Abstract
Objectives
In the Kingdom of Saudi Arabia (KSA), current data on diabetes are lacking, and a rise of the epidemic is feared, given the epidemiologic transition in the country. To inform public health authorities on the current status of the diabetes epidemic, we analyzed data from the Saudi Health Interview Survey (SHIS).
Methods
Saudi Health Interview Survey is a cross-sectional national multistage survey of individuals aged 15 years or older. A total of 10,735 participants completed a health questionnaire and were invited to the local health clinics for biomedical exams.
Results
1,745,532 (13.4 %) Saudis aged 15 years or older have diabetes. Among those, 57.8, 20.2, 16.6, and 5.4 % are undiagnosed, treated uncontrolled, treated controlled, and untreated, respectively. Males, older individuals, and those who were previously diagnosed with hypertension or hypercholesterolemia were more likely to be diabetic.
Conclusions
Our findings call for increased awareness of pre-diabetes, diabetes, and undiagnosed diabetes in KSA. Combatting diabetes and other non-communicable diseases should be the task of the Ministry of Health and other ministries as well, to offer a comprehensive socio-cultural approach to fighting this epidemic.

Similar content being viewed by others
References
Alberti Kgmm, Zimmet Pz (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation. Diabet Med 15:539–553. doi:10.1002/(SICI)1096-9136(199807)15:7<539:AID-DIA668>3.0.CO;2-S
Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI et al (2011) Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr Phys Act 8:140. doi:10.1186/1479-5868-8-140
Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY et al (2004) Diabetes mellitus in Saudi Arabia. Saudi Med J 25:1603–1610
American Diabetes Association (2013) Economic costs of diabetes in the U.S. in 2012. Diabetes Care 36:1033–1046. doi:10.2337/dc12-2625
Amuna P, Zotor FB (2008) Epidemiological and nutrition transition in developing countries: impact on human health and development. Proc Nutr Soc 67:82–90. doi:10.1017/S0029665108006058
Ceriello PA (2006) Oxidative stress and diabetes associated complications. Endocr Pract 12:60–62. doi:10.4158/EP.12.S1.60
Clark M (2011) Health care system in Saudi Arabia: an overview. East Mediterr Health J 17:784–793
Craig CL, Marshall AL, Sjöström M et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395. doi:10.1249/01.MSS.0000078924.61453.FB
Egede LE (2004) Diabetes, major depression, and functional disability among U.S adults. Diabetes Care 27:421–428. doi:10.2337/diacare.27.2.421
Fatani HH, Mira SA, El-Zubier AG (1987) prevalence of diabetes mellitus in rural Saudi Arabia. Diabetes Care 10:180–183. doi:10.2337/diacare.10.2.180
Goldberg RB (2006) Lifestyle interventions to prevent type 2 diabetes. Lancet 368:1634–1636. doi:10.1016/S0140-6736(06)69676-1
Harris MI, Eastman RC (2000) Early detection of undiagnosed diabetes mellitus: a US perspective. Diabetes Metab Res Rev 16:230–236. doi:10.1002/1520-7560(2000)9999:9999<:AID-DMRR122>3.0.CO;2-W
Kalyani RR, Saudek CD, Brancati FL, Selvin E (2010) Association of diabetes, comorbidities, and A1C with functional disability in older adults results from the National Health and Nutrition Examination Survey (NHANES), 1999–2006. Diabetes Care 33:1055–1060. doi:10.2337/dc09-1597
Key TJ, Allen NE, Spencer EA, Travis RC (2002) The effect of diet on risk of cancer. Lancet 360:861–868. doi:10.1016/S0140-6736(02)09958-0
Lindström J, Ilanne-Parikka P, Peltonen M et al (2006) Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 368:1673–1679. doi:10.1016/S0140-6736(06)69701-8
Lozano R, Naghavi M, Foreman K et al (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2095–2128. doi:10.1016/S0140-6736(12)61728-0
Maziak W, Critchley J, Zaman S et al (2013) Mediterranean studies of cardiovascular disease and hyperglycemia: analytical modeling of population socio-economic transitions (MedCHAMPS)—rationale and methods. Int J Public Health 58:547–553. doi:10.1007/s00038-012-0423-4
Ministry of Health (2005) Kingdom of Saudi Arabia, in collaboration with WHO (2005) Ministry of Health, Kingdom of Saudi Arabia, in collaboration with, World Health Organization. EMRO, Country-Specific standard report Saudi Arabia
Ministry of Health, Kingdom of Saudi Arabia (2013) Kingdom of Saudi Arabia Projected Population 2013
Ministry of Health, Kingdom of Saudi Arabia (2014) National Program for Diabetes Awareness. http://sahsehlo.moh.gov.sa/Pages/Home.aspx
Mokdad AH, Jaber S, Aziz MIA et al (2014) The state of health in the Arab world, 1990–2010: an analysis of the burden of diseases, injuries, and risk factors. Lancet 383:309–320. doi:10.1016/S0140-6736(13)62189-3
Ng SW, Zaghloul S, Ali HI et al (2011) The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States. Obes Rev Off J Int Assoc Study Obes 12:1–13. doi:10.1111/j.1467-789X.2010.00750.x
Ng CS, Lee JYC, Toh MP, Ko Y (2014) Cost-of-illness studies of diabetes mellitus: a systematic review. Diabetes Res Clin Pract. doi:10.1016/j.diabres.2014.03.020
NHANES (2009) National Heatlth and Nutrition Examination Survey (NHANES). Health Tech/Blodd Pressure Procedures Manual. Centers for Disease Control and Prevention
Secretariat General (2012) The Cooperation Council for the Arab States of the Gulf. http://www.gcc-sg.org/eng/
Stampfer MJ, Hu FB, Manson JE et al (2000) Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med 343:16–22. doi:10.1056/NEJM200007063430103
Stewart R, Liolitsa D (1999) Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med J Br Diabet Assoc 16:93–112
WHO EMRO (2012) International Conference on healthy Lifestyles and noncomunicable diseases in the arab world and the middle east. The Riyadh Declaration
WHO (2014) WHO Diabetes: the cost of diabetes. In: WHO. http://www.who.int/mediacentre/factsheets/fs236/en/. Accessed 22 May 2014
WHO Regional Office for the Eastern Mediterranean (2012) International conference on healthy lifestyles and noncommunicable diseases in the Arab world and the Middle East, Riyadh, 10–12 September 2012. Riyadh, Saudi Arabia
WHO/FAO Expert Consultation (2003) Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser 916:i–viii, 1–149, backcover
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
El Bcheraoui, C., Basulaiman, M., Tuffaha, M. et al. Status of the diabetes epidemic in the Kingdom of Saudi Arabia, 2013. Int J Public Health 59, 1011–1021 (2014). https://doi.org/10.1007/s00038-014-0612-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-014-0612-4