Incidence of diabetes and its predictors in the Greater Beirut Area: a five-year longitudinal study

Mona P Nasrallah; Martine Elbejjani; Lara Nasreddine; Hassan Chami; Hussein Ismaeel; Mohamad Fleifel; Fatima Al Zahraa Chokor; Hani Tamim

doi:10.1186/s13098-022-00833-w

Incidence of diabetes and its predictors in the Greater Beirut Area: a five-year longitudinal study

Diabetol Metab Syndr. 2022 May 4;14(1):67. doi: 10.1186/s13098-022-00833-w.

Authors

Mona P Nasrallah^{1

2}, Martine Elbejjani^{3

4}, Lara Nasreddine^{2

5}, Hassan Chami⁶, Hussein Ismaeel^{2

7}, Mohamad Fleifel¹, Fatima Al Zahraa Chokor^{3

5}, Hani Tamim^{8

9

10}

Affiliations

¹ Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
² Vascular Medicine Program, American University of Beirut, Beirut, Lebanon.
³ Faculty of Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.
⁴ Faculty of Medicine, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
⁵ Faculty of Agricultural and Food Sciences, Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon.
⁶ Faculty of Medicine, Department of Internal Medicine, Division of Pulmonary and Critical Care, American University of Beirut Medical Center, Beirut, Lebanon.
⁷ Faculty of Medicine, Department of Internal Medicine, Division of Cardiology, American University of Beirut, Beirut, Lebanon.
⁸ Faculty of Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon. htamim@alfaisal.edu.
⁹ Faculty of Medicine, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. htamim@alfaisal.edu.
¹⁰ College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia. htamim@alfaisal.edu.

Abstract

Background: Type 2 Diabetes (T2D) remains a world epidemic. Obtaining accurate estimates of its incidence and their predictors will aid in targeting preventive measures, allocating resources, and strategizing its management. The Middle East North Africa region has high T2D prevalence and rates of rise. Few incidence studies exist for the region, and none from Lebanon. The current study objective was to determine diabetes incidence and diabetes predictors in a community-based Lebanese sample. A secondary objective was to describe the metabolic control over time in adults with preexisting diabetes.

Methods: This is a five-year (2014-2019) follow-up study on a random sample of 501 residents of the Greater Beirut area. Out of 478 people eligible to participate in the follow-up study, 198 returned (response rate 39.5%). Assessment included medical history, anthropometric measures, food frequency, sleep, and lifestyle questionnaires. Laboratory data included glycemic indices (fasting glucose and HbA1C) and other biological markers. The diagnosis of probable diabetes (PD) was based on one abnormal test for either fasting glucose ≥ 126 mg/dL or HbA1C ≥ 6.5% or having history of diabetes.

Results: The incidence of diabetes was 17.2 (95% CI 9.6-28.7) per 1000 person-years. Cardiometabolic risk factors independently associated with diabetes were: older age, higher BMI, family history of diabetes, metabolic syndrome, higher CRP and triglyceride level; whereas an independent predictor of diabetes was previous BMI. In addition, the 42 participants with preexisting diabetes had worsening of their metabolic profile over a five-year period.

Conclusions: The incidence of diabetes was high as compared to some reported world rates, and in line with the high prevalence in the MENA region. The risk was highest in those with positive family history and the presence of the metabolic syndrome or its components. Preventive measures should particularly target participants with that specific risk profile. This becomes particularly important when observing that metabolic control gets worse over time in individuals with diabetes.

Keywords: Beirut; Incidence; Lebanon; MENA region; Metabolic syndrome; Predictors; Type 2 Diabetes.