An increase in prevalence of diabetes mellitus in Jordan over 10 years.

OBJECTIVE This study aimed to determine the prevalence of type 2 diabetes mellitus (DM) and impaired fasting glycemia (IFG), identify their associated factors, determine how the prevalence of type 2 DM has changed over 10 years, and assess the awareness and state of control of diabetes in Jordan. METHODS Data were analyzed from a cross-sectional study that included a random sample of 1121 Jordanians aged 25 years and above. A subject was deemed affected by DM if this diagnosis was known to the patient or if his or her condition complies with the American Diabetes Association definition. IFG was defined as a fasting serum glucose level of >or=6.1 mmol/l (110 mg/dl) but <7 mmol/l. HbA(1c) >7.5% was defined as "unsatisfactory" metabolic control. RESULTS The age-standardized prevalence of diabetes and IFG was 17.1% and 7.8%, respectively, with no significant differences between women and men. Of the 195 diabetic subjects, 146 (74.9%) had been previously diagnosed. More than half (54%) of those previously diagnosed were found to be with unsatisfactory glycemic control. Compared to the 1994 survey, there was a significant increase in the prevalence of diabetes by 31.5%. Increase in age, increase in body mass index, and having a family history of diabetes were associated with increased odds of diabetes and IFG. While the level of education had no effect on IFG, higher level of education was associated with a decrease in the odds of having diabetes. CONCLUSION The prevalence of type 2 diabetes and IFG is high in Jordan and is increasing. More than half of the patients with diabetes have unsatisfactory control. Therefore, they are likely to benefit from programs aimed at encouraging behaviors toward achieving optimum weight as well as physical activity behaviors. Physicians caring for patients with diabetes may need to adopt a more vigorous approach for diabetes control.

[1]  J. Mckenney,et al.  Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). , 2001, JAMA.

[2]  P. Zimmet.  Kelly West Lecture 1991 Challenges in Diabetes Epidemiology—From West to the Rest , 1992, Diabetes Care.

[3]  G. Sundkvist,et al.  Incidence, prevalence, and mortality of diabetes in a large population. A report from the Skaraborg Diabetes Registry. , 1999, Diabetes care.

[4]  P. Landsman,et al.  Reassessment of cardiovascular risk in diabetes. , 2006, Current opinion in lipidology.

[5]  M. Engelgau,et al.  The Evolving Diabetes Burden in the United States , 2004, Annals of Internal Medicine.

[6]  C. Rotimi,et al.  Diabetes in the Caribbean: results of a population survey from Spanish Town, Jamaica , 1999, Diabetic medicine : a journal of the British Diabetic Association.

[7]  K. Reynolds,et al.  Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: International Collaborative Study of Cardiovascular Disease in Asia (InterASIA) , 2003, Diabetologia.

[8]  T. Schacker,et al.  Clinical and Epidemiologic Features of Primary HIV Infection , 1996, Annals of Internal Medicine.

[9]  V. Vaccarino,et al.  Excess type 2 diabetes in African-American women and men aged 40–74 and socioeconomic status: evidence from the Third National Health and Nutrition Examination Survey , 2000, Journal of Epidemiology and Community Health.

[10]  P. Raskin,et al.  Report of the expert committee on the diagnosis and classification of diabetes mellitus. , 1999, Diabetes care.

[11]  B. Brorsson,et al.  Diabetic patients in primary health care--quality of care three years apart. , 1998, Scandinavian journal of primary health care.

[12]  M. Rewers,et al.  Global Estimates for Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Adults , 1993, Diabetes Care.

[13]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[14]  B. Ahrén,et al.  Diabetes and impaired fasting glycemia in a rural population of Bangladesh. , 2003, Diabetes care.

[15]  K. Alberti,et al.  PREVALENCE OF DIABETES AND IMPAIRED GLUCOSE TOLERANCE IN RURAL TANZANIA , 1989, The Lancet.

[16]  K. Svärdsudd,et al.  A Model for Early Diagnosis of Type 2 Diabetes Mellitus in Primary Health Care , 1993, Diabetic medicine : a journal of the British Diabetic Association.

[17]  R. Bilous,et al.  Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas , 2000, Journal of epidemiology and community health.

[18]  Diabetes mellitus. Report of a WHO Study Group. , 1985, World Health Organization technical report series.

[19]  K. Flegal,et al.  Comparison of Diabetes Diagnostic Categories in the U.S. Population According to 1997 American Diabetes Association and 1980–1985 World Health Organization Diagnostic Criteria , 1997, Diabetes Care.

[20]  P. B. Eveleth,et al.  Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee , 1996 .

[21]  Prasun Patra,et al.  The burden of diabetes and impaired fasting glucose in India using the ADA 1997 criteria: prevalence of diabetes in India study (PODIS). , 2004, Diabetes research and clinical practice.

[22]  A. Al-Nuaim,et al.  Prevalence of Glucose Intolerance in Urban and Rural Communities in Saudi Arabia , 1997, Diabetic medicine : a journal of the British Diabetic Association.

[23]  T. Jørgensen,et al.  Prevalences of diabetes and impaired glucose regulation in a Danish population: the Inter99 study. , 2003, Diabetes care.

[24]  M. Davies.  New diagnostic criteria for diabetes—are they doing what they should? , 1999, The Lancet.

[25]  Prevalence of selected risk factors for chronic disease--Jordan, 2002. , 2003, MMWR. Morbidity and mortality weekly report.

[26]  C. Jackson,et al.  The Prevalence of Diabetes and Impaired Glucose Tolerance in a British Population , 1993, Diabetes Care.

[27]  P. Savage,et al.  Cardiovascular disease in older adults with glucose disorders: comparison of American Diabetes Association criteria for diabetes mellitus with WHO criteria , 1999, The Lancet.

[28]  Musaiger Ao.  Diabetes mellitus in Bahrain: an overview. , 1992 .

[29]  P. Magnus,et al.  Rapid changes in the prevalence of obesity and known diabetes in an adult Norwegian population. The Nord-Trøndelag Health Surveys: 1984-1986 and 1995-1997. , 1999, Diabetes care.

[30]  P. Jousilahti,et al.  Increasing prevalence of diabetes mellitus in Oman , 2002, Diabetic medicine : a journal of the British Diabetic Association.

[31]  J. Marrugat,et al.  [Prevalence of diabetes mellitus in the province of Girona, Spain: the REGICOR study]. , 2004, Revista espanola de cardiologia.

[32]  R. Pugh,et al.  Diabetes, obesity and hypertension in urban and rural people of bedouin origin in the United Arab Emirates. , 1995, The Journal of tropical medicine and hygiene.

[33]  M. Harris.  Epidemiological Correlates of NIDDM in Hispanics, Whites, and Blacks in the u.s. Population , 1991, Diabetes Care.

[34]  B. Lundman,et al.  Outcomes of diabetes care: a population-based study. , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[35]  C. Berne,et al.  The influence of glucose self-monitoring on glycaemic control in patients with diabetes mellitus in Sudan. , 2006, Diabetes research and clinical practice.

[36]  B. Lundman,et al.  Diabetes and it's complications in a Swedish county. , 1998, Diabetes research and clinical practice.

[37]  B. C. Choi,et al.  Risk factors for diabetes mellitus by age and sex: results of the National Population Health Survey , 2001, Diabetologia.

[38]  A. Green,et al.  Rising prevalence of diabetes: evidence from a Danish pharmaco-epidemiological database. Commentary , 2003 .

[39]  K. Svärdsudd,et al.  Prevalence and Incidence of Diabetes in a Swedish Community 1972–1987 , 1991, Diabetic medicine : a journal of the British Diabetic Association.

[40]  C. H. Courtney,et al.  TYPE 2 DIABETES MELLITUS: Etiology, Pathogenesis, and Natural History , 2010 .

[41]  P. Zimmet,et al.  The Rising Global Burden of Diabetes and its Complications: Estimates and Projections to the Year 2010 , 1997, Diabetic medicine : a journal of the British Diabetic Association.

[42]  D. Sellen,et al.  Genetics of Criminal and Antisocial Behaviour. Ciba Foundation Symposium 194. Pp. 283. Edited by G. R. Bock & J. A. Goode. (Wiley, Chichester, 1996.) £50.00. , 1998, Journal of Biosocial Science.

[43]  A. Batieha,et al.  Diabetes and impaired glucose tolerance in Jordan: prevalence and associated risk factors , 1998, Journal of internal medicine.

[44]  D. Deen.  Metabolic syndrome: time for action. , 2004, American family physician.

[45]  K. Flegal,et al.  Prevalence of Diabetes, Impaired Fasting Glucose, and Impaired Glucose Tolerance in U.S. Adults: The Third National Health and Nutrition Examination Survey, 1988–1994 , 1998, Diabetes Care.

[46]  J. Marrugat,et al.  Prevalencia de diabetes mellitus en la provincia de Girona, España: el estudio REGICOR , 2004 .

[47]  A. Musaiger.  Diabetes Mellitus in Bahrain: An Overview , 1992, Diabetic medicine : a journal of the British Diabetic Association.