diabetes national diabetes control programme national diabetes control committee with members from...
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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
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• 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
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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%.
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National Health Survey, 2000
Total: 5856
IFG: 6.1%
IFG+diabetes: 17.8%
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Survey Method used DM IGT IFG
1991 post glucose load, plasma
10% 10% ----
fasting plasma glucose
8.3% ---- 5.7%
2000 fasting plasma glucose
11.6% ---- 6.1%
Prevalence of Diabetes and IGT in Oman using 1999 WHO diagnostic criteria
DM: diabetes mellitus, IGT: Impaired glucose tolerance, IFG: Impaired fasting glucose
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Age Group Number examined
IFG (%) Diabetes (%)
Total IFG + Diabetes
(%)
20-29 1176 4.2 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 6.6 26.2 32.8
All 2917 7.1 12.0 19.1
Prevalence of diabetes in males in the national health survey, 2000
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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
Prevalence of diabetes in females in the national health survey, 2000
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1991 2000
Body mass index (kg/M²)
M: 24.3F: 26.3
M: 25.2F: 25.8
Overweight (%)
M: 28.8F: 29.5
M: 32.1F: 27.3
Obesity (%) M: 10.5F: 25.1
M: 16.7F: 23.8
Dhofar: 71%, Muscat and Dahirah: 50%
Body Mass Index, overweight and obesity
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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
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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).
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0 500 1000 1500 2000 2500 3000 3500 4000
Nervous
Blood, Endocrine
GU
Digestive
Resp
Ill-defined
Infections
Inj+ Poison
Cancer
CVD
Hospital Mortality 1989-1993
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Diabetes Prevalence in GCC
10.0%
14.0%15.0%
18.0%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
20.0%
Oman KSA Kuwait UAE
Prevalence
Ages 20+ years
Al-Nuaim, 1997
Asfour et al, 1991
Abedlla et al, 1998
MOH, UAE, 2000
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Diabetes Mellitus, GCC Estimates, 1995-2025
2961 59
34
10984
237217
75
260
0
50
100
150
200
250
300
Bah Kw Om Qat UAE
Prevalence (000)
1995
2000
2025
Source: The World Health Report, 1997, WHO
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Prevalence 1991 vs 2000Oman
Criteria DM IGT IFG
1991 WHO (old)
10%
2-OGTT
10% -------
1991 WHO (new)
8.3%
FPG
10% 5.7%
2000 WHO (new)
11.7%
FPG
------- 6.1%
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Age & Diabetes
0
5
10
15
20
25
30
20-29 30-39 40-49 50-59 60-69 70-79 80+ All
MALESFemales
National Health Survey, Oman, 2000
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57865214572Total
55195139No
26775192Yes
Total-+Do you have Diabetes
Fasting Blood Glucose for Diabetes
380
Undiagnosed Diabetes in Oman
National Health Survey, Oman, 2000
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Trends of BMI by Gender (Oman)
1991 2000
Males 24.3 25.2
Females 26.3 25.8
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Atherosclerosis, cardiovascular diseaseAtherosclerosis, cardiovascular disease
Central/abdominal obesity
High FPG
HBP
MicroalbuminuriaHigh TG
Metabolic Metabolic Syndrome Syndrome
ororINSULININSULIN
RESISTANCERESISTANCE
Endothelial dysfunction
Low HDL
Insulin Resistance Syndrome (Metabolic Syndrome)
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Atherosclerosis, cardiovascular diseaseAtherosclerosis, cardiovascular disease
Central/abdominal obesity 24.6%
High FPG 18.1%
HBP 23.1%
MicroalbuminuriaHigh TG 20.7%
Oman 21%
Endothelial dysfunction
Low HDL 75.4%
Al-Lawati JA, Prevalence of the metabolic syndrome among Omani adults. Diabetes Care 2003;26(6):1781-5.
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Overweight in GCC
36.135.2
28.7
32.1
27.126.9
32.3
29.5
0
5
10
15
20
25
30
35
40
Bahrain Kuwait KSA Oman
Male Female
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Obesity in GCC
22
32.3
15.5 16.7
23.823.6
40.641.4
0
5
10
15
20
25
30
35
40
45
Bahrain Kuwait KSA Oman
Male Female