The global diabetes pandemic: the Tunisian experience

Abstract

Objective: The prevalence of diabetes mellitus is known to be increasing rapidly worldwide, but few population-based surveys have been undertaken in Africa or the Middle East. The aims of this study are to report the prevalence of diabetes mellitus and impaired fasting glucose (IFG) in Tunisia, to compare the prevalence to previous studies and to analyse the relationship between diabetes and age, sex, area of residency and body mass index (BMI). Subjects and setting: We have used data from the Tunisian National Nutrition Survey, a cross-sectional health study providing a large nationally representative sample of the Tunisian population including 3729 adults. We used the American Diabetes Association diagnostic criteria to determine the prevalence of diabetes mellitus and IFG. Results: The overall diabetes prevalence was 9.9% (9.5% in men and 10.1 in women) giving age-adjusted prevalence of diabetes of 8.5% (7.3% in men and 9.6% in women).Step-wise logistic regression showed age of more than 40 years, urban residency and high BMI to each be significantly and independently related to diabetes prevalence. The prevalence of diabetes mellitus has more than doubled in Tunisia over a 15-year period. Conclusions: Our study has demonstrated a high prevalence of diabetes in the adult population with a wide difference among the rural and urban areas with an increased prevalence compared to previous studies. The results underline the need to increase public awareness and to emphasize the benefit of lifestyle modification in order to prevent type II diabetes.

Prevalence and Correlates of Glucose Homeostasis Abnormalities in the Far-North Region Cameroon

“…Prevalence rates of comparable magnitudes were reported from Northern Africa, with an estimated of 13.8% for Algeria in 2010 [22], 9.9% for Tunisia in 2007 [23], and 14.1% for Libya in 2001 [24]. Our results suggest that targeted programs are needed to improve education on a population basis, focusing on the importance of low fat and low glycemic index diet, as well as on increased fruits and vegetables consumption [25].…”

Prevalence and causes of visual impairment in diabetic patients in Tunisia, North Africa

“…1 The overall diabetes prevalence in Tunisia is 9.9%, 2 and is estimated to be 11.2% in 2030. 3 The prevalence of visual impairment and blindness due to diabetic retinopathy (DR) and diabetic eye complications is on the rise worldwide and more specifically in North Africa and the Middle East region, 1 and DR is a priority disease in the VISION 2020 initiative for the global elimination of avoidable blindness, and the World Health Organization has made prevention of visual impairment and blindness an international priority.…”

Diabetes Mellitus in Developing Countries and Case Series

“…Traditional rural communities still have very low prevalence at most 1-2% except in some specific highr i s k g r o u p s , w h e r e a s 1 -3 % o r m o r e a d u l t s i n u r b a n c o m m u n i t i e s h a v e d i a b e t e s . T h e combination of the rising prevalence of diabetes and the high rate of long-term complications in Africa will lead to a drastic increase of the burden of diabetes on health systems of African countries [34] and may have a devastating human and economic toll if the trends remain unabated [35]. In comparison to previous estimates from sub-Saharan Africa, the prevalence of adult onset diabetes seems to be on the increase [36].…”

“…The low number of health care providers with the requisite knowledge, expertise, and experience in the care of children with diabetes is another major issue. Diabetes care in developing countries needs to address the specific background of the patient population, their needs, medical problems, and social constraints [35]. The region of sub-Saharan Africa contains 33 of the 50 poorest countries in the world and will experience the greatest risk in the prevalence of diabetes over the next 20 years [36].…”

“…Health conditions in most African countries are poor and a large percentage of families live below the poverty line of one United States dollar per month [35]. Access to health services is limited and living conditions are poor.…”