Diabetes National Diabetes Control Programme National Diabetes Control Committee with members from MOH and out

1. 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

2. 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

3. 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%.

4. National Health Survey, 2000 Total: 5856 IFG: 6.1% IFG+diabetes: 17.8%

5. Prevalence of Diabetes and IGT in Oman using 1999 WHO diagnostic criteria DM: diabetes mellitus, IGT: Impaired glucose tolerance, IFG: Impaired fasting glucose

6. Prevalence of diabetes in males in the national health survey, 2000

7. Prevalence of diabetes in females in the national health survey, 2000

8. Body Mass Index, overweight and obesity Dhofar: 71%, Muscat and Dahirah: 50%

9. 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

10. 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).

11. Hospital Mortality 1989-1993

12. Diabetes Prevalence in GCC Ages 20+ years MOH, UAE, 2000 Abedlla et al, 1998 Al-Nuaim, 1997 Asfour et al, 1991

13. Diabetes Mellitus, GCC Estimates, 1995-2025 Source: The World Health Report, 1997, WHO

14. Prevalence 1991 vs 2000Oman

15. Age & Diabetes National Health Survey, Oman, 2000

16. Fasting Blood Glucose for Diabetes Do you have Diabetes + - Total Yes 192 75 267 No 5139 5519 Total 572 5214 5786 Undiagnosed Diabetes in Oman 380 National Health Survey, Oman, 2000

20. Trends of BMI by Gender (Oman)

21. Insulin Resistance Syndrome (Metabolic Syndrome) Central/abdominal obesity High TG Microalbuminuria Low HDL Metabolic Syndrome or INSULIN RESISTANCE HBP Endothelial dysfunction High FPG Atherosclerosis, cardiovascular disease

22. Al-Lawati JA, Prevalence of the metabolic syndrome among Omani adults. Diabetes Care 2003;26(6):1781-5. Central/abdominal obesity 24.6% High TG 20.7% Microalbuminuria Low HDL 75.4% Oman 21% HBP 23.1% Endothelial dysfunction High FPG 18.1% Atherosclerosis, cardiovascular disease

23. Overweight in GCC

24. Obesity in GCC