title: 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).
  
  
  METHODS
  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.
authors.affiliation: Institut National de Nutrition, Tunis, Tunisia. radhia.bouguerra@rns.tn
authors.forename: R
authors.initials: R
authors.lastname: Bouguerra
authors.forename: H
authors.initials: H
authors.lastname: Alberti
authors.forename: L B
authors.initials: LB
authors.lastname: Salem
authors.forename: C B
authors.initials: CB
authors.lastname: Rayana
authors.forename: J E
authors.initials: JE
authors.lastname: Atti
authors.forename: S
authors.initials: S
authors.lastname: Gaigi
authors.forename: C B
authors.initials: CB
authors.lastname: Slama
authors.forename: B
authors.initials: B
authors.lastname: Zouari
authors.forename: K
authors.initials: K
authors.lastname: Alberti
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000517:prevention & control; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014416:Tunisia / Q000453:epidemiology; D014505:Urban Population