Essay on Worldwide vs. Middle East Statistics

It has been determined that under 15 years, 98,200 children developed T1D internationally an annual basis, with this figure rising to 128,900 under the age of twenty years. In fact, estimations indicate that under 15 years, 600,900 children live with type 1 diabetes internationally and under 20 years, this figure increases to 1,110,100.

In the region of MENA or Middle East and North Africa, which comprises mostly of Arab nations, it is determined that there exist 60,000 cases of children suffering from T1D under 15 years old. Variations in the incidence of T1D are indicated by studies in Arab nations, ranging to 29/100,000 in KSA [20] from 2.54/100,000 in Omani region [19]. In general, these differences can be attributed to the socioeconomic status’s diversity among the Arabs, differences in marriage practices, and wide geographical range.

Saudi Arab has 4/5^th of Arabian Peninsula and it has a population of over 33.3 million people. Of this population, 26 percent people are aged less than 15 years. It is indicated by studies that in recent years, there has been an increase in the incidence of type 1 diabetes. In comparison with the developed nations, the number of studies performed in KSA on the prevalence and incidence of T1DM is inadequate.

In accordance with the estimates of IDF or International Diabetes Federation for the incidence in 2015, KSA and Kuwait are seemingly featured in the highest ten list of nations with highest rates of incidence in the world.

In addition, in UAE, the number of children suffering type 1 diabetes has become twice since 2000. In babies, it has been diagnosed when they are only 16 months old. Actually, 5-10 percent is made up by type 1 diabetes of the overall diabetics in the country. 75 percent of the diabetic cases in children going to school are diagnosed in the students of UAE and type 1 diabetes seems to account for largest.

1.5 Environmental Factors

Gluten of Worldwide vs. Middle East Statistics

The timing of introduction of any cereal type, in DAISY, was related to a higher risk and chance of islet autoimmunity with nadir in a U-shaped relationship at introduction at approximately 6 months of life. Association was shown by BABYDIAB with early exposure to gluten. No clear association was determined by Finnish DIPP study with gluten. It was reported by DIPP, in Finland, that root vegetables’ introduction by the age of 4 months seemed to double the chance of islet autoimmunity in comparison with later introduction. Additionally, first exposure to eggs before the 8 months of age was related to a higher chance of islet autoimmunity. It was indicated by ABIS that less than the usual or daily vegetable consumption in the diet of mother was related to an increased chance of islet autoimmunity. Generally, cross-study differences might be associated with nation differences in the nutrition of infants. There is also a risk of false associations due to multiple comparisons.

Breastfeeding of Worldwide vs. Middle East Statistics

Even though a small decrease in the risk of T1D was determined by some retrospective studies, ABIS failed to identify a protective effect in prospective cohort studies in Sweden. Regardless, children and babies who were breastfed when introduced to cereals seemingly had a decreased chance of islet autoimmunity. It is suggested by these findings that a protective role might be played by breastfeeding in the relationship between T1D and dietary factors.

Infections of Worldwide vs. Middle East Statistics

In general, seroepidemiological studies and case reports have directed attention to different viral infections as the cause of T1D. A number of viruses have been studied with enteroviruses having more evidence from researches in human beings and animal models. In vitro and vivo, these viruses possess a tropism to the islets of human pancreas, and they have been identified in patients’ pancreas who were diagnosed recently with T1D. studies consistent with the enteroviral infections at the diagnosis of T1D seem to include frequent detection of VP protein immunoreactivity in children’ β cells with type 1 diabetes than controls matched by age; the expression of VP1 in β-cells that produces PKR’s elevated levels with MCL1’s degradation and higher susceptibility of the cells to the disease of apoptosis; and that dsRNA and MDA5’s elevated levels in β cells of patients with T1D. It is suggested by evidence that during pregnancy, enteroviral infections might seemingly result in islet autoimmunity and persistent infection in baby and mother. In fact, a plausible mechanism for enteroviruses’ persistence in pancreatic islets has been indicated by enteroviral myocarditis studies.

Whether enteroviruses serve as islet autoimmunity’s triggers, nonspecific precipitating stressors, or promoters of T1D, is an unresolved issue. Still, it is suggested by an in-vitro research that human pancreatic ductal cells’ persistent enteroviral infections might diminish their capability of Trans differentiating into β cells and thus decreasing the mass decline of β-cell because of autoimmunity.

1.6 History of the Middle East and Environmental Factors (1970s – today)

Recognising the fact that type 1 diabetes is a genetic disease, different areas with its higher prevalence should be considered important for genetic studies associated with the disease for understanding the disease’s genetic etiology. This serves to make Arab countries interesting because of unique structures of Arabs due to consanguineous marriages with a first-cousin marriage preference [38] that is still increasing and is accountable for disorders based on genes in Arab nations [39]. In Qatar, consanguineous marriages increased to 54.5 percent from 41.8 percent in a single generation with first-cousin marriage of 35 percent [40]. In addition, in many Arab nations, endogamous marriages reach 100 percent, especially in various Gulf States including United Arab Emirates, Qatar, Oman, Kuwait, Bahrain, and Saudi Arab.

It would not be wrong to say that the Arabian Gulf nations have seemingly experienced a significant increase in the incidence of diabetes over the course of last ten years. In fact, it is determined that close to twenty percent of the population of adults in the Gulf countries is seemingly living with diabetes. It is far higher than the international average of 8.5 percent and it is more than the prevalence in Britain, France, Germany, and the US.