Diabetes Epidemiology in Qatar: Current and Future Trends and Impact of Interventions

Laith Abu-Raddad, Ph.D.
Professor of Population Health Sciences
Director, WHO Collaborating Centre for Disease Epidemiology Analytics
Director, Biostatistics, Epidemiology and Biomathematics Research Core

Diabetes poses a global health challenge. In 2021, 1 in 10 adults (537 million) had diabetes, and this is projected to increase to 783 million by 2045 (a 46% increase).¹ Half of those with diabetes are undiagnosed.¹ The cost of diabetes burden reached 966 billion USD in 2021. In the Middle East and North Africa (MENA), 73 million adults had diabetes in 2021, projected to rise to 136 million by 2045 (an 87% increase).¹

Qatar faces a significant burden of diabetes, with a projected increase in prevalence from 17.8% (37,179 persons) in 2023 to 29.5% (84,516 persons) by 2050 among adult Qataris aged 20-79 years. ² Obesity is the main driver of the diabetes epidemic in Qatar, accounting for 57.5% of diabetes cases.³ Diabetes expenditure is expected to reach nearly one-third of national health expenditure by 2050.⁴

A diabetes risk score is an assessment tool used to easily estimate an individual's probability of developing diabetes in the future. It takes into account factors like age, body weight, and physical activity level to evaluate the risk. By utilizing a diabetes risk score, individuals and healthcare professionals can identify those at higher risk of developing diabetes. This enables the implementation of targeted preventive measures, lifestyle interventions, and early detection strategies. Our research team has recently developed the Qatar Diabetes Risk Score specifically for Qataris, which has been found to be highly accurate in predicting diabetes risk.⁵

To slow down the rapidly rising diabetes epidemic in Qatar, relying solely on awareness and education efforts is insufficient. Individual behavioral change is challenging to achieve and sustain.⁶ Structural interventions that involve policy facilitation to create an environment where healthier choices are easier have a higher likelihood of making an impact.⁷

Our study on diabetes among Qataris proposed five intervention approaches, with a focus on structural interventions.⁸ Each approach demonstrated an impact on reducing diabetes incidence and prevalence. The lifestyle management intervention approach resulted in a 9.5% reduction in new diabetes cases by 2050. The active commuting intervention approach, which involved promoting cycling and walking, averted 8.5% of new cases by 2050. The subsidy and legislative intervention approach, which included subsidies on fruits and vegetables and taxation on sugar-sweetened beverages, led to a 7.4% reduction in new cases by 2050. While each intervention had an effect, none individually had a large impact.

Based on the evidence, there is a need for increased investment in a combination of individual-level and structural public health interventions. This investment holds the greatest potential to prevent the onset of diabetes and slow down the rising trends of diabetes. Policy-level facilitation is needed to create an environment that makes the "healthier choice the easier choice" and, consequently, to reduce diabetes risk by reducing its key risk factors.

References

1. IDF Diabetes Atlas. Tenth edition 2021. https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf. Accessed on December 6, 2021.
2. Awad SF, Toumi A, Al-Mutawaa KA, et al. Type 2 diabetes epidemic and key risk factors in Qatar: a mathematical modeling analysis. BMJ Open Diabetes Res Care 2022;10.
3. Awad SF, O'Flaherty M, Critchley J, Abu-Raddad LJ. Forecasting the burden of type 2 diabetes mellitus in Qatar to 2050: A novel modeling approach. Diabetes Research and Clinical Practice 2018;137:100-8.
4. Awad SF, Dargham SR, Toumi AA, et al. A diabetes risk score for Qatar utilizing a novel mathematical modeling approach to identify individuals at high risk for diabetes. Scientific Reports 2021;11:1-10.
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8. Alareeki A, Awad SF, Critchley JA, et al. Epidemiological impact of public health interventions against diabetes in Qatar: Mathematical modelling analyses.Frontiers Public Health - Public Health and Nutrition under review 2023.