Background: Diabetes mellitus is a leading cause of morbidity and mortality worldwide, imposing a considerable burden on health systems and societies as it affects both individuals and their families and has a large impact on the economic and social development of a country. Objectives: The purpose of this study was to study the prevalence of diabetes and pre-diabetes among the Dubai population and associations with diabetes risk factors. Methodology: A cross-sectional Diabetes Household Survey was carried out in the Emirates of Dubai during 2017 as a complementary stage of the Dubai Household Survey, 2014, which was a randomly selected, multistage, stratified, cluster survey. The sampling technique was selected to assess the rates of undiagnosed diabetes as well as the rates of pre-diabetes through screening with HbA1c. The size of the 2017 survey sample was estimated at 300 individuals for Emirati and 300 for non-Emirati. An additional 200 individuals were added to address non-response cases. These were added to those who were identified as diabetics in the 2014 Household Health Survey and then weighted to give a representative sample for the Dubai population. Results: The study revealed that the prevalence of diabetes in Dubai among UAE nationals was 19%, and it was 14.7% for expats. Consequently, the overall prevalence of diabetes in Dubai is 15.2%. Undiagnosed diabetes was 10% in UAE nationals and 10.9% in expats. Pre-diabetes in UAE national males was lower than in females, although this pattern was not observed among expats. Younger age, normal weight, and exercise were associated with lower rates of diabetes and pre-diabetes in UAE nationals and expats. Hypertension was associated with higher rates of diabetes regardless of nationality. Conclusions: The study concluded that the prevalence of diabetes among the Dubai population is alarmingly high and that a large proportion of the population are not aware of their diagnosis. A higher prevalence of diabetes is associated with multiple factors, such as age, male gender, hypertension, higher BMI, lack of exercise, and lower level or no education, as well as a family history of diabetes mellitus. Many of these factors can be easily modified, which could lead to a decrease in the burden of the disease.
Background and aims The Middle East (ME) has a high prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), driven by obesity and type-2 diabetes mellitus (T2DM). Studies in Saudi Arabia (KSA) and United Arab Emirates (UAE) predict an escalating impact of NAFLD/NASH, particularly advanced fibrosis due to NASH (AF-NASH), increasing cases of cirrhosis, liver cancer and death. The scale of this burden in other ME countries is unknown with no reports of NAFLD/NASH healthcare resource utilization (HCRU) or costs. We estimated the clinical and economic burden of NAFLD/NASH in KSA, UAE and Kuwait. Methods Markov models populated with country-specific obesity and T2DM prevalence data estimated numbers and progression of NAFLD/NASH patients from 2018 to 2030. Model inputs, assumptions and outputs were collected from literature, national statistics, and expert consensus. Results Over 13 years, the KSA model estimated cases increasing as follows: patients with fibrosis F0–3 doubled to 2.5 m, compensated and decompensated cirrhosis and hepatocellular carcinoma trebled to 212,000; liver failure or transplant patients increased four-fold to 4,086 and liver-related death escalated from < 10,000 to > 200,000. Similar trends occurred in UAE and Kuwait. Discounted lifetime costs of NASH standard-care increased totaling USD40.41 bn, 1.59 bn and 6.36 bn in KSA, UAE (Emiratis only) and Kuwait, respectively. NASH-related costs in 2019 comprised, respectively, 5.83%, 5.80% and 7.66% of national healthcare spending. Conclusions NASH, especially AF-NASH, should be considered a higher priority in ME Public Health policy. Our analyses should inform health policy makers to mitigate the enormity of this escalating regional burden.
These consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East.
<b><i>Introduction:</i></b> Obesity is a chronic relapsing disease of which, globally, the prevalence has reached epidemic proportions. The ACTION-IO study (NCT03584191) investigated the perceptions, attitudes, and behaviors of people with obesity (PwO) and healthcare professionals (HCPs), which can help in devising strategies for its optimal management. Here, we present the results from the United Arab Emirates (UAE). <b><i>Methods:</i></b> The ACTION-IO study was a cross-sectional study conducted in 11 countries, including the UAE, that collected data via a survey. Eligible UAE PwO were ≥18 years with a BMI of ≥30 kg/m<sup>2</sup> (self-reported height and weight). Eligible HCPs were in direct patient care. Data were collected in the UAE between July 11, 2018, and September 5, 2018. <b><i>Results:</i></b> A total of 750 PwO and 200 HCPs completed the survey in the UAE. Both PwO (82%) and HCPs (78%) acknowledged obesity as a chronic disease and agreed that it has a large impact on overall health (PwO 88% and HCPs 80%). More HCPs felt that diabetes and stroke (both 91%) had a larger impact on overall health than did obesity. Many PwO (76%) assumed full responsibility for their weight loss; 84% of HCPs acknowledged responsibility for actively contributing to patient weight loss efforts. The top motivator for weight loss among PwO was wanting to be more fit/in better shape (45%), while HCPs believed the main motivator was general health concerns (83%). The top barrier against initiating weight management discussions provided by HCPs was that they felt PwO were not interested in losing weight (69%), whereas only 10% of PwO selected this response. The mean delay between struggling with excess weight and having a weight management discussion with an HCP was 4 years. <b><i>Discussion/Conclusion:</i></b> These UAE results highlight differences in the perceptions and attitudes toward obesity from PwO and HCPs and reflect a need to understand weight management concerns to initiate earlier and more effective PwO–HCP conversations. The findings will inform educational needs on the biological basis of obesity and its clinical management and will help to address regional barriers for effective obesity care.
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