Title: Diabetes Research Initiatives in Sharjah, UAE
1Diabetes Research Initiatives in Sharjah, UAE
- Nabil Sulaiman
- nsulaiman_at_sharjah.ac.ae
- n.sulaiman_at_unimelb.edu.au
- Diabetes Supercourse, Alexandria 12 Jan 2009
2Sharjah Diabetes Study
- Background
- Why the study
- Methods
- Preliminary results
- Conclusions
- Recommendations
3Environmental and behavioral changes
- New dietary habits (what and how we eat),
- Lack of physical activity,
- Overweight/ obesity, and
- Stresses of urbanization and working condition
- will lead to further rise of CVD and diabetes,
and their risk factors.
4Summary
- Diabetes is a major and complex health problem
worldwide. - Prevalence in UAE (24 IGT18) is the 2nd
highest in the world - Onset of the disease in the GCC is early in late
20s - With early Dx and appropriate Mgt diabetics can
live better and longer
5- Sharjah Diabetes Study
- N. Sulaiman, Dh. Al Badri, N. Sajwani, S. Saleh,
D. Young
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8Sharjah Diabetes Study
1 Nabil Sulaiman, 2Dhafir Al Badry, 2Najla
Sajwany, 1Amal Hussein, 1Saba Saleh, 2Doris
Young (1Department of Family and Community
Medicine, University of Sharjah, 2 Ministry of
Health UAE, 3Department of General Practice,
University of Melbourne)
- Background
- Diabetes is a major and complex health problem
worldwide. - Diabetes prevalence in UAE is the 2nd highest in
the world, reaching about 24 in UAE nationals. - The prevalence of pre diabetes is reported to be
about 18. - With early identification and appropriate
management, people with diabetes can live better
and longer
METHODOLOGY
- PRELIMINARY RESULTS
- Participants 347 diabetic patients were
interviewed and their medical records were
cheeked - Gender 65.4 (n 227) females and 34.6 (n120)
males - Nationality UAE 83.9, Pakistan 3.5, Egypt
2.6, others 10 including Palestine, Lebanon,
Yemen, Iraq, Poland , Syria, Iran and Sudan. - Marital Status 8.9 single, 87.9 married,
divorced 1.4 and 1.4 widowed. - Consanguineous Marriage 16.4 (n57)
- Occupation 47.3 housewife, 28.2 clerks, 6.3
students, 0.6retired. - Family History 23.1 (N80) had a positive
family history of diabetes. - Smoking 3.2 (n11) current smokers, 3.2
(n11), ex-smokers, never smoked 93.1 (n323).
The study design is a cross sectional baseline
survey of patients with diabetes attending
Primary Medical Care Centers in Sharjah during
2007/08.
- Data Collection
- Research Assistant attended diabetes mini clinics
at Riffa and Asit centres and diabetes clinic at
Al-Qassimi and Kuwaiti Hospitals - Patients were invited to participate
- Patients were interviewed using structured
questionnaires - Their data were extracted from medical records
- Data cleaning and analysis was performed using
SPSS
- Aim
- To improve diabetes management, control and
quality of life of patients with diabetes in UAE - Objectives
- Establish an electronic database for diabetic
patients in Sharjah - Audit their medical records to identify gaps in
management. - Pilot test known EB intervention to investigate
their appropriateness to Sharjah - Determine barriers and facilitators to the
implementation of the intervention
- Diabetes Control Indicators
- body weight and waist circumference from medical
records - knowledge and attitudes towards healthy eating
using physical activity questionnaire and - Biochemical indicators such as AbA1c and
cholesterol, lipids, blood glucose and urine test
- CONCLUSIONS
- Diabetes Mellitus is common problem in primary
medical centers in Sharjah. - There is gap in self-management education
including self monitoring, manifested by high
levels of obesity and lack of physical activity. - Diabetes control in Sharjah measured by HbA1c
could be improved compared with international
guidelines. - Measures to improve control may include employing
Diabetes Nurse Educators to assist doctors at the
medical centers to train patients as well as CME
courses for doctors working at the centers.
This project was funded by the University of
Sharjah. For information please contact Dr Nabil
Sulaiman, HOD Family and Community Medicine, The
University of Sharjah E-mail nsulaiman_at_sharjah.ac
.ae or n.sulaiman_at_unimelb.edu.au
9Sharjah Diabetes Study
- Aim
- To improve diabetes management, control and
quality of life of patients with diabetes in UAE
10Sharjah Diabetes Study
- Objectives
- Identify gaps in diabetes management
- Determine barriers and facilitators to
implementation of known interventions - Pilot test known EB intervention in Sharjah
11Study Design
- Cross sectional baseline survey of patients
with diabetes attending Primary Medical Centers
in Sharjah during 2007/08.
12Data Collection
- Research Assistant attended diabetes mini clinics
at Riffa and Wasit centres and diabetes clinic at
Al-Qassimi and Kuwaiti Hospitals - Patients were invited to participate and
interviewed using questionnaires - Their data were extracted from medical records
- Data cleaning and analysis was performed using
SPSS
13Diabetes Control Indicators
- Medical Records
- Biochemical indicators such as HbA1c and
cholesterol, lipids, blood glucose and urine test - Weight and waist circumference
- Patients questionnaire
- Knowledge and attitudes
- healthy eating
- physical activity
14Preliminary Results
- Sample 347 patients
- Gender 65.4 females
- Mean age 53.2 (14.6)
- BMI 29.8 (5.9)
15Nationality
-
- UAE 83.9,
- Pakistan 3.5,
- Egypt 2.6,
- Others 10 (Palestine, Lebanon, Yemen, Iraq,
Syria, Iran and Sudan)
16Diabetes in Families
17Marital Status
- Marital Status
- 87.9 married
- 8.9 single
- 2.8 divorced/widowed
- Consanguineous Marriage 16.4 (n57)
18Gender difference
19-
- HbA1c
- 78 of patients has HbA1c (gt7)
- BP
- 57 have high BP
20Management Methods
21Complications (83)
- 26 (Eye glaucoma, laser surgery)
- 74 (feet ulcer, loss of sensation)
- 2 (Kidney protein urea or albumin urea)
- 4 (loss of toe/ foot)
- 6 (angina, heart attack)
22Self monitoring
23Self Management
- I can exercise several times a week (25 strongly
agree) - I can not exercise unless I feel like exercising
(28 strongly agree) - I can recognize when my blood sugar is too high
(27 strongly agree)
24Self Management
- I can do what was recommended to prevent low
blood sugar (24 SA) - I can figure out what self treatment when blood
sugar gets high (29 SA) - I can fit my diabetes self treatment routine into
my usual lifestyle (26 SA)
25CONCLUSIONS
- Diabetes Mellitus is common problem in primary
medical centers in Sharjah. - High levels of obesity
- Low physical activity
- Gap in self-management education including self
monitoring, manifested by high levels of obesity
and lack of physical activity.
26Recommendations
- Diabetes management in Sharjah could be improved
compared with international guidelines - Measures to improve control
- Diabetes Nurse Educators
- Patients self management education
- Peer-led or peer-support models
- CME for doctors at PHC centers
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