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

This paper discusses the escalating prevalence of diabetes in Jordan, highlighting statistics, risk factors, and treatment modalities. The author, Dr. Mohamed M. El-Zaheri, sheds light on the concerning rise of diabetes cases in the country, emphasizing the need for proactive measures to address this national health issue. The data presented underscores the urgency of implementing effective strategies to combat diabetes and its associated complications in Jordan.

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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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