Recent Expeditious Growth of Type 1 Diabetes in the Gulf Arab Countries

Abstract

The incidence of Type 1 Diabetes (T1D) in the Arab world, particularly, oil and gas rich Gulf Cooperative Council (GCC) countries has more than doubled in the last twenty years. Therefore, there is a dire need for careful systematic familial cohort studies, especially in high-risk populations. Several immunogenetic factors affect the pathogenesis of the disease. Genes in the human leukocyte antigen (HLA) account for the major genetic susceptibility to the disease. The triggering agents initiate disease onset by destruction of pancreatic β-cells. The autoantibodies against glutamic acid decarboxylase (GADA), insulinoma antigen-2 (IA-2A), insulin (IAA), and zinc transporter-8 (ZnT-8A) comprise the most reliable biomarkers for T1D in both children and adults. Although three of the GCC countries, namely Kuwait, Saudi Arabia and Qatar are among the top 10 countries with high incidence rate of T1D, no proper diagnostic and prediction tools were applied in the region. Understanding the disease sequelae in a homogenous gene pool with high consanguinity in the GCC could help solve the challenges in understanding pathogenesis, as well as hasten the prevention of T1D. Arab states must incorporate T1D predictive and intervention policies on a war-footing basis to minimize the burden of this serious disease.

Trends in incidence rates of childhood type 1 diabetes mellitus: A retrospective study in Isfahan province, Iran

“…Recent epidemiological data showed a fast-growing incidence rate in the Middle East and Asia 54,55 . It is suggested that in addition to genetic and environmental risk factors, consanguinity is one of the potential risk factors for type 1 diabetes mellitus in this region.…”

Association of interleukin-4, interleukin-13 gene polymorphisms, HLA-DQ and DR genotypes with genetic susceptibility of type-1 Diabetes Mellitus in Kuwaiti children

“…Most of the susceptibility loci identified in the recent years have a clear role in modulation of T cell development and activation, indicating that common biological pathways may be implicated in the etiology of different autoimmune diseases (7). A number of recently published reviews and reports provided comprehensive information about the genetic risk factors (MHC and non-MHC loci), epidemiological aspects and immune system involvement in T1DM patients from Kuwait (8)(9)(10)(11). These reports include information on genetic factors which influence both susceptibility and resistance to T1DM (8).…”