High Fasting Plasma Glucose, Diabetes, and Its Risk Factors in the Eastern Mediterranean Region, 1990-2013: Findings From the Global Burden of Disease Study 2013

Diabetes Care. 2017 Jan;40(1):22-29. doi: 10.2337/dc16-1075. Epub 2016 Oct 26.


Objective: The prevalence of diabetes in the Eastern Mediterranean Region (EMR) is among the highest in the world. We used findings from the Global Burden of Disease 2013 study to calculate the burden of diabetes in the EMR.

Research design and methods: The burden of diabetes and burden attributable to high fasting plasma glucose (HFPG) were calculated for each of the 22 countries in the EMR between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, deaths, and disability-adjusted life years (DALYs).

Results: The diabetes death rate increased by 60.7%, from 12.1 per 100,000 population (95% uncertainty interval [UI]: 11.2-13.2) in 1990 to 19.5 per 100,000 population (95% UI: 17.4-21.5) in 2013. The diabetes DALY rate increased from 589.9 per 100,000 (95% UI: 498.0-698.0) in 1990 to 883.5 per 100,000 population (95% UI: 732.2-1,051.5) in 2013. In 2013, HFPG accounted for 4.9% (95% UI: 4.4-5.3) of DALYs from all causes. Total DALYs from diabetes increased by 148.6% during 1990-2013; population growth accounted for a 62.9% increase, and aging and increase in age-specific DALY rates accounted for 31.8% and 53.9%, respectively.

Conclusions: Our findings show that diabetes causes a major burden in the EMR, which is increasing. Aging and population growth do not fully explain this increase in the diabetes burden. Programs and policies are urgently needed to reduce risk factors for diabetes, increase awareness of the disease, and improve diagnosis and control of diabetes to reduce its burden.

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / analysis*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / etiology
  • Diabetes Mellitus / mortality*
  • Fasting / blood*
  • Female
  • Global Burden of Disease / statistics & numerical data*
  • Humans
  • Male
  • Mediterranean Region / epidemiology
  • Middle Aged
  • Prevalence
  • Quality-Adjusted Life Years
  • Risk Factors


  • Blood Glucose