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Prevalence and correlates of diabetes and its comorbidities in four Gulf Cooperation Council countries: evidence from the World Health Survey Plus
  1. Sara Afshar Morgan1,
  2. Mohamed Mahmoud Ali2,
  3. Andrew Amos Channon3,
  4. Sultana Al-Sabahi4,
  5. Huda Al Suwaidi5,
  6. Nabil Osman6,
  7. Mostafa Al Salameen7,
  8. Tawfik Khoja8
  1. 1 Primary Care and Population Health, University of Southampton, Southampton, UK
  2. 2 Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
  3. 3 Department of Social Statistics and Demography, University of Southampton, Southampton, UK
  4. 4 Center of Studies and Research, Ministry of Health, Muscat, Oman
  5. 5 Vulnerable Group Department, Community Development Authority, Dubai, United Arab Emirates
  6. 6 General Director for Health Statistics and Information, Ministry of Health, Riyadh, Saudi Arabia
  7. 7 Department of Health Registration, National Center of Health Information, Ministry of Health, Kuwait City, State of Kuwait, Kuwait
  8. 8 Department of Primary Care & Public Health, School of Public Health, Imperial College, London, UK
  1. Correspondence to Dr Mohamed Mahmoud Ali, Department of Reproductive Health and Research, World Health Organization, Geneva 1211, Switzerland; alim{at}


Background The Gulf Cooperation Council countries are witnessing unprecedented changes due to fast economic development and population growth. The aims of this study were twofold: first, to estimate the prevalence of diabetes and its comorbidities; second, to examine the association of sociodemographic risk factors and healthcare service utilisation with diabetes.

Methods Data from the World Health Survey Plus (WHS+) from Kuwait, Oman, Saudi Arabia and the United Arab Emirates were used. The WHS+ is a nationally representative household survey of the adult population, conducted between 2008 and 2009. Both logistic regression and zero-inflated Poisson models were applied to examine the associations of risk factors, comorbidity and treatment with self-reported diabetes.

Results The highest level of diabetes was observed in Kuwait, with 40.8% among the oldest age group. High body mass index, older age and low education were all associated with diabetes in all settings. High levels of comorbidity existed within the diabetic population. Over 50% of diabetics in all countries reported having at least one chronic condition. In Kuwait and Saudi Arabia, one in five diabetics reported having two or more comorbidities. Treatment prevalence was above 80% across all sociodemographic categories.

Conclusion The burden of diabetes, although high, is not uniform across populations in the four Gulf countries. Differential exposure to risk, such as unhealthy lifestyles, may be creating a disadvantage for certain populations and influencing the co-occurrence of chronic conditions. In response, a multifaceted and patient-centred approach is needed at all levels of healthcare to control and prevent non-communicable diseases.

  • Gulf Arab countries
  • diabetes
  • non-communicable disease
  • chronic comorbidity
  • World Health Survey Plus

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  • Correction notice This article has been corrected since it first published online. The second author and last author names have been corrected.

  • Contributors The initial concept was developed by TK, SAM and AAC. AAC and MAA-S undertook the analysis with input and advice from all co-authors, notably SA-S, HAS, NO, MMA and TK. SM drafted the manuscript. All co-authors were involved in editing the manuscript; this process was led by both MAA-S and SAM.

  • Funding This paper is financially supported by the World Health Organization Regional Office of Eastern Mediterranean, Cairo, Egypt.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.