dr. abdulraziaq al-madani diabetes complications in the gulf countries

Dr. Abdulraziaq Al-Madani

Diabetes Complicationsin the Gulf Countries

Diabetes Mellitus

an Epidemic Disease in the

Gulf Countries

EpidemiologicalData

Diabetes Mellitus Prevalence

Kuwait14.8

Bahrain11.0

UAE15.7

Qatar15.0

Saudi Arabia12.3

Oman10.0

Diabetes Mellitus

an Epidemic Disease in the

Gulf Countries

EpidemiologicalData

Impaired Glucose Tolerance Prevalence

Kuwait12.8

Bahrain11.0

UAE13.2

Qatar11.0

Saudi Arabia11.9

Oman10.0

0

1

2

3

4

5

6

7

8

Developedcountries

Developingcountries

World total

1995 2000 2025

Prevalence of Diabetes Mellitus

Prevalence:

Diabetes prevalence in the adult population (>20 years) by year and region for developed and developing countries and world total.

WHO report 2000.

Diabetes Complications in the Gulf Countries

0

10

20

30

40

50

60

1995 2000 2025Sub-Saharan Africa Middle Eastern Crescent China

Number of diabeticsNumber of Diabetics:

WHO data for the expected number of diabetic patients according to regions and years.

WHO report 2000.

Million

s



Diabetic Neuropathy

Diabetic Retinopathy

Diabetic Nephropathy

Diabetic Vasculopathy

1

2

343

3

3

1

1

1

2

2 2

0

10

20

30

40

50

Nephropathy

Prevalence of microvascular complications:

Comparing data from Arabcountries with data of the highest & lowest prevalence world wide in the year 2000.

The major complications willbe soon the highest in Arab countries due to the lack of prevention programs.

WHO report 2000.

Neuropathy

Retinopathy



Diabetic Neuropathy




0

20000

40000

60000

80000

100000

Developedcountries

Developingcountries

World total

1995 2000 2025

Neuropathy

Neuropathy:

Number of persons with diabetic neuropathy in different countries and according to the time.

WHO report 2000



NEUROPATHY WITH

DURATION

0

20

40

60

80

100

<1 5 10 15 20 25 30

%

Years

Diabetes Care 1, 168-188 1978

IDDM

NIDDM


IDDM NIDDMTotal

Population: No. 168.000 1.512.0001.680.000

% 10% 90% ( 14% )

Duration: 10 years ( % ) 10% 30%( Number) 16.800 453.600

470.400 20 years ( % ) 30% 80%

( Number) 50.400 1.209.6001.260.000

30 years ( % ) 60% 100%( Number ) 100.800 1.512.000

1.680.000

Number of Neuropathic Saudi Diabetics


Diabetic Neuropathy





RETINOPATHY WITH

DURATION

0

20

40

60

80

100

<1 5 10 15 20 25 30 35

%

Years

ADA 1993 Vital Statistic

Any Retinopathy

Proliferative Retinopathy


BLINDNESS BY DURATION OF

DIABETES

0

2

4

6

10 20 30

%

Years

ADA 1993 Vital Statistic

Age at diagnosis

20 years old

Age at

dia

gnosis 6

0 ye

ars ol

d

0

20000

40000

60000

80000

100000

120000

Developedcountries

Developingcountries

World total

1995 2000 2025

Retinopathy

Retinopathy:

Number of persons with diabetic retinopathy in different countries and according to the time.

WHO report 2000


Prevalence of Retinopathy inSaudi diabetic patients

31.5%

IDDM 42.5%NIDDM 25.3%

Risk factors for Retinopathy in Saudi diabetic patients

Duration > 10 years.

Presence of nephropathy.

Older than 60 years.

Poor diabetes control.

Use of insulin.



Diabetic Neuropathy





NEPHROPATHY WITH DURATION

0

10

20

30

40

50

60

<1 5 10 15 20 >20

%

Years

NIDDM

IDDM

NovoCare 1995

0

1

2

3

4

5

<1 5 10 15 20 25 30 35 40

Years

N Engl J Med 1987 , 317. 1390-1398

Rate

/ 1

00

su

bje

cts

/ year

0

10000

20000

30000

40000

50000

Developedcountries

Developingcountries

World total

1995 2000 2025

Nephropathy

Nephropathy:

Number of persons with diabetic nephropathy in different countries and according to the time.

WHO report 2000


ESRF in Saudi Arabia:

• Increase in the total cases.

• More increase in the diabetic ESRF.

• Slow transplantation program.

0

20

40

60

80

100

1985 1990 1995 2000Others Diabetic

%


Dialysis in Riyadh

Number of patients.

Vs

Number of units.

0

400

800

1200

1600

2000

2400

1985 1990 1995 2000Unit Cases



Diabetic Neuropathy




Cancer6%

Others6%

CVA18%

IHD46%

MI18%

Cardiac arrest6%

2000 Saudi diabetics ( Initial )

General Mortality

inSaudi

diabeticpatients

2000 Diabetics attending Diabetic Center KSU.

70 %


General mortality55 per 1000 per 5yrs11 per 1000 per year

Cardiac mortality8 per 1000 per year

Cardiac Mortality70%

Non-cardiac Mortality30%

Cardiac Morbidity9.1%

CardiacMortality

inSaudi

diabeticpatients

2000 Saudi diabetics ( Initial )

Cardiac mortality 8 per 1000 per year

In Saudi Arabia 12,000,000 Inhabitance1,500,000 Diabetics

Cardiac deaths in diabetics =8 X 1,500

= 12,000 per year

Cardiac mortality 8 per 1000 per year

In Saudi Arabia 12,000,000 Inhabitance1,500,000 Diabetics

Cardiac deaths in diabetics =8 X 1,500

= 12,000 per year


Number of deaths:

In millions for patients aged> 20 years estimated for the year 2000.Percentage of total deaths attributable to diabetes:

11.9% Baseline3.5%

Optimistic3.8% Etiologic~ 9% WHO

WHO report 2000.

9 %

Nu

mb

er

of

death


Diabetes in the Gulf countries

Diabetes is the leading cause for Blindness

Diabetes is the leading cause for ESRF

Diabetes is the leading cause for IHD

Diabetes is the leading cause for CVA

Diabetes is the leading cause for Amputation


dr. abdulraziaq al-madani diabetes complications in the gulf countries

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