Type 2 Diabetes in the Middle East and North Africa (MENA)
Background: Diabetes is a growing public health problem in the MENA region with a significant impact on morbidity, mortality, and healthcare resources. Currently, the prevalence of type 2 diabetes (T2D) in the MENA region is estimated at 9.7 %.
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Type 2 Diabetes in the Middle East and North Africa (MENA) Yasmin Khan and Osama Hamdy
Introduction The Middle East and North Africa (MENA) region encompasses approximately 22 countries and comprises 6 % of the world’s population. It is a geographic area with rich history and linguistic, ethnic, and cultural diversity. According to WHO statistics from 2010, Egyptians account for more than one-third of the population in this region, followed by North Africans and Arabs from the Gulf (Fig. 4.1). The MENA region has one of the highest prevalence rates of diabetes in the world (11 %) (Fig. 4.2). Diabetes is a global pandemic affecting more than 415 million adults worldwide. This number is expected to surge to 642 million by 2040 [1]. According to the International Diabetes Federation (IDF), over 35 million people in MENA have diabetes. Saudi Arabia leads the MENA region with the highest prevalence of diabetes (23.9 %), and Egypt is the country with the largest number of diabetes patients (7.5 mil-
Y. Khan, MD, MPH (*) Adult Diabetes Section, Joslin Diabetes Center, Boston, MA, USA e-mail: [email protected] O. Hamdy, MD, PhD, FACE Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA e-mail: [email protected]
lion) [1]. The rapid rise is due to a multitude of factors, including economic and demographic changes over the last few decades that have led to a decrease in physical activity and rise in obesity. The MENA region has among the highest obesity rates in the world (Fig. 4.3). Diabetes is associated with early mortality and increased risk for microvascular and macrovascular complications. Approximately 40 % of patients with diabetes have chronic kidney disease, and almost 60–70 % of patients with diabetes have mild to severe forms of nervous system damage. In addition, patients with diabetes are two to four times more likely to have fatal or nonfatal coronary events or stroke. Almost 70–80 % of patients with diabetes die from one of these two conditions. The American Heart Association considers diabetes to be one of the six major controllable risk factors for cardiovascular disease. Researchers also consider diabetes as a risk equivalent to having a prior heart attack. In addition to being a major public health problem, diabetes is also associated with significant healthcare costs. Worldwide, the global cost of diabetes continues to soar and is now estimated to be 825 billion dollars per year [2]. The IDF estimates that in 2015, countries in the Middle East spent over 17 billion dollars on diabetes care. This figure accounts for only 2.5 % of global spending on the disease [1]. Healthcare expenditure
© Springer International Publishing Switzerland 2017 S. Dagogo-Jack (ed.), Diabetes Mellitus in Developing Countries and Underserved Communities, DOI 10.1007/978-3-319-41559-8_4
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Y. Khan and O. Hamdy
50 Fig. 4.1 Ethnicity of the MENA region (Source: 2010 WHO statistics)
26.7 (8%) lestinians jordanians Iraqis 38.9 (12%)
(1%) (3%)
Egyptians/ Sudaneses 108.4 (33%)
Gulf Arabs
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