The causes and Epidemiology of Diabetes

The causes and Epidemiology of Diabetes

The disease burden of diabetes is already high in various countries and continues to rise day by day. This is increased further by the worldwide rise in the prevalence of unhealthy lifestyles and obesity amongst populations. In 2013, it was estimated that the global prevalence of diabetes is 382 million with this figures expected to rise by 2035. Type I and type II diabetes are the main types of diabetes. Of the total prevalence, types II diabetes accounts for the majority of the patients. The two types of the can lead to various complications ranging from retinopathy, diabetic ketoacidosis, ischemic heart disease, peripheral vascular disease, and stroke. Zayed (2016) conducted a systematic review of the epidemiology of diabetic ketoacidosis in Arab patients having type I diabetes.

Background of the study

The Arabic speaking countries are 26 comprising of both high and low-income countries. The countries have been invaded by immigrants from Turkey, Europe, and Rome together with traders leading to the mixing of the demographic distributions of the ethnic groups. Among these populations, type 1 diabetes is the most common chronic condition affecting a majority of the children. The condition is responsible for about 5 to 10% of the total cases in diabetes worldwide and increases at the rate of 3% on an annual basis. The incidence rate varies among different populations globally. Various studies have reported variations in the Arab countries.

In the case of diabetes type 1, there is a complete deficiency of insulin in the body making the patient vulnerable to diabetic acidosis. Diabetic ketoacidosis occurs at any age of type I diabetes with most instances occurring in patients with age less than 19 years. Despite the death rate being reduced, DKA continues to claim more lives. The mortality rates are also relatively high in developing nations than the developed nations. With all the above known, this study aimed at determining the frequency of DKA in Arab countries and quantify the prevalence rate among the patients with type 1 diabetes. The author established the significance of the study basing it on the increased number of patients affected by diabetes type 1 hence was prompted to determine its frequency.

Research Questions

The research questions included:

  • What is the frequency of diabetic ketoacidosis among the Arabic countries?
  • What is the prevalence rate in patients with type 1 diabetes among Arabic nations?

In this case, the purpose of the study and the research questions are related. This relationship exists since the questions also aim at determining the frequency and quantifying the prevalence of DKA.

Methods of Study

No potential risk was determined or stated to exist in the carrying out of this review. However, the results of the review would quantify the burden of diabetes type 1 and its complications in the Arabic countries. This would give a clear picture of the affected individuals and prompts management of the conditions as well as the complexities that arise from it. The research was approved by the institutional review board through the administration of a questionnaire to the researcher concerning the study and the manner unto which it was going to be conducted.

The study determined various variables which were assessed despite the fact that they were not defined by the author. These included the age of the patients, the prevalence of diabetes type I and DKA as well as the ethnic group and country of occurrence. The data was collected via review of various research articles that were scholarly and peer-reviewed. It was a systematic review that was done all the literature published on patients from the Arabic countries with type I diabetes who presented with DKA. The research used four databases encompassing Scopus, Web of Science, PubMed as well as ScienceDirect.

The data collection entailed using search terms such diabetes ketoacidosis or DKA in combination with the name of each Arabic country. The search language was English. Relevant articles were determined by title and abstract. The data collected were reviewed three times for accurate and correct capture of the patients. The data collected were analyzed concerning the contribution of the various countries to the overall prevalence of diabetes ketoacidosis.

Results of Study

The author determined 574 citations out of which 329 remained removal of the duplicates and 246 being unrelated. The 38 legible citations were screened and information obtained from the abstract for one of the articles since it could not be obtained from the full article. Quantitative analysis was done on 29 studies and summarized in a table. An additional search was done using Google scholar and Google using the same terms with no article obtained concerning the countries.

The review was done over 46 years from 1969 to 2015. The rates of prevalence in 12 Arab nations ranged from the 17% to 100% with the frequency of DKA being 46.7%. In all the Arab countries, the quantitative rate of the diabetic ketoacidosis was about 46.7% in about 4688 patients with type I diabetes. There was also significant variation in the incident rates of type 1 diabetes among Arab countries. The rates were low in Oman and high in Saudia Arabia. The author also determined lack of epidemiological studies to determine the actual prevalence in 22 Arab countries despite the fact that type 1 diabetes is prevalent in the Arabic world. These findings reflect reality hence my confidence in them.

The researcher identified various limitations of the study. These included the absence of numerous studies related to patients with type I diabetes especially the complications of type I diabetes and language of search that was English despite one of the studies being published in French. Besides, there also existed variations of various studies among different countries making it difficult to come up with trends on the prevalence of diabetic ketoacidosis in the countries in the Arabic world. There also existed guest workers who were from other regions hence not reflecting the exact picture of the related countries. At the same time, it was not easy to do a meat analysis since the records used were from the hospital with no controls.

With the raised prevalence and incidence rate of diabetic ketoacidosis from type I diabetes, it signifies the burden of the condition and the complication in the Arab countries. This is significant to the nursing team as it calls for interventions both at the prevention level to reduce the incident rate and also on the management to prevent the complication that develops from type I diabetes such as diabetic acidosis.

Ethical Considerations

The article was approved and published in 2016. Throughout the study, patient privacy was maintained with no naming of patients or participants both in the study as well as the reviewed articles. Despite the fact that the author used the hospital records, no hospital or patient in a hospital was identified with the reports and articles used indicating an overall summary of all the participants and the records used. The authors also recognized all the articles and studies used to obtain the data needed.  Use of citations and references acknowledged the authors of the research studies. This move assisted in both making the work original and avoiding plagiarism.


Arabic world contributes a significant number of the global burden of type I diabetes as well as diabetes acidosis. Through this study, the incidence and prevalence of type I diabetes and its complications are determined. With the results indicating an increased rate of the prevalence of diabetic ketoacidosis among patients with type I diabetes. The gap is essential in nursing practice since there is need to venture into the management strategies that will reduce and contain diabetes mellitus. At the same time, the nurse can invest in the prevention of diabetes. This can be done through health education on healthy lifestyles, e.g., doing physical exercises, eating healthy foods and going for medical checkups.

The study by Zayed provides an extensive review of various articles that examined the prevalence of the diabetic acidosis. The articles used were from various databases and various hospitals hence increasing its validity and eligibility indetermination of the prevalence rate of the condition. The study can be generalized to the Arabic world since the reviewed articles were from different countries and different hospitals.




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