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      Prediabetes and diabetes prevalence and risk factors comparison between ethnic groups in the United Arab Emirates

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          Abstract

          The economic growth has paralleled the rise of diabetes and its complications in multiethnic population of United Arab Emirates (UAE). Previous studies have shown that characteristics of diabetes is variable across different ethnicities. The objective of this study was to compare diabetes prevalence and risk factors between UAE nationals and different expatriate’s ethnic groups in UAE using data from UAE National Diabetes and Lifestyle Study (UAEDIAB). The UAE nationals made one-fourth (n = 797, 25%) of total cohort and the remaining 75% belonged to immigrants. Across different ethnicities, adjusted prevalence of prediabetes ranged from 8% to 17%, while adjusted prevalence of newly diagnosed diabetes ranged from 3% to 13%. UAE nationals, Arabs non-nationals and Asians had the highest number of pre-diabetic as well as newly diagnosed diabetic patients. Adjusted prevalence of diabetes was highest in UAE nationals (male 21% and female 23%) as well as Asian non-Arabs (male 23% and female 20%), where 40% of both groups fell under the range of either prediabetes or diabetes conditions. Multivariate factors of diabetes versus non-diabetes included older age, ethnicities of Asian non-Arabs and local UAE nationals, family history of diabetes, obesity, snoring, decreased level of high density lipoprotein, elevated levels of triglycerides and blood pressure. In conclusion, diabetes prevalence and risk factors vary across the different ethnic groups in UAE, and hence interventions towards identification and prevention of diabetes should not treat all patients alike.

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          Aging and insulin secretion.

          Glucose tolerance progressively declines with age, and there is a high prevalence of type 2 diabetes and postchallenge hyperglycemia in the older population. Age-related glucose intolerance in humans is often accompanied by insulin resistance, but circulating insulin levels are similar to those of younger people. Under some conditions of hyperglycemic challenge, insulin levels are lower in older people, suggesting beta-cell dysfunction. When insulin sensitivity is controlled for, insulin secretory defects have been consistently demonstrated in aging humans. In addition, beta-cell sensitivity to incretin hormones may be decreased with advancing age. Impaired beta-cell compensation to age-related insulin resistance may predispose older people to develop postchallenge hyperglycemia and type 2 diabetes. An improved understanding of the metabolic alterations associated with aging is essential for the development of preventive and therapeutic interventions in this population at high risk for glucose intolerance.
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            Nutrition transition in the United Arab Emirates.

            The United Arab Emirates has undergone remarkable economic and social transformations over the past few decades. We present findings on the prevalence of overweight and obesity, dietary and activity patterns among Emiratis in 2009/10, and explore associated urbanization and wealth factors. A cross-sectional study was conducted in 628 randomly selected households in all seven emirates. Sociodemographics, 24-h dietary recalls, physical activity and anthropometric data were collected from adult females (≥ 19 years), adolescents (11-18 years) and children (6-10 years) in each family via in-person interviews using validated questionnaires. In 2009/10, 65% of adult women, 28% of male adolescents and 40% of female adolescents, 25% of male children and 41% of female children were overweight or obese. 43% of girls and 38% of boys (6-10 years) consumed more calories than their estimated energy requirements. Snacking represents a major source of Emirati caloric intake (>20%) of total calories. In addition, caloric beverages account for 8-14% of total calories. Meanwhile, physical activity levels are low, especially among females Emiratis and those living in urban areas. These trends represent the potential risk for severe cardiometabolic problems in the United Arab Emirates. The significant gender differentials among children and adolescents are driven by diet and activity differences. More attention should be paid to educate the public on nutrition (for example, limit the consumption of sugared sodas, fruit drinks and whole milk, promote water and low-fat/skim milk consumption instead) and encourage physical activity from a young age, especially among females. Built environments and social support for improved lifestyle choices by individuals are needed.
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              Understanding the High Prevalence of Diabetes in U.S. South Asians Compared With Four Racial/Ethnic Groups: The MASALA and MESA Studies

              OBJECTIVE We compared South Asians with four other racial/ethnic groups in the U.S. to determine whether sociodemographic, lifestyle, or metabolic factors could explain the higher diabetes prevalence and whether insulin resistance and β-cell dysfunction occurred at younger ages and/or lower adiposity levels compared with other groups. RESEARCH DESIGN AND METHODS We performed a cross-sectional analysis of two community-based cohorts, the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study and the Multi-Ethnic Study of Atherosclerosis (MESA); all participants had no known cardiovascular disease and were between 44 and 84 years of age. We compared 799 South Asians with 2,611 whites, 1,879 African Americans, 1,493 Latinos, and 801 Chinese Americans. Type 2 diabetes was classified by fasting plasma glucose ≥126 mg/dL or use of a diabetes medication. Insulin resistance was estimated by the homeostasis model assessment (HOMA) and β-cell function was measured by the HOMA-β model. RESULTS South Asians had significantly higher age-adjusted prevalence of diabetes (23%) than the MESA ethnic groups (6% in whites, 18% in African Americans, 17% in Latinos, and 13% in Chinese Americans). This difference increased further after adjustment for potential confounders. HOMA of insulin resistance (HOMA-IR) levels were significantly higher and HOMA-β levels were lower among South Asians compared with all other racial/ethnic groups after adjustment for age and adiposity. CONCLUSIONS The higher prevalence of diabetes in South Asians is not explained by traditionally measured risk factors. South Asians may have lower β-cell function and an inability to compensate adequately for higher glucose levels from insulin resistance.
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                Author and article information

                Contributors
                nsulaiman@sharjah.ac.ae
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                25 November 2019
                25 November 2019
                2019
                : 9
                : 17437
                Affiliations
                [1 ]ISNI 0000 0004 4686 5317, GRID grid.412789.1, Sharjah Institute of Medical Research, , College of Medicine, University of Sharjah, ; Sharjah, United Arab Emirates
                [2 ]ISNI 0000 0004 4686 5317, GRID grid.412789.1, College of Medicine, , University of Sharjah, ; Sharjah, United Arab Emirates
                [3 ]ISNI 0000 0000 9760 5620, GRID grid.1051.5, Baker Heart and Diabetes Institute, ; 75 Commercial Road, Melbourne, Victoria 3004 Australia
                Article
                53505
                10.1038/s41598-019-53505-7
                6877520
                31767874
                7bdb6d03-083f-4212-9eeb-580f7aff7722
                © The Author(s) 2019

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 18 February 2019
                : 29 October 2019
                Funding
                Funded by: FundRef https://doi.org/10.13039/100012001, Al Jalila Foundation;
                Award ID: 150326
                Award Recipient :
                Categories
                Article
                Custom metadata
                © The Author(s) 2019

                Uncategorized
                metabolic disorders,epidemiology,risk factors
                Uncategorized
                metabolic disorders, epidemiology, risk factors

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