Diabetes in Egypt (2003)

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Diabetes in Egypt(2003)

• Prof. Morsi Arab

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PREVELANCE OF COMPLICATIONS OF DIABETES
MELLITUS IN EGYPT
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Alex 1 Menoufeya 2 El Menia 3 Assiut
4 Mansoura 5 El Behira 6 Kafr El Sheikh 7
Matrouh 8 Other Govern. 9
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Age and Sex ( percent )
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Type of Diabetes
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BMI Increased BMI and Gender
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• Fertility Abortions and Labour in Diabetic
  Females . (among 1060 diabetic females)
• - The average number of normally born children /
  pt 3.6
• - The average number of aborted children / pt
  0.9
• - The frequency of abortions among all
  pregnancies 21.5
• - The average frequency of Caesarian labour
  4.7

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Parental History of Diabetes
Diabetic Mother in 29.1 Diabetic
Father in 22.3 Both parents in
7.8 Neither Parents in
39.3
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• Fasting Hyperglycemia
• - Controlled (lt 120 mg/dl ) 19.8
• - Total Uncontrolled
  80.2
• Hyperglycemic 121-150 mg/dl 15.6
• Marked hyperglycemia 151-200 31.3
• Severe hyperglycemia 211-220 12.5
• Very severe hyperglycemia gt 220 20.8

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• Post Prandial Hyperglycemia
• - Controlled lt 160 mg/dl 13.5
• - Accepted 161-180 mg/dl 7.9
• Total
  21.4
• - Uncontrolled gt180 mg/dl
  78.6
• Moderate 181-220 mg/dl 17.4
• Severe 221- 260 mg/dl 16.0
• Very Severe gt 260 mg/dl 45.2
• TOTAL
  100

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Uncontrolled Diastolic Hypertension
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Uncontrolled Systolic Hypertension
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Diabetes KetoAcidosis (DKA)- Incidence
( among all patients at all frequencies at
any time of the duration of diabetes ) 12.2
.- The mean age in patients who developed DKA
( at least once in life )
42.5 years- The mean age
in patients who never developed DKA

53.1 years
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Hypoglycemia- Incidence of Hypoglycemic
episodes at any frequency and at any time
during the course of Diabetes. Among 1588
patients was 20.5 - The
mean age of patients who developed
hypoglycemic episodes at any time 50.8
years - The mean age of patients who did not
experience hypoglyceamic episodes
52.1 years
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Serum Cholesterol and Hypercholsterolemia
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Cardiac Complications Angina 15.0
Positive E.C.G. Changes 7.9 Signs of
Cardiac Dysfunction 21.3 (C. H.V. and
or arrhythmia )
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Retinopathy ( in 1173 patients ) - Free
68.9 - Back ground 22.6
- Proliferative 9.5
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Serum Creatinine
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Ankle Reflex as early indicator of neuropathy
n 1833 pts., AR was - present in 44.5
-
absent in 55.5
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• Prevalence
• of foot complications
• among diabetic patients
• Among 2000 patients
• 1- Fungus infection
  22.0
• 2- Foot ulcers
  6.8
• 3- Evident Ischaemic changes 9.7
  
• 4- Amputations
  3.0
• 5- Deformities
  1.0

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Treatment by Insulin I- Out of 2000 diabetic
patients - 882 are insulin recipients (
44.1 ) - 199 are on animal insulin ( 23
) - 683 are on Human insulin ( 77 )II- The
average total daily dose ( 45.5 units) -
34.1 of pts on ( one ) injection - 58.4
of pts on ( two ) injections) - 7.5 of
pts on multiple injections III- The form of
insulin received is - Intermediate in
83.0 - Mixed in 14.6 -
Short in 4.2
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The Extra Burden of Cost of Treatment of
Complicated Diabetes at a Private Alexandria
Hospital, 2001 ( average of 100 diabetic patients
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Distribution of costs of Hospital Treatment of
Diabetic Patients ( L.E. per day ) at a Private
Hospital for Middle Class Egyptian Population at
the City of Alexandria , Egypt 2001
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Estimated Costs of Ambulatory (out patient)
Treatment of Diabetes in Egypt at 2001 Cost
Prices in USD/ year
(A) Insulin ( Dose 10-80 units /d )
(B) Oral Antidiabetic Agents
Heavily subsidized moderately
subsidized
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Estimated Costs of Ambulatory (out patient)
Treatment of Diabetes in Egypt at 2001 Cost
Prices in USD/ year ( Cont.)

• ( C ) Other costs at average frequencies per
  year
• Laboratory , and other follow up investigations
  (E.C.G radiol., etc. )
• Physician fees and other specialist consultations
• Total 143 USD/Year

76.4 66.6
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The Burden of the Cost of Ambulatory Treatment of
Diabetes on Individuals at Low-Income and
High-Income Middle East Countries, based on the
Cost Prices of Insulins and Oral Antidiabetic
Agents (in USD per year)
Heavily subsidized moderately
subsidized
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The Burden of the Cost of Ambulatory Treatment of
Diabetes on Individuals at Low-Income and
High-Income Middle East Countries , based on the
Cost Prices of Insulins and Oral Antidiabetic
Agents ( in USD per year) (Cont.)
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The Burden of the Cost of Ambulatory Treatment of
Diabetes on Individuals at Low-Income and
High-Income Middle East Countries , based on the
Cost Prices of Insulins and Oral Antidiabetic
Agents (in USD per year) (Cont.)
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Thank You