Prevalence, correlates and management of type 2 diabetes mellitus in Lebanon: findings from a national population-based study

Diabetes Res Clin Pract. 2014 Sep;105(3):408-15. doi: 10.1016/j.diabres.2014.06.005. Epub 2014 Jun 23.

Abstract

Aims: This study aims to examine the prevalence, associated risk factors and complications of diabetes, as well management and preventive care in Lebanon, a small, middle-income country of the Mediterranean region.

Methods: Using a comprehensive multi-dimensional questionnaire, a cross-sectional national survey of 2195 Lebanese adults aged ≥25 years was conducted based on the WHO STEPwise guidelines. The outcome variable, diabetes, was self-reported. Measures for diabetes management included frequency of blood glucose testing and regular eye and foot exams. Macrovascular and microvascular complications were also recorded.

Results: The prevalence of type 2 diabetes was 8.5% (95%CI=7.3-9.7). Factors associated with an increased risk of having diabetes were: being divorced or widowed (OR=2.56; 95%CI=1.07-5.42) compared to single, being obese (OR=1.50, 95%CI=1.00-2.57), and having a family history of diabetes (OR=3.40;95%CI=2.48-5.19). Vigorous physical activity significantly decreased the odds of diabetes (OR=0.42; 95%CI=0.24-0.72). Diabetes management and self-care goals were as follows: 82% were not measuring their blood sugar via dextro on a daily basis, 64.2% did not have a foot exam within the past year, and 52.4% did not obtain the recommended yearly eye exam. The most common complications included heart disease (27.8%) and retinopathy (16.6%).

Conclusions: Prevalence of diabetes in Lebanon was comparable to that found in the West, yet remained lower than estimates in other resource-rich neighboring countries. Adherence to management and self-care measures was sub-optimal resulting in high complication rates. Contextual factors play a role in increasing diabetes risk. Population-based interventions to enhance and promote self-management behaviors are essential to improve complication rates.

Keywords: Complications; Lebanon; Management; Prevalence; Type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose Self-Monitoring / statistics & numerical data
  • Cross-Sectional Studies
  • Diabetes Complications / epidemiology*
  • Diabetes Complications / prevention & control*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / therapy*
  • Diagnostic Techniques, Cardiovascular
  • Diagnostic Techniques, Ophthalmological
  • Disease Management
  • Exercise / physiology
  • Female
  • Humans
  • Lebanon / epidemiology
  • Male
  • Middle Aged
  • Obesity
  • Prevalence
  • Protective Factors
  • Risk Factors
  • Self Care*
  • Socioeconomic Factors
  • Surveys and Questionnaires