title: A study of diabetes complications in an endogamous population: an emerging public health burden.
abstract: OBJECTIVE
  The aims of this study were to determine the prevalence of diabetic complications namely neuropathy, nephropathy, and retinopathy among Qatari's DM patients; and to find associations between these complications and socio-demographic and clinical characteristics in a highly consanguineous population.
  
  
  METHODS
  It is an observational cohort study.
  
  
  METHODS
  The survey was carried out at the Hamad General Hospital and Primary Health Care (PHC) centers in the State of Qatar.
  
  
  METHODS
  The study was conducted from May 2011 to January 2013 among Qatari nationals above 20 years of age. Of the 2346 registered with diagnosed diabetes attending Hamad General Hospital and PHC centers, 1633 (69.3%) agreed and gave their consent to take part in this study.
  
  
  METHODS
  Questionnaire included socio-demographic variables, body mass index (BMI), consanguinity, lifestyle habits, family history of diabetes, blood pressure and development of diabetes complications such as retinopathy, nephropathy, and neuropathy were collected at regular intervals throughout the follow-up. Univariate and multivariate statistical analysis were performed.
  
  
  RESULTS
  Out of 1633 diabetic patients, 842 (51.6%) were males. The prevalence of diabetic nephropathy 12.4% and retinopathy was 12.5% followed by neuropathy 9.5% among diabetic population. The proportion of diabetic neuropathy and nephropathy were significantly higher among diabetic patients with age 60 years and above as compared to younger age groups (p=0.010). Nephropathy was significantly higher among male diabetic (p=0.014) and smokers (p<0.001) while diabetic neuropathy was more common among diabetic hypertensive patients (p=0.028). Multivariate logistic regression showed that Age (p=0.025), being male (p=0.045), and having high blood pressure (p=0.006) were significant predictors of diabetic neuropathy. For diabetic retinopathy, family history of DM (p<0.001), consanguinity (p=0.010), having high blood pressure (p=0.042) and physical activity (p<0.001) were significant predictors of diabetic retinopathy. Meanwhile, for diabetic nephropathy, age (p<0.001), smoking (p=0.045), physical activity (p<0.001) hypertension (p<0.001) and gender (p=0.012) were the significant predictors.
  
  
  CONCLUSIONS
  Diabetes exerts a significant burden in Qatar, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high morbidity and mortality and prevalence of complications observed. The significant interactions between diabetes and associated complications highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.
authors.affiliation: Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Qatar; Department of Public Health, Weill Cornell Medical College, Qatar; Department Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK. Electronic address: abener@hmc.org.qa.
authors.forename: Abdulbari
authors.initials: A
authors.lastname: Bener
authors.affiliation: Department of Ophthalmology, Hamad General Hospital, Hamad Medical Corporation, Qatar.
authors.forename: Fareed
authors.initials: F
authors.lastname: Al-Laftah
authors.affiliation: Qatar Diabetic Associations and Qatar Foundation, Doha, Qatar.
authors.forename: Abdulla O A A
authors.initials: AO
authors.lastname: Al-Hamaq
authors.affiliation: Department of Endocrinology, Al-Wakra Hospital, Hamad Medical Corporation, Qatar.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Daghash
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Qatar.
authors.forename: Waleed K
authors.initials: WK
authors.lastname: Abdullatef
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011634:Public Health; D011780:Qatar / Q000453:epidemiology; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Complications; Diabetes; Epidemiology; Nephropathy; Neuropathy; Retinopathy