Abstract
Type 2 diabetes mellitus (T2DM) has become a modern-day plague by reaching epidemic levels throughout the world. Due to its similar pathogenesis, gestational diabetes (GDM) increases in parallel to T2DM. The prevalence of T2DM (3.9–18.3%) and GDM (5.1–37.7%) in countries of the Arab Gulf are amongst the highest internationally, and they are still rising precipitously. This review traces the reasons among the Arab nations for (a) the surge of T2DM and GDM and (b) the failure to contain it. During the last five decades, the massive oil wealth in many Arab countries has led to the unhealthy lifestyle changes in physical activity and diet. The excess consumption of calories turned the advantageous genes, originally selected for the famine-like conditions, detrimental: fueling obesity and insulin resistance. Despite genetic differences in these populations, GDM—a marker for future obesity and T2DM—can overcome this scourge of T2DM through active follow-up and screening after delivery. However, the health policies of most Arab countries have fallen short. Neglecting this unique chance will miss an irreplaceable opportunity to turn the tide of the T2DM and obesity epidemic in the Middle Eastern Arab Gulf countries—as well as globally.
Highlights
Hyperglycemia in pregnancy (HIP) is the most common metabolic abnormality during pregnancy.It is further sub-classified by the World Health Organization (WHO) into diabetes in pregnancy (DIP)and gestational diabetes mellitus (GDM)
The 1980 and 1985 guidelines of the WHO used the same criteria on the oral glucose tolerance test (OGTT) for the diagnosis of GDM and Type 2 diabetes mellitus (T2DM); the only difference being the presence of pregnancy
GDM is not just a harbinger of T2DM after childbirth as we believed in the past; it is a unique chance to identify women and infants at risk for future obesity, T2DM, and cardiovascular disease [73]
Summary
Hyperglycemia in pregnancy (HIP) is the most common metabolic abnormality during pregnancy. There are major discrepancies in the ability of these criteria to identify women with GDM and their capacity to predict adverse pregnancy outcome [3] This is because among various health and diabetes associations, the glucose thresholds for the diagnosis of GDM vary even though the same diagnostic oral glucose tolerance test is used (Table 1). The 1980 and 1985 guidelines of the WHO used the same criteria on the oral glucose tolerance test (OGTT) for the diagnosis of GDM and T2DM; the only difference being the presence of pregnancy. Though the criteria for the diagnosis for GDM are not consistent amongst the major diabetes and health organizations, they are more uniform for T2DM
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