Epidemiology of diabetes mellitus in Tunisia. HSHS 2 study (Hammam Sousse Sahloul Heart Study)

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Published Mar 6, 2022
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Vol. 100 No. 3 (2022): Issue Mar 2022

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Sana Mbarki
Asma Ben Abdelaziz
Donia Ben Hassine
Sarra Melki
Nabila Ben Rejeb
Asma Omezzine
Ali Bouslama
Ahmed Ben Abdelaziz

Abstract

Background: National epidemiological studies on diabetes mellitus are rare, ancient and often carried out schools or clinics settings.

Objectives: To determine the prevalence of diabetes mellitus and identify its risk factors in the adult population of the city of Hammam Sousse (Tunisia) during the year 2009.

Methods: This study is a part of analysis of the HSHS database (Hammam Sousse Sahloul Heart Study), a «community-based» cross-sectional study on
cardiovascular risk factors including diabetes mellitus, with a two-stage proportional probability cluster random sample. All subjects aged 20 years and more
underwent a lifestyle interview, clinical examination with anthropometric measurements, and blood sampling. The diagnosis of diabetes mellitus was defined by a
fasting blood glucose level ≥7 mmol/l. Overweight was defined by a Body Mass Index (BMI) ≥ 25 kg/m². A multivariate logistic regression analysis was conducted to
determine independent risk factors associated with diabetes mellitus.

Results: The population was composed of 481 males (M) and 960 females (F), a sex ratio of 0.5 with mean ages respectively of 49.6±16.35 years and 46.6±16.18
years. The prevalence of diabetes mellitus adjusted by age and sex was 12.1% (95%CI[11.7-12.5]); M: 12.7% (95%CI[12.1-13.3]), F: 11.5% (95%CI[10.9-12.1]). The
prevalence rate of patients newly detected with diabetes mellitus was 1.9% (95%CI[1.7-2.1]): M: 1.8% (95%CI[1.6-2.0]), F: 2.1% (95%CI[1.8-2.4]). The multivariate
study revealed five independent factors significantly associated with diabetes mellitus. In addition to non-modifiable factors (male gender, age ≥40 years old, low
schooling level and family history of diabetes), diabetes mellitus was 2 (95%CI[1.3-3.2]) times more prevalent in overweight cases.

Conclusion: In deep trouble of this epidemiological situation of diabetes mellitus, it is urgent to launch a universal intervention strategy based on the promotion of
a healthy lifestyle motivating regular physical activity and a low-calorie diet.

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