, Mohammed AJ. Addressing the threat of chronic diseases in Oman. Prev Chronic Dis. 2008;5:A99.PubMedGoogle Scholar
  37. 37.
    Barakat MN, Al-Shereiqi SZ. Operational and management Guidelines for the National non-communicable diseases screening program. Communicable Diseases Surveillance and Control. Directorate General of Health Affairs. Accessed in March 28: 2010 http://www.moh.gov.om/reports/Guidelines_Manual_for_the_national_NCD_screening_program.pdf.
  38. 38.
    Mabry RM, Reeves MM, Eakin EG, Owen N. Gender differences in prevalence of the metabolic syndrome in Gulf Cooperation Council Countries: a systematic review. Diabet Med. 2010;27:593–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Al-Daghri NM, Al-Attas OS, Al-Rubeaan K, Mohieldin M, Al-Katari M, Jones AF, et al. Serum leptin and its relation to anthropometric measures of obesity in pre-diabetic Saudis. Cardiovasc Diabetol. 2007;6:18.PubMedCrossRefGoogle Scholar
  40. 40.
    Bener A, Zirie M, Janahi IM, Al-Hamaq AO, Musallam M, Wareham NJ. Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar. Diabetes Res Clin Pract. 2009;84:99–106.PubMedCrossRefGoogle Scholar
  41. 41.
    Al Rashdan I, Al Nesef Y. Prevalence of overweight, obesity, and metabolic syndrome among adult Kuwaitis: results from community-based national survey. Angiology. 2010;61:42–8.PubMedCrossRefGoogle Scholar
  42. 42.
    Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295:1549–55.PubMedCrossRefGoogle Scholar
  43. 43.
    Saadi H, Nagelkerke N, Al-Kaabi J, Afandi B, Al-Maskari F, Kazam E. Screening strategy for type 2 diabetes in the United Arab Emirates. Asia Pac J Publ Health. 2010;22(3 Suppl):54S–9S.CrossRefGoogle Scholar
  44. 44.
    Al-Isa A, Akanji AO, Thalib L. Prevalence of the metabolic syndrome among female Kuwaiti adolescents using two different criteria. Br J Nutr. 2010;103:77–81.PubMedCrossRefGoogle Scholar
  45. 45.
    Al-Shoumer KA, Al-Asousi AA, Doi SA, Vasanthy BA. Serum leptin and its relationship with metabolic variables in Arabs with type 2 diabetes mellitus. Ann Saudi Med. 2008;28:367–70.PubMedCrossRefGoogle Scholar
  46. 46.
    Ganguly SS, Al-Lawati A, Al-Shafaee MA, Duttagupta KK. Epidemiological transition of some diseases in Oman: a situational analysis. World Hosp Health Serv. 2009;45:26–31.PubMedGoogle Scholar
  47. 47.
    Fonseca VA, Zinman B, Nauck MA, Goldfine AB, Plutzky J. Confronting the type 2 diabetes epidemic: the emerging role of incretin-based therapies. Am J Med. 2010;123:S2–S10.PubMedCrossRefGoogle Scholar

Copyright information

© Research Society for Study of Diabetes in India 2011

Authors and Affiliations

  • Mohammed A. Al-Shafaee
    • 1
  • Kamlesh Bhargava
    • 1
  • Yahya Mohammed Al-Farsi
    • 1
  • Shirley Mcilvenny
    • 2
  • Ahmed Al-Mandhari
    • 1
  • Samir Al-Adawi
    • 3
  • Abdullah Al Maniri
    • 1
  1. 1.Department of Family Medicine and Public Health, College of Medicine and Health SciencesSultan Qaboos UniversityMuscatSultanate of Oman
  2. 2.Natural Vibrant Health - Wholistic Integrated ClinicRobinaAustralia
  3. 3.Department of Behavioral Medicine, College of Medicine and Health SciencesSultan Qaboos UniversityMuscatSultanate of Oman

Personalised recommendations