title: Diabetes mellitus in Egypt: glycaemic control and microvascular and neuropathic complications.
abstract: We performed a cross-sectional, population-based survey of persons 20 years of age and older living in Cairo and surrounding rural villages. The purpose was to describe glycaemic control and the prevalence of microvascular and neuropathic complications among Egyptians with diagnosed diabetes, previously undiagnosed diabetes, impaired glucose tolerance, and normal glucose tolerance. A total of 6052 households were surveyed. The response rate was 76% for the household survey and 72% for the medical examination. Among people with previously diagnosed diabetes, mean haemoglobin A1c, was 9.0%. Forty-two per cent had retinopathy, 21% albuminuria, and 22% neuropathy. Legal blindness was prevalent (5%) but clinical nephropathy (7%) and foot ulcers (1%) were uncommon in persons with diagnosed diabetes. Among people with diagnosed diabetes, microvascular and neuropathic complications were associated with hyperglycaemia. Retinopathy was also associated with duration of diabetes; albuminuria with hypertension and hypercholesterolaemia; and neuropathy with age, female sex, and hypercholesterolaemia. Albuminuria was as common in people with previously undiagnosed diabetes (22%) as those with diagnosed disease (21%). Mean haemoglobin A1c was lower (7.8%) and retinopathy (16%) and neuropathy (14%) were less prevalent in people with previously undiagnosed disease. Ocular conditions, blindness, and neuropathy were prevalent in the non-diabetic population. The microvascular and neuropathic complications of diabetes are a major clinical and public health problem in Egypt.
authors.affiliation: University of Michigan Medical Center, Ann Arbor 48109-0354, USA. wherman@unich.edu
authors.forename: W H
authors.initials: WH
authors.lastname: Herman
authors.forename: R E
authors.initials: RE
authors.lastname: Aubert
authors.forename: M M
authors.initials: MM
authors.lastname: Engelgau
authors.forename: T J
authors.initials: TJ
authors.lastname: Thompson
authors.forename: M A
authors.initials: MA
authors.lastname: Ali
authors.forename: E S
authors.initials: ES
authors.lastname: Sous
authors.forename: M
authors.initials: M
authors.lastname: Hegazy
authors.forename: A
authors.initials: A
authors.lastname: Badran
authors.forename: S J
authors.initials: SJ
authors.lastname: Kenny
authors.forename: E W
authors.initials: EW
authors.lastname: Gunter
authors.forename: A M
authors.initials: AM
authors.lastname: Malarcher
authors.forename: R J
authors.initials: RJ
authors.lastname: Brechner
authors.forename: S F
authors.initials: SF
authors.lastname: Wetterhall
authors.forename: F
authors.initials: F
authors.lastname: DeStefano
authors.forename: P J
authors.initials: PJ
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Habib
authors.forename: S
authors.initials: S
authors.lastname: abd el Shakour
authors.forename: A S
authors.initials: AS
authors.lastname: Ibrahim
authors.forename: E M
authors.initials: EM
authors.lastname: el Behairy
mesh_terms: D000328:Adult; D000419:Albuminuria; D001786:Blood Glucose / Q000378:metabolism*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000097:blood / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D014505:Urban Population
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin