Diabetes mellitus in Egypt: Glycaemic control and microvascular and neuropathic complications

We performed a cross-sectional, population-based survey of persons 20 years of age and older living in Cairo and surrounding rural villages. The purpo se was to describe glycaemic control and the prevalence of microvascular an d neuropathic complications among Egyptians with diagnosed diabetes, previo usly undiagnosed diabetes, impaired glucose tolerance, and normal glucose t olerance. A total of 6052 households were surveyed. The response rate was 7 6 % for the household survey and 72 % for the medical examination. Among pe ople with previously diagnosed diabetes, mean haemoglobin A(1c) was 9.0 %. forty-two per cent had retinopathy, 21 % albuminuria, and 22 % neuropathy. Legal blindness was prevalent (5 %) but clinical nephropathy (7 %) and foot ulcers (1 %) were uncommon in persons with diagnosed diabetes. Among peopl e with diagnosed diabetes, microvascular and neuropathic complications were associated with hyperglycaemia. Retinopathy was also associated with durat ion of diabetes; albuminuria with hypertension and hypercholesterolaemia; a nd neuropathy with age, female sex, and hypercholesterolaemia. Albuminuria was as common in people with previously undiagnosed diabetes (22 %) as thos e with diagnosed disease (21 %). Mean haemoglobin A(1c) was lower (7.8 %) a nd retinopathy (16 %) and neuropathy (14 %) were less prevalent in people w ith previously undiagnosed disease. Ocular conditions, blindness, and neuro pathy were prevalent in the non-diabetic population. The microvascular and neuropathic complications of diabetes are a major clinical and public healt h problem in Egypt. (C) 1998 John Wiley & Sons, Ltd.