Demographic and lifestyle factors are largely responsible for an alarming increase of diabetes in Qatar and other countries in the Middle East and North Africa, according to a new study from Weill Cornell Medical College and Weill Cornell Medical College in Qatar.
The study, published in the December issue of Qatar Medical Journal, found that a more “westernized” lifestyle, characterized by calorie-rich diets and reduced physical activity, has made people in the region more susceptible to developing type 2 diabetes mellitus and other associated chronic conditions. Investigators say the findings underscore a need to raise awareness of diabetes, promote physical activity and emphasize the risks associated with obesity.
"The Qatar National Health Strategy has identified diabetes as one of the high-priority diseases for preventive healthcare, and for good reason," said senior author Dr. Alvin I. Mushlin, the Nanette Laitman Distinguished Professor of Public Health and a professor of healthcare policy and research and of medicine at Weill Cornell Medical College. "In addition to its direct effect on health and quality of life, diabetes is a cause of conditions such as diabetic retinopathy, kidney failure, cardiovascular disease and associated heart attacks, strokes and earlier death."
Paradoxically, the increase of diabetes and other non-communicable diseases in this region is largely tied to major improvements in economic conditions, the investigators said. There have been remarkable improvements in the health infrastructure, a lengthening of life expectancy, an increasingly aging population, and a fast pace of urbanization.
To determine the risk factors that have led increased incidence of the disease, the investigators looked at patient records for more than 450 patients — including Qatari nationals and immigrants — with type 2 diabetes who had received care from Hamad Medical Corporation Hospital's outpatient adult diabetes clinics from 2006-2008. They compared these patients to nearly 350 other patients who received care from various outpatient and inpatient clinics at the hospital.
Since more than 80 percent of the population of Qatar consists of immigrants from countries throughout the Arab world, South Asia and other regions, the researchers also conducted a sub-analysis of only Qatari nationals to see if this group had a different risk factor profile than the population at large.
"In our study, Qatari nationality was the strongest risk factor for DM, followed by higher income, obesity, no college education and no vigorous or moderate exercise," said lead author Dr. Paul J. Christos, a lecturer in healthcare policy and research in the Division of Biostatistics and Epidemiology.
"While further evaluation of DM risk factors among the Qatari population (as opposed to the resident population) is important and of interest," said study co-author Dr. Laith Abu-Raddad, an associate professor and principal investigator of the Infectious Disease Epidemiology Group at Weill Cornell Medical College in Qatar, "these findings highlight the need to focus short-term DM interventions on addressing demographic/lifestyle risk factors to achieve substantial and timely declines in DM levels."