Spotlight: Alarming rise in diabetic cases a major challenge

Oman is facing a rapidly rising diabetic cases and the number of people affected with it over the coming three decades will grow further. According to a report published in the Journal of Diabetes Investigation, the rising number of people with diabetes will make it challenging for the country to control the ‘silent killer’ if no major preventive interventions are implemented now.
The report, based on a research done in collaboration between Oman’s Ministry of Health and Weill Cornell Medicine-Qatar, investigated and forecast diabetes burden and its associated economic costs up to 2050.

“The type 2 diabetes mellitus epidemic in Oman is expected to increase significantly over the next three decades, consuming nearly one-third of the national health expenditure. The type 2 diabetes mellitus burden is heavily influenced by obesity”, the report points out.

Interventions targeting this single risk factor should be a national priority to reduce and control the burden of type 2 diabetes mellitus in Oman, states the report. Diabetes mellitus is one of the fastest growing global health challenges of the 21st century. Based on the 2019 International Diabetes Federation (IDF) Diabetes Atlas, 463 million adults aged 20-79 years are estimated to be living with diabetes mellitus today, worldwide, and 700 million are projected to be living with the condition by 2045.

Specifically, the Middle East and North Africa (MENA) region is estimated to have the highest diabetes mellitus prevalence of all regions in both 2019 and 2045. The type 2 diabetes mellitus prevalence in Oman was projected to increase within the coming decade by 18.5 per cent, and further by 31.8 per cent between 2030 and 2050.

“Over 2020-2050, Oman will witness a nearly 200 per cent increase in the number of Omanis living with type 2 diabetes mellitus as a result of a growing and aging population. This will result in type 2 diabetes mellitus consuming 29 per cent of the national health expenditure by the year 2050, which is $1 out of every $3 spent on health”, points out the study.

risk factors

The study titled, “Forecasting the type 2 diabetes mellitus epidemic and the role of key risk factors in Oman up to 2050: Mathematical modelling analyses”, used an age-structured mathematical model to characterize type 2 diabetes mellitus epidemiology and trends in the Sultanate between 1990 and 2050. With diabetes mellitus being a main concern to policy-makers in Oman, four national and two regional population-based surveys were carried out to estimate the diabetes mellitus prevalence and associated cardiovascular risk factors between 1991 and 2017.

“Oman’s national surveys revealed that diabetes prevalence has been increasing in the past two decades’’, said Dr Adhra al Maawali, director of the Research and Studies Centre at the Ministry of Health in Oman and co-investigator of the study.

While expressing his concern as the figures were alarming, he said, “we needed to conduct this forecasting study to assess future trends and costs of diabetes in Oman. The findings of the study confirmed our fears. Diabetes prevalence will continue to grow and will reach 24 per cent by 2050. One in every four Omanis will be suffering from diabetes if no major intervention is implemented”.

cases increased

According to the study, the number of Omanis living with type 2 diabetes mellitus was predicted to increase from 190,489 in 2020 to 282,585 in 2030 and to 570,227 in 2050, whereas the annual number of new type 2 diabetes mellitus cases increased from 17,230 to 25,432 and to 47,559 respectively. The incidence rate per 1,000 person-years also increased from 8.3 in 2020 to 9.7 in 2030 and to 12.1 in 2050. The absolute number of type 2 diabetes mellitus prevalent and incident cases, as well as the incidence rate per 1,000 person-years was higher among Omani women compared with men.

Assuming continuation of the increasing trend in obesity prevalence as per the survey data, the study projects an increase in obesity prevalence from 35.9 per cent in 2020 to 69.1 per cent in 2050, with the increase most pronounced for women. “Smoking and physical inactivity prevalence remained stable at 6.6 and 35 per cent, respectively, between 2020 and 2050. Women had lower smoking prevalence of 0.3 per cent than men with 12.6 per cent between 2020 and 2050.

The less physical inactivity prevalence among women compared with women is higher than men, the report points out. According to the Annual Report by Oman’s Ministry of Health, the total diabetic cases on its register at the national level stood at 105,317 cases in 2019. Women constituted 54.3 per cent of a total of 6,430 new diabetes cases registered during 2019 in the Sultanate. About 31 per cent of the cases registered are in the age group between 45 and 49 years followed by those between 40 and 44 years.

The study did not include the expatriate population of Oman, as this analysis was intended for the permanent and stable population of this country. “Expatriates residing in Oman are not permanent residents, they come to Oman for work through work visas and not immigrant visas, and most often stay for a limited number of years”, it states.

The study suggests that type 2 diabetes mellitus prevention should be implemented at both national and governorate levels with multi-sectorial, governmental and societal support, as it is an emerging threat to social and economic development. In addition, aiming at reducing the modifiable risk factors for type 2 diabetes mellitus, existing public awareness campaigns and interventions need to be expanded by strengthening the implementation of Oman’s National Policy for Diet, Physical Activity and Health, and introducing legislation on foods and beverages.

SAMUEL KUTTY
@samkuttyvp