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IDF-EMME Region Meeting September 7-9, 2007 Cairo, Egypt

IDF-EMME Region Meeting September 7-9, 2007 Cairo, Egypt. Diabetes Mellitus in Jordan: “ A Worsening National Health Problem”. Mohamed M. El- Zaheri , MD, FACE Clinical Associate Professor of Medicine (JU).

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IDF-EMME Region Meeting September 7-9, 2007 Cairo, Egypt

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  1. IDF-EMME Region MeetingSeptember 7-9, 2007 Cairo, Egypt

  2. Diabetes Mellitus in Jordan:“A Worsening National Health Problem” Mohamed M. El-Zaheri, MD, FACE Clinical Associate Professor of Medicine (JU). Consultant Internist – Endocrinologist, National Center of Diabetes, Endocrine & Genetic Diseases. Chairman, Department of Internal Medicine, Jordan Hospital & Medical Center. President, The Jordanian Society For The Care Of Diabetes. Amman, JORDAN

  3. Worldwide prevalence of diabetes in 2000 Numberofpersons < 5,000 5,000–74,000 75,000–349,000 350,000–1,499,000 1,500,000–4,999,000 > 5,000,000 No data available Adapted from WHO Diabetes Programme Facts and Figures: www.who.int/diabetes/facts/world_figures/en. Accessed 1 August, 2006.

  4. Worldwide prevalence of diabetes in 2030 (projected) Number of persons < 5,000 5,000–74,000 75,000–349,000 350,000–1,499,000 1,500,000–4,999,000 > 5,000,000 No data available Total cases > 300 million adults Adapted from WHO Diabetes Programme Facts and Figures: www.who.int/diabetes/facts/world_figures/en. Accessed 1 August, 2006.

  5. Prevalence of diabetes in Eastern Mediterranean and Middle East Region in 2003 Saudi Arabia 9.4% 1 million Afghanistan 8.2% 0.9 million Egypt 9.8% 3.9 million Pakistan 8.5% 6.2 million Sudan 3.1% 0.5 million United Arab Emirates 20.1% 0.4 million Yemen 7.7% 0.6 million Total cases > 19 million adults International Diabetes Federation. Diabetes Atlas. 2nd Edition. www.eatlas.idf.org. Accessed 27 October, 2006.

  6. Diabetes in USA

  7. Global burden of diabetes 1995–2025 300 228 135 89 72 51 ↑ 122% ↑156% 300 250 200 150 100 50 0 1995 2025 Number of adult population with diabetes (millions) ↑ 41% Developed Developing All countries King H et al. Diabetes Care 1998;21:1414–31

  8. PREVALENCE OF MALE OBESITY

  9. PREVALENCE OF FEMALE OBESITY

  10. UKPDS Results: Causes of Death Intensive Conventional Cause Rate* % Rate* % MI 7.6 42 8 42 Stroke 1.6 9 1.3 7 Sudden death 0.9 5 1.6 8 PVD 0.1 1 0.3 2 All macrovascular 10.2 57 11.2 59 Renal disease 0.3 2 0.2 1 Cancer 4.4 25 4.4 23 Other specified 2.4 13 2.7 14 Unknown 0.5 3 0.2 1 Total 17.9 100 18.9 100 *Per 1000 patient years Adapted from UK Prospective Diabetes Study Group Lancet 1998;352:837-853.

  11. Diabetes In Jordan

  12. Map Of JORDAN

  13. Diabetes & IGT In JordanOverall Prevalence (WHO Criteria) % Ajlouni K, et al ; J. Int. Med., 244: 317-323, 1998

  14. Diabetes Mellitus In JordanPrevalence by Age Yr % Age Categories Ajlouni, K, et al ; J. Int. Med., 244: 317-323, 1998

  15. Diabetes & IGT In JordanPrevalence By Age % yr Ajlouni K, et al ; J. Int. Med., 244: 317-323, 1998

  16. Diabetes Mellitus in JordanPrevalence by Other Variables % Ajlouni K, et al ; J. Int. Med., 244: 317-323, 1998 Smoking: NS, Sex: NS

  17. IGT In JordanPrevalence By Other Variables * % * = NS Sex : NS, Smoking : NS Ajlouni K, et al, J. Int. Med. ; 244: 317-323, 1998

  18. * Natural History of IGT in N. Jordan( Over a period of 2 Years ) P-value = 0.12 *WHO Criteria Ammari F., et al, Practical Diabetes International; vol. 15 (5), 1998

  19. Relationship Of Some Variables To Subsequent Progression To Type 2 Diabetes Ammari F., et al, Practical Diabetes International; vol. 15 (5), 1998

  20. Age n= 539 49% 40% 5% 5% 1% age years Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  21. GLYCOSYLATEDHEMOGLOBIN n= 283 74% of patients have HbA1c ≥ 7% (and 42% ≥ 9%) 18% 17% 16% 16% 10% 8% 8% 7% HbA1c %% Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  22. TOTAL CHOLESTEROL n= 228 64% 36% of patients have their cholesterol ≥ 200 mg/dl 26% 8% 1% 1% <1% mg/dl Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  23. LOW DENSITY LIPOPROTIEN CHOLESTEROL n= 224 51% 49% of patients have LDL ≥100 mg/dl 25% 13% 9% 1% 1% mg/dl Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  24. TRIGLYCERIDES n= 225 45% 55% of patients have TG ≥150 mg/dl 27% 21% 6% <1% mg/dl Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  25. HIGH DENSITY LIPOPROTIEN CHOLESTEROL n= 224 29% 50% of patients have HDL < 40 mg/dl 25% 21% 13% 8% 4% mg/dl Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  26. HDL – Cholesterol, MALES n = 128 33% 59% have HDL levels <40mg/dl 26% 23% 11% 5% 2% mg/dl Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  27. HDL – Cholesterol, FEMALES n = 96 27% 24% 67% have HDL levels <50 mg/dl 16% 15% 11% 7% mg/dl

  28. TYPE OF ANTI-DIABETIC TREATMENT n= 545 36% on insulin (8%+OAA) 20% 20% 40% on Sulphonylurea 14% Rx result 10% 9% 8% 6% 4% 4% Sunnoqrut N et al, Program of 1st Joint JSED-AACE Congress, May 17-19,Amman, Jordan (Abstract # OP3)

  29. The change in Prvalence 0f type 2 DM in Jordan between 1994 & 2004 Ajlouni K et al, The Journal of Diabetes and its Complications, (in press)

  30. (NCEP May 2001, 3 out of 5)

  31. Distribution Of Co-Morbidities By BMI

  32. Age-specific prevalence of the metabolic syndrome among Jordanians aged ≥25 years by sex % n= 1121 (total) Khader Y et al, J Diabetes and its Complications 21 (2007) 214-219

  33. Causes of end-stage renal disease in patients on haemodialysis (HD) in Jordan, 2004 % n= 1711 Abdallah S et al. Eastern Mediterranean Health Journal, 2007, 13 (4):803-809

  34. Causes of end-stage renal disease in patients on haemodialysis (HD) in Jordan in 2002 vs. 2003 % n= 1711 Abdallah S et al. Eastern Mediterranean Health Journal, 2007, 13 (4):803-809

  35. Causes of end-stage renal disease in patients on haemodialysis (HD) in Jordan, 2004 % n = 1711 Abdallah S et al. Eastern Mediterranean Health Journal, 2007, 13 (4):803-809

  36. Conclusions - Diabetes Prevalence in Jordan is High and Is Rising at a Rate of 4% per Decade. - Risk Factors for DM Include Obesity, Illiteracy, Hypertension, Hyperlipidemia and Advancing Age. - Prevalence of The Metabolic Syndrome Above Age 25 is 36.3 %

  37. EUXAPIΣΤŴ MercieDankeeGraciasThank You

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