Prevalence, correlates and management of type 2 diabetes mellitus in Lebanon: Findings from a national population-based study

Aims: This study aims to examine the prevalence, associated risk factors and complications of diabetes, as well management and preventive care in Lebanon, a small, middle-income country of the Mediterranean region. Methods: Using a comprehensive multi-dimensional questionnaire, a cross-sectional national survey of 2195 Lebanese adults aged ≥25 years was conducted based on the WHO STEPwise guidelines. The outcome variable, diabetes, was self-reported. Measures for diabetes management included frequency of blood glucose testing and regular eye and foot exams. Macrovascular and microvascular complications were also recorded. Results: The prevalence of type 2 diabetes was 8.5% (95%CI = 7.3-9.7). Factors associated with an increased risk of having diabetes were: being divorced or widowed (OR = 2.56; 95%CI = 1.07-5.42) compared to single, being obese (OR = 1.50, 95%CI = 1.00-2.57), and having a family history of diabetes (OR = 3.40;95%CI = 2.48-5.19). Vigorous physical activity significantly decreased the odds of diabetes (OR = 0.42; 95%CI = 0.24-0.72). Diabetes management and self-care goals were as follows: 82% were not measuring their blood sugar via dextro on a daily basis, 64.2% did not have a foot exam within the past year, and 52.4% did not obtain the recommended yearly eye exam. The most common complications included heart disease (27.8%) and retinopathy (16.6%). Conclusions: Prevalence of diabetes in Lebanon was comparable to that found in the West, yet remained lower than estimates in other resource-rich neighboring countries. Adherence to management and self-care measures was sub-optimal resulting in high complication rates. Contextual factors play a role in increasing diabetes risk. Population-based interventions to enhance and promote self-management behaviors are essential to improve complication rates.