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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Type 2 Diabetes | Research

Burden of type 2 diabetes mellitus and its risk factors in North Africa and the Middle East, 1990–2019: findings from the Global Burden of Disease study 2019

Authors: Nazli Namazi, Sahar Saeedi Moghaddam, Shahnaz Esmaeili, Maryam Peimani, Yeganeh Sharifnejad Tehrani, Fatemeh Bandarian, Parnian Shobeiri, Ensieh Nasli-Esfahani, Mohammad-Reza Malekpour, Negar Rezaei, Nazila Rezaei, Babak Arjmand, Bagher Larijani, Farshad Farzadfar

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

The prevalence of Type 2 Diabetes Mellitus (T2DM) in the North Africa and Middle East region is alarmingly high, prompting us to investigate the burden and factors contributing to it through the GBD study. Additionally, there is a lack of knowledge about the epidemiological status of T2DM in this region, so our aim is to provide a comprehensive overview of the burden of T2DM and its associated risk factors.

Methods

Using data from the 2019 Global Burden of Disease Study, we calculated the attributable burden of T2DM for each of the 21 countries in the region for the years 1990 and 2019. This included prevalence, mortality, disability-adjusted life years (DALYs), and risk factors.

Results

Between 1990 and 2019, there was a significant increase in the age-standardized incidence (79.6%; 95% Uncertainty Interval: 75.0 to 84.5) and prevalence (85.5%; [80.8 to 90.3]) rates of T2DM per 100,000 populations. The age-standardized mortality rate (1.7%; [-10.4 to 14.9]), DALYs (31.2%; [18.3 to 42.2]), and years lived with disability (YLDs) (82.6%; [77.2 to 88.1]) also increased during this period. Modifiable risk factors, such as high body mass index (56.4%; [42.8 to 69.8]), low physical activity (15.5%; [9.0 to 22.8]), and ambient particulate matter pollution (20.9%; [15.2 to 26.2]), were the main contributors to the number of deaths.

Conclusion

The burden of T2DM, in terms of mortality, DALYs, and YLDs, continues to rise in the region. The incidence rate of T2DM has increased in many areas. The burden of T2DM attributed to modifiable risk factors continues to grow in most countries. Targeting these modifiable risk factors could effectively reduce the growth and disease burden of T2DM in the region.
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Literature
1.
go back to reference Sanches JM, Zhao LN, Salehi A, Wollheim CB, Kaldis P. Pathophysiology of type 2 diabetes and the impact of altered metabolic interorgan crosstalk. FEBS J. 2023;290(3):620–48.CrossRefPubMed Sanches JM, Zhao LN, Salehi A, Wollheim CB, Kaldis P. Pathophysiology of type 2 diabetes and the impact of altered metabolic interorgan crosstalk. FEBS J. 2023;290(3):620–48.CrossRefPubMed
2.
go back to reference Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE. Understanding the influence of psychological and socioeconomic factors on diabetes self-care using structured equation modeling. Patient Educ Couns. 2015;98(1):34–40.CrossRefPubMed Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE. Understanding the influence of psychological and socioeconomic factors on diabetes self-care using structured equation modeling. Patient Educ Couns. 2015;98(1):34–40.CrossRefPubMed
3.
go back to reference Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157: 107843.CrossRefPubMed Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157: 107843.CrossRefPubMed
4.
go back to reference Saeedi P, Salpea P, Karuranga S, Petersohn I, Malanda B, Gregg EW, et al. Mortality attributable to diabetes in 20–79 years old adults, et al 2019 estimates: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2020;162:108086.CrossRefPubMed Saeedi P, Salpea P, Karuranga S, Petersohn I, Malanda B, Gregg EW, et al. Mortality attributable to diabetes in 20–79 years old adults, et al 2019 estimates: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2020;162:108086.CrossRefPubMed
5.
go back to reference Moradi-Lakeh M, Forouzanfar MH, El Bcheraoui C, Daoud F, Afshin A, Hanson SW, et al. High fasting plasma glucose, diabetes, and its risk factors in the eastern mediterranean region, 1990–2013: findings From the Global Burden of Disease Study 2013. Diabetes Care. 2017;40(1):22–9.CrossRefPubMed Moradi-Lakeh M, Forouzanfar MH, El Bcheraoui C, Daoud F, Afshin A, Hanson SW, et al. High fasting plasma glucose, diabetes, and its risk factors in the eastern mediterranean region, 1990–2013: findings From the Global Burden of Disease Study 2013. Diabetes Care. 2017;40(1):22–9.CrossRefPubMed
6.
go back to reference Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, et al. Diabetes in Iran: prospective analysis from first nationwide diabetes report of National Program for Prevention and Control of Diabetes (NPPCD-2016). Sci Rep. 2017;7(1):1–10.CrossRef Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, et al. Diabetes in Iran: prospective analysis from first nationwide diabetes report of National Program for Prevention and Control of Diabetes (NPPCD-2016). Sci Rep. 2017;7(1):1–10.CrossRef
7.
go back to reference Ali NSM, Allela OQ, Salih HM, Ahmed IH. Prevalence of Type 2 Diabetes Associated Complications in Kurdistan Region Iraq. J Basic Clin Pharmacol. 2019;10(1):1–6. Ali NSM, Allela OQ, Salih HM, Ahmed IH. Prevalence of Type 2 Diabetes Associated Complications in Kurdistan Region Iraq. J Basic Clin Pharmacol. 2019;10(1):1–6.
8.
go back to reference Al Mansour MA. The prevalence and risk factors of type 2 diabetes mellitus (DMT2) in a semi-urban Saudi population. Int J Environ Res Public Health. 2020;17(1):7.CrossRef Al Mansour MA. The prevalence and risk factors of type 2 diabetes mellitus (DMT2) in a semi-urban Saudi population. Int J Environ Res Public Health. 2020;17(1):7.CrossRef
9.
go back to reference Mirahmadizadeh A, Fathalipour M, Mokhtari AM, Zeighami S, Hassanipour S, Heiran A. The prevalence of undiagnosed type 2 diabetes and prediabetes in Eastern Mediterranean region (EMRO): a systematic review and meta-analysis. Diabetes Res Clin Pract. 2020;160: 107931.CrossRefPubMed Mirahmadizadeh A, Fathalipour M, Mokhtari AM, Zeighami S, Hassanipour S, Heiran A. The prevalence of undiagnosed type 2 diabetes and prediabetes in Eastern Mediterranean region (EMRO): a systematic review and meta-analysis. Diabetes Res Clin Pract. 2020;160: 107931.CrossRefPubMed
10.
go back to reference Khan Y, Hamdy O. Type 2 diabetes in the middle east and north africa (MENA). Diabetes Mellitus in Developing Countries and Underserved Communities: Springer; 2017. p. 49–61. Khan Y, Hamdy O. Type 2 diabetes in the middle east and north africa (MENA). Diabetes Mellitus in Developing Countries and Underserved Communities: Springer; 2017. p. 49–61.
12.
go back to reference Murray CJ, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The lancet. 2020;396(10258):1223–49.CrossRef Murray CJ, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The lancet. 2020;396(10258):1223–49.CrossRef
13.
go back to reference Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204–22.CrossRef Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204–22.CrossRef
14.
go back to reference Keykhaei M, Masinaei M, Mohammadi E, Azadnajafabad S, Rezaei N, Moghaddam SS, et al. A global, regional, and national survey on burden and Quality of Care Index (QCI) of hematologic malignancies; global burden of disease systematic analysis 1990–2017. Exp Hematol Oncol. 2021;10(1):1–15.CrossRef Keykhaei M, Masinaei M, Mohammadi E, Azadnajafabad S, Rezaei N, Moghaddam SS, et al. A global, regional, and national survey on burden and Quality of Care Index (QCI) of hematologic malignancies; global burden of disease systematic analysis 1990–2017. Exp Hematol Oncol. 2021;10(1):1–15.CrossRef
15.
go back to reference Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, MacIntyre MF, et al. The global burden of cancer 2013. JAMA Oncol. 2015;1(4):505–27.CrossRefPubMed Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, MacIntyre MF, et al. The global burden of cancer 2013. JAMA Oncol. 2015;1(4):505–27.CrossRefPubMed
16.
go back to reference Stevens GA, Alkema L, Black RE, Boerma JT, Collins GS, Ezzati M, et al. Guidelines for accurate and transparent health estimates reporting: the GATHER statement. PLoS Med. 2016;13(6): e1002056.CrossRefPubMedPubMedCentral Stevens GA, Alkema L, Black RE, Boerma JT, Collins GS, Ezzati M, et al. Guidelines for accurate and transparent health estimates reporting: the GATHER statement. PLoS Med. 2016;13(6): e1002056.CrossRefPubMedPubMedCentral
18.
go back to reference Al Busaidi N, Shanmugam P, Manoharan D. Diabetes in the Middle East: government health care policies and strategies that address the growing diabetes prevalence in the Middle East. Curr Diab Rep. 2019;19(2):8.CrossRefPubMed Al Busaidi N, Shanmugam P, Manoharan D. Diabetes in the Middle East: government health care policies and strategies that address the growing diabetes prevalence in the Middle East. Curr Diab Rep. 2019;19(2):8.CrossRefPubMed
19.
go back to reference Peters SA, Woodward M. Sex differences in the burden and complications of diabetes. Curr DiabRep. 2018;18(6):1–8. Peters SA, Woodward M. Sex differences in the burden and complications of diabetes. Curr DiabRep. 2018;18(6):1–8.
20.
go back to reference Xu G, You D, Wong L, Duan D, Kong F, Zhang X, et al. Risk of all-cause and CHD mortality in women versus men with type 2 diabetes: a systematic review and meta-analysis. Eur J Endocrinol. 2019;180(4):243–55.CrossRefPubMedPubMedCentral Xu G, You D, Wong L, Duan D, Kong F, Zhang X, et al. Risk of all-cause and CHD mortality in women versus men with type 2 diabetes: a systematic review and meta-analysis. Eur J Endocrinol. 2019;180(4):243–55.CrossRefPubMedPubMedCentral
21.
go back to reference Mansyur CL, Rustveld LO, Nash SG, Jibaja-Weiss ML. Social factors and barriers to self-care adherence in Hispanic men and women with diabetes. Patient Educ Couns. 2015;98(6):805–10.CrossRefPubMed Mansyur CL, Rustveld LO, Nash SG, Jibaja-Weiss ML. Social factors and barriers to self-care adherence in Hispanic men and women with diabetes. Patient Educ Couns. 2015;98(6):805–10.CrossRefPubMed
22.
go back to reference Kalyani RR, Lazo M, Ouyang P, Turkbey E, Chevalier K, Brancati F, et al. Sex differences in diabetes and risk of incident coronary artery disease in healthy young and middle-aged adults. Diabetes Care. 2014;37(3):830–8.CrossRefPubMedPubMedCentral Kalyani RR, Lazo M, Ouyang P, Turkbey E, Chevalier K, Brancati F, et al. Sex differences in diabetes and risk of incident coronary artery disease in healthy young and middle-aged adults. Diabetes Care. 2014;37(3):830–8.CrossRefPubMedPubMedCentral
24.
go back to reference Tönnies T, Heidemann C, Paprott R, Seidel-Jacobs E, Scheidt-Nave C, Brinks R, et al. Estimating the impact of tax policy interventions on the projected number and prevalence of adults with type 2 diabetes in Germany between 2020 and 2040. BMJ Open Diabetes Res Care. 2021;9(1): e001813.CrossRefPubMedPubMedCentral Tönnies T, Heidemann C, Paprott R, Seidel-Jacobs E, Scheidt-Nave C, Brinks R, et al. Estimating the impact of tax policy interventions on the projected number and prevalence of adults with type 2 diabetes in Germany between 2020 and 2040. BMJ Open Diabetes Res Care. 2021;9(1): e001813.CrossRefPubMedPubMedCentral
25.
go back to reference Zhou X, Siegel KR, Ng BP, Jawanda S, Proia KK, Zhang X, et al. Cost-effectiveness of diabetes prevention interventions targeting high-risk individuals and whole populations: a systematic review. Diabetes Care. 2020;43(7):1593–616.CrossRefPubMed Zhou X, Siegel KR, Ng BP, Jawanda S, Proia KK, Zhang X, et al. Cost-effectiveness of diabetes prevention interventions targeting high-risk individuals and whole populations: a systematic review. Diabetes Care. 2020;43(7):1593–616.CrossRefPubMed
26.
go back to reference Zaccardi F, Dhalwani NN, Papamargaritis D, Webb DR, Murphy GJ, Davies MJ, et al. Nonlinear association of BMI with all-cause and cardiovascular mortality in type 2 diabetes mellitus: a systematic review and meta-analysis of 414,587 participants in prospective studies. Diabetologia. 2017;60(2):240–8.CrossRefPubMed Zaccardi F, Dhalwani NN, Papamargaritis D, Webb DR, Murphy GJ, Davies MJ, et al. Nonlinear association of BMI with all-cause and cardiovascular mortality in type 2 diabetes mellitus: a systematic review and meta-analysis of 414,587 participants in prospective studies. Diabetologia. 2017;60(2):240–8.CrossRefPubMed
27.
go back to reference Booth GL, Luo J, Park AL, Feig DS, Moineddin R, Ray JG. Influence of environmental temperature on risk of gestational diabetes. CMAJ. 2017;189(19):E682–9.CrossRefPubMedPubMedCentral Booth GL, Luo J, Park AL, Feig DS, Moineddin R, Ray JG. Influence of environmental temperature on risk of gestational diabetes. CMAJ. 2017;189(19):E682–9.CrossRefPubMedPubMedCentral
28.
go back to reference Blauw LL, Aziz NA, Tannemaat MR, Blauw CA, de Craen AJ, Pijl H, et al. Diabetes incidence and glucose intolerance prevalence increase with higher outdoor temperature. BMJ Open Diabetes Res Care. 2017;5(1): e000317.CrossRefPubMedPubMedCentral Blauw LL, Aziz NA, Tannemaat MR, Blauw CA, de Craen AJ, Pijl H, et al. Diabetes incidence and glucose intolerance prevalence increase with higher outdoor temperature. BMJ Open Diabetes Res Care. 2017;5(1): e000317.CrossRefPubMedPubMedCentral
29.
go back to reference Vasileiou V, Kyratzoglou E, Paschou SA, Kyprianou M, Anastasiou E. The impact of environmental temperature on the diagnosis of gestational diabetes mellitus. Eur J Endocrinol. 2018;178(3):209–14.CrossRefPubMed Vasileiou V, Kyratzoglou E, Paschou SA, Kyprianou M, Anastasiou E. The impact of environmental temperature on the diagnosis of gestational diabetes mellitus. Eur J Endocrinol. 2018;178(3):209–14.CrossRefPubMed
30.
go back to reference Cuschieri S, Agius JC. The interaction between diabetes and climate change–A review on the dual global phenomena. Early Hum Dev. 2020:105220. Cuschieri S, Agius JC. The interaction between diabetes and climate change–A review on the dual global phenomena.  Early Hum Dev. 2020:105220.
31.
go back to reference Alhyas L, Nielsen JDJ, Dawoud D, Majeed A. Factors affecting the motivation of healthcare professionals providing care to Emiratis with type 2 diabetes. JRSM short reports. 2013;4(2):1–13.CrossRef Alhyas L, Nielsen JDJ, Dawoud D, Majeed A. Factors affecting the motivation of healthcare professionals providing care to Emiratis with type 2 diabetes. JRSM short reports. 2013;4(2):1–13.CrossRef
Metadata
Title
Burden of type 2 diabetes mellitus and its risk factors in North Africa and the Middle East, 1990–2019: findings from the Global Burden of Disease study 2019
Authors
Nazli Namazi
Sahar Saeedi Moghaddam
Shahnaz Esmaeili
Maryam Peimani
Yeganeh Sharifnejad Tehrani
Fatemeh Bandarian
Parnian Shobeiri
Ensieh Nasli-Esfahani
Mohammad-Reza Malekpour
Negar Rezaei
Nazila Rezaei
Babak Arjmand
Bagher Larijani
Farshad Farzadfar
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Type 2 Diabetes
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-16540-8

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