title: Trends and risk factors of hyperglycemia and diabetes among Kuwaiti adults: National Nutrition Surveillance Data from 2002 to 2009.
abstract: BACKGROUND
  Current prevalence estimates for diabetes in Arabian Gulf countries are some of the world's highest, yet regional trends and contributing factors are poorly documented. The present study was designed to determine temporal changes in the prevalence of impaired fasting glucose (IFG) and diabetes and associated factors in Kuwaiti adults.
  
  
  METHODS
  Data analysis from the nationally representative cross-sectional Kuwait National Nutrition Surveillance System. 2745 males and 3611 females, aged 20-69 years, attending registration for employment or pensions and Hajj Pilgrimage health check-ups or accompanying children for immunizations from 2002 through 2009 were participated. Socio-demographic and lifestyle information, height and weight, and blood samples were collected.
  
  
  RESULTS
  During the 8 years (2002-09), prevalences of IFG in males and females decreased by 7.4% and 6.8% and of diabetes by 9.8% and 8.9% in males and females, respectively. Linear regression for blood glucose level with time, adjusted for age, BMI, blood cholesterol and education level, showed a greater decrease in males than females (1.12 vs 0.93 mmol/L); males also showed an increase in 2002-2003 followed by a marked decrease in 2006-2007 while females showed a significant decrease in 2008-2009. Both males and females showed the largest decrease in the 2nd half of the study accounting for the majority of the overall decrease (1.13 mmol/L for males and 0.87 mmol/l for females for the 4 years). Compared with 2002-03, the OR for IFG in males decreased with time, and becoming significantly lower (OR=0.32; 95% CI: 0.21-0.49) for 2008-09. In females, the OR for IFG decreased significantly with time, except in 2006-07. Similarly, the OR for diabetes in males decreased to 0.34 (95% CI: 0.24-0.49) and in females to 0.33 (95% CI: 0.22-0.50) in 2008-09. For both genders, age and BMI were independently positively associated with IFG and diabetes, while education levels and smoking were negatively associated with IFG and diabetes. No significant association was found for either hypercholesterolemia or exercise in either gender.
  
  
  CONCLUSIONS
  Continued monitoring of blood glucose is needed to see if negative trends observed in 2008-2009 endure and further research of contributing factors is required for development of targeted intervention strategies.
authors: Nutrition and Dietetics, School of Public Health and Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, 4222, Australia. f.ahmed@griffith.edu.au
authors: Faruk
authors: F
authors: Ahmed
authors: Carol
authors: C
authors: Waslien
authors: Mona A
authors: MA
authors: Al-Sumaie
authors: Prasanna
authors: P
authors: Prakash
authors: Ahmad
authors: A
authors: Allafi
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology*; D007730:Kuwait / Q000453:epidemiology; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000706:statistics & numerical data / Q000639:trends; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002784:Cholesterol
references: Diabet Med. 2002 Nov;19(11):954-7
references: 12421434
references: BMC Public Health. 2007 Nov 14;7:328
references: 17999777
references: J Intern Med. 1998 Oct;244(4):317-23
references: 9797495
references: Eur J Clin Nutr. 2002 Aug;56(8):709-14
references: 12122545
references: Obes Rev. 2011 Jan;12(1):1-13
references: 20546144
references: BMC Public Health. 2009 May 29;9:167
references: 19480675
references: Med Princ Pract. 2010;19(2):105-12
references: 20134172
references: Prev Chronic Dis. 2008 Jan;5(1):A17
references: 18082006
references: Diabetes Res Clin Pract. 2010 Jan;87(1):4-14
references: 19896746
references: Nutrition. 2001 Mar;17(3):225-9
references: 11312064
references: World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
references: 11234459
references: Diabetes Care. 1995 Feb;18(2):258-68
references: 7729308
references: Int J Food Sci Nutr. 2001 Jul;52(4):301-11
references: 11474894
references: Diabetes. 1999 May;48(5):937-42
references: 10331395
references: Arch Intern Med. 2004 Oct 25;164(19):2147-55
references: 15505129
references: Prog Cardiovasc Dis. 2003 Mar-Apr;45(5):405-13
references: 12704597
references: BMC Public Health. 2009 Jun 16;9:186
references: 19531260
references: Public Health Nutr. 2012 Nov;15(11):2124-30
references: 22349029
references: Ann Saudi Med. 2007 Jul-Aug;27(4):241-50
references: 17684435
references: Popul Health Metr. 2006 Apr 24;4:5
references: 16635266
references: Acta Diabetol. 1999 Sep;36(3):133-40
references: 10664317
references: Diabetes Res Clin Pract. 2005 Aug;69(2):188-95
references: 16005369
references: Acta Diabetol. 1996 Jul;33(2):145-9
references: 8870817
references: Cardiovasc Diabetol. 2009 Apr 16;8:21
references: 19371412
references: Diabetes Res Clin Pract. 2004 Sep;65(3):275-81
references: 15331208
references: J Clin Endocrinol Metab. 2004 Jun;89(6):2583-9
references: 15181027
references: Saudi Med J. 2004 Nov;25(11):1603-10
references: 15573186
references: Croat Med J. 2005 Apr;46(2):302-7
references: 15849854
references: JAMA. 1993 Jun 16;269(23):3015-23
references: 8501844
references: Diabetes Res Clin Pract. 1998 Dec;42(3):187-96
references: 9925350
references: J Biosoc Sci. 2002 Apr;34(2):277-81
references: 11926459