Diabetes

The worldwide occurrence of type 2 diabetes

Over the past three decades, major social and economic changes have transformed many of the countries in the region. Some Gulf States have undergone rapid economic growth and urbanization, associated with reducedinfant mortality and increasing life expectancy. Other countries in the regionhave seen a decrease in economic growth due to dramatic political changes2.The region has the greatest disparity in gross national income per capita,ranging from ID133, 850 in Qatar to ID1,980 in Afghanistan1

Prevalence

Approximately 35.4 (24.3–47.4%) million people,or 9.1% (6.3–12.2%) of adults aged 20-79, areliving with diabetes in the Middle East and NorthAfrica Region in 2015. Over 40.6% of these areundiagnosed.Although 54.9% of all adults in the region live inurban areas, 67.0% of people with diabetes live inurban environments. The vast majority (83.9%) ofthe people with diabetes in the region are livingin low- or middle- income countries.

Countries with high diabetes prevalence include Saudi Arabia (raw diabetes prevalence of 17.6%) and Kuwait (14.3%). Due to their different population structures, these countries both have an age-adjusted comparative prevalence of 20.0%. The countries with the largest number of adults with diabetes are Egypt (7.8 [3.8-9.0] million), Pakistan (7.0 [5.1-10.0] million) and Iran(4.6 [3.6-6.3] million). A further 30.2 million people in the region, or 7.8% of the adult population, are estimated to have impaired glucose tolerance and are therefore at high risk of developing diabetes. It is estimated that the number of people with diabetes in the region will double to 72.1 million by 2040.

Mortality

Diabetes was responsible for 342,000 deaths in 2015. Over half (51.3%) of all deaths from diabetes in the region occurred in people under 60. These early deaths may be the result of a combination of factors: the rapidly changing environments and lifestyles in the region, late diagnoses and health systems that are not equipped to provide optimal management to the increasing numbers of people with diabetes.

Data sources

A total of 30 sources from 16 countries were used to estimate diabetes prevalence in adults for the 21 countries in the region. Only Kuwait had a nationwide study conducted within the last five years. Algeria, Jordan, Oman, Pakistan, Saudi Arabia, the State of Palestine and the United Arab Emirates had estimates partly based on oral glucose tolerance tests. Diabetes prevalence figures for the remaining countries may be underestimates.

The Middle East and North Africa Region poses a particular challenge for estimating diabetes prevalence because a large proportion of the resident population in many countries consists of migrants and refugees. As a result, studies that include only national citizens can make only a limited contribution to the overall picture of diabetes for the whole country.