A cross-sectional study of the association between persistent organic pollutants and glucose intolerance among Greenland Inuit

AIMS/HYPOTHESIS: Some evidence supports the hypothesis that persistent organic pollutants (POPs) may increase the risk of type 2 diabetes. The Inuit population in Greenland, which is highly exposed to POPs due to a high intake of marine mammals, has experienced a rapid increase in diabetes prevalence over the last 30 years. Thus the aim was to study the association between POPs and glucose intolerance and markers of insulin resistance and insulin secretion using a population-based design. METHODS: From 1999 to 2002 the Greenland population study was carried out among adult Inuit living in Greenland. The examination included a 75 g OGTT, anthropometric measurements, a structured interview, and blood tests. Plasma glucose and serum insulin were analysed, and three defined subclasses of POPs were analysed in a subgroup. Associations were adjusted for age, sex, waist circumference, Inuit heritage, cigarette smoking, alcohol consumption and educational level. RESULTS: Data on POPs were available on 692 individuals, 305 men (mean age 50 years) and 387 women (mean age 49 years). The prevalence of diabetes was 10.3%, and 10.5% had impaired glucose tolerance. The concentrations of several POPs were exceptionally high. While no associations were found between POPs and stages of glucose intolerance or markers of insulin resistance, POPs were significantly inversely associated with stimulated insulin concentrations and homeostasis model assessment of beta cell function. CONCLUSIONS/INTERPRETATION: The study indicates that POPs may affect insulin secretion rather than being involved in the pathogenesis of insulin resistance. No association was seen between POPs and glucose intolerance or markers of insulin resistance.     

Prevalence and determinants of diabetes mellitus and glucose intolerance in a Canarian Caucasian population - comparison of the 1997 ADA and the 1985 WHO criteria. The Guía Study.

AIMS: To estimate the prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance in a Canarian population according to the 1997 ADA and the 1985 WHO criteria; and to study the cardiovascular risk factors associated with these categories. METHODS: A total of 691 subjects over 30 years old were chosen in a random sampling of the population (stratified by age and sex). An oral glucose tolerance test was performed (excluding known diabetic patients) and lipids were determined in the fasting state. Anthropometric and blood pressure measurements were performed, and history of smoking habits and medications was recorded. RESULTS: The prevalence of diabetes was 15.9% (1997 ADA) and 18.7% (1985 WHO); the prevalence of impaired fasting glucose and impaired glucose tolerance was 8.8 and 17.1%, respectively. The age-adjusted prevalence of diabetes (Segi's standard world population) for the population aged 30-64 years was 12.4% (1985 WHO). The risk factors significantly associated with diabetes (1997 ADA and 1985 WHO) were age, body mass index; waist-to-hip ratio, systolic and mean blood pressure, triglycerides, total cholesterol and low HDL-cholesterol. Age, body mass index and systolic blood pressure were associated with impaired fasting glucose and impaired glucose tolerance; triglycerides were also associated with impaired fasting glucose. CONCLUSIONS: The prevalence of diabetes mellitus and glucose intolerance in Guía is one of the highest among studied Caucasian populations. The new 1997 ADA criteria estimate a lower prevalence of diabetes. Impaired fasting glucose also had a lower prevalence than impaired glucose intolerance and the overlap of these categories was modest.     

Glucose tolerance in a rural population of Bangladesh

CONTEXT:

The prevalence of type 2 diabetes is increasing in the Bangladeshi population. However, there is little information available on the prevalence of glucose intolerance, ie, type 2 diabetes, impaired glucose tolerance, and impaired fasting glucose.

AIMS:

The main aim of this study is to determine the prevalence of different categories of glucose intolerance and their relationship with different anthropometric and demographic characteristics.

SETTINGS AND DESIGN:

This cross-sectional study was performed in a rural area of Bangladesh.

MATERIALS AND METHODS:

A random sample of 5000 persons aged ≥ 20 years was included in this study. Fasting blood glucose was measured in 3981 individuals and 2-h post-glucose blood glucose was measured in 3954 subjects after the known cases of diabetes (n = 27) were excluded. Height, weight, waist and hip circumference, and blood pressure were measured.

STATISTICAL ANALYSIS:

Pearson Chi-squared test and correlation test were used for analysis as appropriate.

RESULTS:

The prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes (DM) were 1.3, 2.0, and 7.0%, respectively. IFG, IGT, and IFG + IGT were more prevalent in females. Age showed a significant positive relationship with increasing levels of glucose intolerance. Body mass index, waist circumference, and waist-to-hip ratio were higher in the glucose-intolerant group than in the normal glucose tolerance (NGT) group. There was a positive correlation between FBG and 2-h BG in NGT and DM subjects.

CONCLUSION:

The FBG value identified more people with glucose intolerance than the 2-h BG. These findings will help developing diabetes preventive strategy in rural populations.     

Study of the Prevalence of Diabetes Mellitus in Adults in the Shougang Corporation in Beijing

The aim was to determine the burden of diabetes mellitus (DM) in an urban area of China to aid us in planning preventive measures for those at risk of DM. A survey was conducted among the 29 859 subjects aged between 30 and 64 belonging to 32 units of the Shougang Corporation (a heavy industry enterprise) within the Beijing area. WHO study protocols and diagnostic criteria were used to determine the prevalence of DM and impaired glucose tolerance (IGT). The results showed that the age-adjusted prevalance of DM and impaired glucose tolerance (IGT) was 3.63 % and 4.19 %, respectively, both increasing with age. Peak prevalence for both occurred in the 60–64 age group. Prevalence showed no difference between the sexes in DM but was higher for females in IGT. Obesity, being overweight, a family history of diabetes mellitus and in women, a history of delivering babies with macrosomia, all correlated closely with the prevalence of DM and IGT. High protein intake was also associated with DM. Smoking had no effect on either DM or IGT. Intellectual workers had a higher incidence of IGT than manual workers. Seventy per cent DM was undiagnosed prior to the survey. This survey, done according to the recommendation of WHO, and including appropriate adjustments, reflects the growing prevalence of DM and IGT in this population. It can be compared with other studies for epidemiological analysis.     

冠心病合并糖代谢异常分析

目的探讨冠心病患者合并糖代谢异常的构成比变化趋势。方法回顾性分析1997、2002、2007年广东省心血管病研究所心内科住院的冠心病(2951例)合并糖代谢异常患者457例的临床资料,以上述3年的病案进行统计学处理,构成比标准化依据国际卫生组织人口构成。结果在内科住院的冠心病病人中,合并空腹血糖受损、糖耐量异常、2型糖尿病较1997年呈上升趋势;1997、2002、2007年的构成比分别为3.8%、16.5%、和10.8%。结论冠心病合并糖代谢异常越来越常见,在冠心病的二级预防中应高度重视糖代谢异常发生的防治。     

Undiagnosed diabetes and impaired glucose regulation in adult Ghanaians using the ADA and WHO diagnostic criteria

Fasting glucose and oral glucose tolerance test (OGTT) criteria for glucose homeostasis were compared in a cross-sectional cluster, community study in Accra, Ghana. A total of 4636 subjects without prior diagnosis of diabetes had fasting plasma glucose, 2-hour OGTT and measurement of cardiovascular risk factors. Mean age of subjects was 44.2 years; 39.1% of subjects were males. The overall prevalence of undiagnosed diabetes ascertained with both criteria was 4.5% (n=209). The prevalence of undiagnosed diabetes by fasting (3,2%) and OGTT (3.1%) criteria were similar (p>0.05). The prevalence of impaired glucose tolerance (IGT) (15.8%) was higher than that of impaired fasting glucose (IFG) (10.7%). Only 56.5% (n=83) of subjects with diabetes by fasting criteria also had diabetes by OGTT criteria. Sixty-two subjects (42.8%) with diabetes by OGTT had normal or impaired fasting glucose. There was poor agreement between the two diagnostic criteria (kappa=0.31). The concordant normoglycaemic group was the youngest and had the lowest body-mass indey (BMI), waist girth, waist-hip ratio (WHR), total cholesterol, and systolic and diastolic blood pressures. The concordant diabetic group, in contrast, had the highest BMI, waist girth, WHR, total cholesterol and triglyceride levels. Both systems gave similar undiagnosed diabetes rates bur dissimilar IFG and IGT rates. There was poor agreement between the two diagnostic criteria. Diagnostic criteria influenced cardiovascular risk factors. A case may be made for using both criteria in order to ascertain all “diabetes” and all “at-risk” subjects. Received: 4 January 2001 / Accepted in revised form: 18 January 2002     

Epidemiology of Diabetes Mellitus in the Elderly in Northern Greece: a Population Study

This population based study was undertaken to ascertain the overall prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in the elderly using the WHO criteria. The role of obesity in the development of DM or IGT has been investigated for both sexes per decade of age. Furthermore the potential for DM to increase with age, as has been suggested before, has been evaluated using the IGT as a proportion of total glucose intolerance (IGT/TGI) for the same parts of the tested sample. From the 647 persons registered as elderly people in a small town in northern Greece (total population 5875 people), 66 persons did not participate in this survey. Fifty-six subjects (9.7%) had previously diagnosed DM. The remainder were tested using fasting blood glucose measurements or an oral glucose tolerance test (OGTT). The prevalence of previously undiagnosed DM according to fasting blood glucose values or after 2 h of 75 g load values was 10.1% and 9.3%, respectively. Thus the overall prevalence of DM was 29.1% and of IGT was 15.1%. These data support an increased frequency of DM (65% previously undiagnosed) and IGT in the elderly, whereas this population's susceptibility seems to decline in the older groups for both sexes. Obesity remains a risk factor for DM and IGT particularly among the younger groups although its role has been found to decline with age.     

Prevalence of Diabetes Mellitus in an Elderly Finnish Population

The prevalence of diabetes mellitus was investigated in a northern Finnish community population aged 70 years or over. Of the eligible 483 persons, 78.5% (n = 379) took part in the study. The presence of diabetes mellitus was assessed by questions about the participants' previously diagnosed diabetes and 2 h oral glucose tolerance tests, which were performed according to the current WHO criteria. Only the participants who were on oral hypoglycaemic drugs or insulin treatment were excluded from the 2 h oral glucose tolerance tests. In the total population the prevalence of Type 2 diabetes was 22.0% among men and 28.2% among women; the difference between sexes was not significant (women's risk ratio (RR) 1.3, 95% confidence interval (CI) 0.9-1.9). Among those aged 80 years or over the risk ratio for women was 11.3 compared with men (95% CI 1.6–79.5). Among men the prevalence was higher in the age group 70–79 years compared with those aged 80 years or over (RR 8.1, 95% CI 1.2–57.1). By contrast, among women, diabetes was less common among those aged 70–79 years compared with those aged 80 years or over (RR 0.6, 95% CI 0.4-1.0). The proportion of undiagnosed diabetes was clearly over one-third among men and just over one-third among women. Of men, 31.9% suffered from impaired glucose tolerance; the corresponding figure for women was 35.3%. The comparatively high proportion of undiagnosed diabetes and impaired glucose tolerance among elderly people lends support to the more frequent use of the 2 h glucose tolerance test in clinical practice.     

The natural history of impaired glucose tolerance in the Micronesian population of Nauru: A six-year follow-up study

Summary A longitudinal study of 266 randomly selected non-diabetic Nauruans (215 normal subjects, 51 with impaired glucose tolerance) has permitted the natural history of impaired glucose tolerance to be studied in this Micronesian population. Nauruans are known to suffer from a very high prevalence of abnormal glucose tolerance. The subjects were first examined in 1975–1976, and a follow-up examination was performed in 1982. Of the subjects with impaired glucose tolerance, 26% developed diabetes during the study period (4% per annum) compared with 7% of normal subjects (1% per annum). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (odds ratio 3.6, 95% confidence interval 1.4–9.1). Of those with impaired glucose tolerance on initial examination, 39% were normoglycaemic at follow-up. In subjects with impaired glucose tolerance, of nine factors examined only plasma glucose concentration at the time of the initial examination was consistent in predicting progression to diabetes, when the data were examined by both univariate and multivariate methods. Both 2-h and fasting plasma glucose values were useful predictors. Thus, Nauruans with impaired glucose tolerance have a higher risk of subsequent diabetes than their normoglycaemic counterparts, after controlling for age and obesity. Nevertheless, the prognosis of impaired glucose tolerance is unpredictable as a substantial proportion of such subjects return to normality. Plasma glucose concentration is the most important predictor of subsequent diabetes. These results accord with recent findings from longitudinal studies of impaired glucose tolerance in other populations.     

The effects of physical activity, body mass index (BMI) and waist circumference (WC) on glucose intolerance in older people: A nationwide study from Taiwan

We investigated the gender-specific effects of physical activity, BMI and WC on glucose intolerance in an elderly Taiwanese population (n = 1344) aged 65 and above, who participated in the Elderly Nutrition and Health Survey in Taiwan in 1999-2000. In this cross-sectional study, physical activity was assessed using the Modified Baecke Questionnaire for Older Adults (MBQOA). Categories of physical activity level were defined by tertiles of MBQOA scores. Glucose intolerance in subjects not previously diagnosed with diabetes was categorized according to 2003 American Diabetes Association criteria. After adjustment for potential confounders, physical activity was significantly inversely associated with the presence of undiagnosed type 2 diabetes and impaired fasting glucose (IFG) in older women. In older men, the association was less clear. BMI and WC were significantly positively associated with the presence of undiagnosed diabetes in men and were significantly associated with IFG in both sexes. In older women, undiagnosed diabetes was strongly associated with increased WC, but not with BMI. Our findings highlight that older women with low physical activity or high WC, and older men with high BMI or WC are important target populations for interventions to prevent glucose intolerance.     

四川巴中地区老年人糖尿病及糖调节受损患病率的调查

目的了解四川巴中地区老年人糖尿病（DM）及糖调节受损的发病现状。方法采用多级抽样的方法,抽取2414名巴中地区60岁及以上人群进行问卷调查、体检、血糖检查和糖耐量试验。结果2414名对象中,有252例患DM,患病率为10．4％;女性DM患病率高于男性,城镇高于农村,大专及以上文化程度的发病率最低,从事脑力劳动的高于体力劳动的,随经济收入的增高,DM患病率增高。单纯IFG患病率为6．6％,单纯的IGT患病率为22．8％,IFG合并IGT的患病率为1．9％。结论巴中地区老年人糖尿病及糖调节受损的患病形势严峻,应重视和加强防治工作。     

Undiagnosed Glucose Intolerance in the Community: the Isle of Ely Diabetes Project

The Isle of Ely Diabetes Project is a prospective population-based study of the aetiology and pathogenesis of Type 2 diabetes mellitus. Between 1990 and 1992, 1156 subjects aged between 40 and 65 years underwent a standard 75 g oral glucose tolerance test (OGTT). A total of 1122 individuals who were not known to have diabetes completed the test and were classified according to WHO criteria; 51 subjects (4.5%) had previously undiagnosed diabetes and 188 (16.7%) had impaired glucose tolerance. The subjects with newly diagnosed glucose intolerance were significantly older, more obese, and shorter than those with normal glucose tolerance. Blood pressure, cholesterol, triglyceride, and LDL-cholesterol concentrations were elevated and HDL-cholesterol levels were lower among those with abnormal rather than normal glucose tolerance. In multiple regression analyses stratified by gender and including age, body mass index, and the waist-hip ratio as covariates, there were significant differences between those with normal and abnormal glucose intolerance in blood pressure, triglyceride, and HDL-cholesterol, but not total or LDL-cholesterol. In both male and female subjects, height had a significant independent negative association with the plasma glucose at 120 min after administration of oral glucose (standardized β coefficient = -0.12, p<0.01).     

Pakistan National Diabetes Survey: Prevalence of Glucose Intolerance and Associated Factors in Shikarpur,Sindh Province

The prevalence of diabetes mellitus and impaired glucose tolerance (IGT) and their relationship to age and obesity was estimated in the rural town of Shikarpur in Sindh Province, Pakistan by a population-based survey in 1994. Oral glucose tolerance tests were performed in a stratified random sample of 967 adults (387 men, 580 women) aged 25 years and above. The diagnoses of diabetes and IGT were made on the basis of WHO criteria. The response rate was 71% for men and 80% for women. The prevalence of diabetes was 16.2% (9.0% known, 7.2% newly diagnosed) in men, and 11.7% (6.3% known, 5.3% newly diagnosed) in women. The prevalence rose with age to a peak of 30% and 21% in 65–74 year-old men and women respectively. IGT was detected in 8.2% of men and 14.3% of women. Thus, total glucose intolerance (diabetes and IGT combined) was present in 25% of subjects examined. These results indicate that glucose intolerance in South Asians can no longer be regarded as a problem confined to migrant communities. Of the 72 subjects previously known to have diabetes, none was using insulin treatment, but 57 (79%) took oral hypoglycaemic agents. Central obesity and positive family history were strongly associated with diabetes, as was prevalence of hypertension. The association with central obesity was greater for women than for men, and suggests important, modifiable risk factor(s) related to lifestyle.     

2010年新疆福海地区哈萨克族居民糖尿病及空腹血糖受损患病率调查

目的 了解新疆福海地区哈萨克族中老年人群糖尿病及空腹血糖受损的患病情况,并分析该人群糖尿病的知晓率、治疗率、控制率.方法 采用分层随机整群抽样方法,抽取新疆福海县,所属5个乡镇的3840名35岁以上哈萨克族居民,进行调查研究并得到相关数据,分别计算总人群和男女性空腹血糖受损及糖尿病的患病率.患病率与年龄的关系采用趋势卡方检验,相同年龄组男女性患病率比较采用卡方检验.结果 该人群空腹血糖受损患病率为6.48%(249/3840),其中男性为6.94%(128/1845),女性为6.07%(121/1995);男、女性及总糖尿病患病率分别为3.96%(73/1845)、2.61%(52/1995)和3.26%(125/3840).糖尿病的知晓率、总体治疗率、控制率、知晓者中的治疗率分别为14.40%(18/125)、10.40%(13/125)、4.80%(6/125)、72.22%(13/18).结论 新疆福海地区哈萨克族人群糖尿病和空腹血糖受损患病率均低于全国平均水平.     

拉萨市区藏族中老年人群糖尿病患病率粗筛

目的 了解拉萨市区藏族中老年人群糖尿病患病情况及分布特点。方法 采用在居民集中区普查的方法对4851例藏族中老年人群进行饮食结构、体力活动问卷调查及空腹、餐后2h血糖和(或)口服葡萄糖耐量检查。结果 拉萨市区藏族中老年人群糖尿病患病率为6．8％，糖耐量低减为11．6％，他们的体重指数超标、体力活动少和血压高者其糖尿病、糖耐量异常的患病率明显高于正常人群。结论 肥胖、高血压、过多脂肪和蛋白的摄入、运动量减少和低文化程度是拉萨市区藏族中老年人群糖尿病的危险因素。     

High Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in the Sultanate of Oman: Results of the 1991 National Survey

A national survey of glucose intolerance and cardiovascular disease risk factors in Oman has demonstrated a high prevalence of diabetes (10%) and impaired glucose tolerance (IGT, 13% in females and 8% in males). Prevalence of diabetes rose with age to a maximum of over 30% in both sexes. Prevalence of total glucose intolerance (diabetes and IGT combined) exceeded 50% in the seventh (females) and eighth (males) decade of life.     

空腹血糖受损诊断标准下调的合理性分析

目的　探讨空腹血糖受损 (IFG)诊断点从 6.1mmol/L下调至 5 .6mmol/L的合理性。方法对1986年入选的 468名非糖尿病人群〔3 41例正常糖耐量 (NGT) ,12 7例糖耐量受损 (IGT)〕在 1988年 ,1990年和 1992年分别进行OGTT复查 ,测定空腹血糖 (FPG)及 2h血糖 (2hPG)。以COX模型分析不同基线血糖水平增加糖尿病的风险。结果　 (1) 10 9例 6年后发生糖尿病。COX成比例风险模型分析校正年龄、性别、体重指数 (BMI)影响后发现FPG与 2型糖尿病发病显著相关 (P =0 .0 0 0 1)。基线FPG 5 .6～ 6.0mmol/L组糖尿病发病危险性比FPG <5 .6mmol/L组已显著增加 ,RR为 3 .3 (95 %CI 2 .0～ 5 .3 ,P =0 .0 0 0 1)。 (2 )受试者工作特征 (ROC)曲线分析FPG预测糖尿病发病的最佳阈值是 5 .6mmol/L ,以FPG 5 .6mmol/L为诊断点IFG预报糖尿病发病的灵敏度、特异度、阳性预测值分别为 45 .0 % ,92 .8%和 65 .3 %。 (3 )NGT个体中COX成比例风险模型校正年龄、性别、BMI后显示 ,FPG分组 (5 .0～ 6.0mmol/L与 <5 .0mmol/L)与糖调节受损 (IGR ,包括IFG或IGT)发生显著正相关 (P =0 .0 0 7)。ROC曲线显示 ,FPG预测糖耐量恶化而进展为DM或IGR的最佳阈值为 5 .3mmol/L。结论　 (1)本组非糖尿病人群中FPG预测糖尿病发病的最佳阈值为 5 .6mmol/L     

Diabetes and impaired glucose regulation in first-degree relatives of patients with type 2 diabetes in isfahan, iran: prevalence and risk factors

OBJECTIVES: The aim of this study was to estimate the prevalence of diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) in first-degree relatives (FDR) of people with type 2 diabetes mellitus. METHODS: A cross-sectional study of FDR of type 2 diabetes patients was conducted between 2003 and 2005. A total of 2,368 FDR of type 2 diabetes outpatients aged 30-60 years (614 men and 1754 women) from Isfahan Endocrine and Metabolism Research Center (Iran) were examined. All subjects underwent a standard 75 g 2-h oral glucose tolerance test (OGTT). IGT, IFG and type 2 diabetes were diagnosed according to the criteria of the American Diabetes Association (ADA). The mean (SD) age of participants was 43.1 (6.9) years. RESULTS: The prevalence of type 2 diabetes, IGT and IFG were 10.3% (95% CI: 9.1-11.5), 19.5% (17.9-21.1) and 17.3% (15.8-18.8) respectively. The prevalence rates were significantly higher than those reported for a control population of the same age (type 2 diabetes, 6.0% (95% CI: 5.7-6.2) and IGT 9.6 (95% CI: 9.3-9.9)). IGT was more frequent among women (OR: 0.66; 95% CI: 0.51-0.87), whereas diabetes (OR: 1.31; 95% CI: 0.96-1.78) and IFG (OR: 1.41; 95% CI: 1.10-1.80) were higher in men. Multivariate analysis revealed that age and obesity or abdominal obesity were significantly associated with diabetes, IGT and IFG. CONCLUSIONS: FDR of people with type 2 diabetes in Iran are at higher risk of IGT and type 2 diabetes than the population at large. Risk increases with age and obesity. These findings may be useful for the identification of persons at risk of developing type 2 diabetes and strongly support the regular screening of FDR of type 2 diabetes patients.     

Insulin resistance and impaired glucose tolerance in obese children and adolescents from Southern Italy

BACKGROUND AND AIM: Obesity in children may lead to insulin resistance and impaired glucose regulation over time. The aim of this study was to investigate the insulin resistance status and the frequency of impaired glucose regulation in obese children and adolescents from the Campania region (Southern Italy), where the prevalence of obesity is among the highest in Europe. METHODS AND RESULTS: We studied 100 (62 male) Italian obese children and adolescents (mean age 10.1+/-2.7 years) and 50 (27 male) normal weight healthy subjects (mean age 10.2+/-2.7 years). Anthropometric measures and biochemical tests were performed in all subjects. In obese patients an oral glucose tolerance test was also performed. The estimate of insulin resistance was calculated by a homeostasis model assessment (HOMA) index. A cut-off HOMA level of >2.5 in children and >4.0 in adolescents was used to identify an insulin-resistance status. Insulin resistance was found in 40.8% of obese children and 41.2% of obese adolescents, whereas it was found in 3.0% of normal children and none of the 17 normal adolescents (p<0.0001 and p<0.002, respectively). None of the subjects had impaired fasting glucose or diabetes, while 4 obese patients had impaired glucose tolerance (4%). CONCLUSIONS: Impaired glucose tolerance is still rare whereas insulin-resistance is already detectable in more than 40% of obese children and adolescents in Southern Italy. Our observations confirm that metabolic risk factors can be found at a very early age and strengthen the case for implementing programmes for prevention and treatment of childhood obesity.     

Known type 2 diabetes mellitus among the Kuwaiti population

The reported prevalence of type 2 diabetes among the Kuwaiti population varied from one source to another. This study was undertaken to define the magnitude of the problem and to suggest plans for future diabetic care. All type 2 Kuwaiti diabetic subjects registered and continuing to attend regularly in two health areas Mubarak Health Area (MHA) and Farwania Health Area (FHA)] were selected for the study. There were 3222 in MHA and 5114 in FHA among the Kuwaiti population aged 20 years and above, accounting for a total crude prevalance of 7.6% in both health areas and for a prevalence rate of 5.6% in MHA and 10.0% in FHA. The age-specific prevalence of type 2 diabetes in both areas combined rose from 2.639 per 100 population in the age group 20–39 years to 15.350% and 26.252% in the age groups 40–59 and 60 and above, respectively. The female to male ratio was 1.7, 1.6, 1.1, respectively, in MHA and 1.7, 2.0, 0.9 in FHA for the age groups 20–39, 40–59, and 60 and above. This study shows that type 2 diabetes is a major public health problem in Kuwait, with a female preponderance. Obesity is a characteristic feature of the population studied, with a mean body mass index of 31.8±6.3 and 28.5±5.1 in women and men, respectively. A positive family history of diabetes mellitus was reported in 63% of the diabetic subjects. There is a need to standardize methods of reporting and to plan a national screening survey.