Diabetes In Kuwait Research Articles

Diabetes and TelecommunicationS (DATES) study to support self-management for people with type 2 diabetes: a randomized controlled trial

BackgroundThe increasing prevalence of type 2 diabetes and suboptimal glycaemic control in Kuwait requires novel, wide-reaching, low-cost interventions to motivate and mobilise individuals towards more effective self-management. More than 2 million people in Kuwait own mobile phones. We will test whether automated personalised health text messages based on principles of motivational interviewing and are responsive to biodata delivered remotely is potentially effective in improving glycaemic control compared to usual care.MethodsThis is a two-arm parallel single-blind randomised controlled trial of 572 individuals with type 2 diabetes in Kuwait. We will develop a culturally appropriate database of text messages supporting positive lifestyle changes in type 2 diabetes. A computer programme will deliver over 400 text messages over a 12-month period using algorithms which provide participants with information on diet and physical activity as well as personalised messages regarding motivators to change behaviours. Individuals aged 18–75 years with established type 2 diabetes who are fluent in Arabic or English and officially resident in Kuwait will be identified via screening of hospital diabetes clinic and primary care practices and invited to participate. A sample of 572 participants will be randomised to usual care or usual care plus the DATES text message intervention. Randomisation will be conducted by an independent Clinical Trials Unit and researchers collecting baseline and outcome data will be blinded to treatment allocation. The primary outcome is change in HbA1c and weight at 12 months in both study arms. Secondary outcomes will include changes in physical activity, fasting lipids and quality of life in both study arms.DiscussionThe potential of mobile phones in improving diabetes self-care in settings with a high prevalence of diabetes and widespread mobile phone usage has face validity. Mobile phones and text messaging are an understudied virtual communication media which can deliver discrete focused psychological support to motivate and enable diabetes self-care changes.Trial registrationISRCTN10342151. 11/03/2015.

Knowledge, attitudes, behaviours and practices towards diabetes mellitus in Kuwait.

Rates of diabetes in Kuwait are among the highest in the world. To inform prevention initiatives, this study assessed diabetes knowledge, attitudes towards it, and personal behaviour relating to risk factors among the Kuwaiti population. A cross-sectional knowledge, attitudes, beliefs and practices survey of 1124 people was performed between July and September 2015. Descriptive analysis and χ2 tests were performed. Although most participants (94%) had heard of diabetes and 87% believed type 2 diabetes to be preventable, knowledge of risk factors was poor [family history (87%), age (44%), low exercise (10%), obesity (4%), diet (0%) and stress (0%)]. Dietary patterns in Kuwait were variable and, of concern, 42% of those with diabetes had been eating more since diagnosis. Lifestyle, particularly among Kuwaitis and people with diabetes, was sedentary - 47% of participants walked < 20 minutes per day. Despite the importance of diet and exercise for diabetes prevention, significant gaps in public education clearly exist. At a policy level, much remains to be done and intensified intersectoral programmes are required to improve public awareness.

Retraction Notice: Diabetes-Related Knowledge and Preventative Practices Among Government Employees with Diabetes in Kuwait.

[This retracts the article on p. e444 in vol. 17, PMID: 29372087.].

Prevalence of health literacy and its correlates among patients with type II diabetes in Kuwait: A population based study

AimsThe purpose of this study is to estimate the prevalence of health literacy among patients with type II diabetes and investigate its association with several covariates. No studies were conducted in the Arabian Gulf region characterizing such factors for this population. MethodsA cross sectional study was implemented in which 359 type II diabetes patients were recruited from diabetes centers across Kuwait. Health literacy was measured by STOFHLA. Multivariate linear regression was applied to investigate the relationship between health literacy and several covariates. ResultsAbout 44.5% had inadequate, 19.5% marginal, and 35.5% adequate health literacy. Patients with inadequate health literacy were more likely to be older, females, widowed, low education, with income less than 500 KD/month. Multivariate linear regression indicated residence, nationality, education level, and age were significantly associated with health literacy. Adding marital status and gender, hierarchical linear regression revealed that 43.4% of the variability was accounted for. ConclusionInadequate health literacy is high in Kuwait. Interventions should be implemented to improve health literacy. This will reduce the prevalence of diabetes-related complications, produce better diabetes outcomes, and improve patients’ quality-of-life. Health literacy should be an integral part to health promotion and chronic diseases’ management programs in Kuwait.

Diabetes-Related Knowledge and Preventative Practices Among Government Employees with Diabetes in Kuwait.

Diabetes mellitus (DM)-related knowledge and preventative practices are vital for the successful management of this condition. In Kuwait, few studies have been conducted to evaluate the knowledge and preventative practices of DM patients. This study aimed to assess DM-related knowledge and preventative practices among government employees with DM in Kuwait and to examine associations between DM knowledge, preventative practices and other variables. This cross-sectional study was conducted in June 2015 and involved 345 employees with DM from 15 government ministries in Kuwait. A self-administered Arabic-language questionnaire was designed to assess DM-related knowledge and preventative practices based on the Diabetes Knowledge Test and the recommendations of the American Diabetes Association, respectively. A total of 312 ministry employees agreed to participate in the study (response rate: 90.4%). The mean age was 45.6 ± 10.6 years. A total of 63.4% were male and 64.1% were Kuwaiti. The median DM knowledge score was 9 out of 14 and the median preventative practice score was 5 out of 14. High knowledge scores were significantly associated with education (β = 1.510; P ≤0.001) and income (β = 0.896; P ≤0.001). High preventative practice scores were significantly associated with income (β = 1.376; P = 0.002), DM duration (β = 0.919; P = 0.026) and knowledge scores (β = 1.783; P = 0.015). Government employees in Kuwait were found to have average DM knowledge and poor preventative practices. It is therefore imperative that policy-makers develop educational and health-promoting campaigns to target government employees with DM in Kuwait.

Factors Associated with Type 1 and Type 2 Diabetes in Infants in Kuwait

Purpose: The purpose of the study is to investigate the factors associated with diabetes and its influence on the prevalence of diabetes in Kuwait. Methods: A questionnaire was designed to explore the relationships between various factors and diabetes in children. The survey included 300 mothers of children up to five years of age in Kuwait and the results were subjected to a two-way contingency table analysis. Results: Variables showing at least a medium effect and a linear relationship are herein reported. Increasing maternal age was found to be related to the increasing prevalence of type 1 diabetes. An association between a higher prevalence of both type 1 and type 2 diabetes in the mother and the child was found. Risk of having a child with diabetes increases with the maternal age. The consumption of fried food or fast food by a child was associated with a higher prevalence of both type 1 and type 2 diabetes. Sugar consumption, both by the mother during pregnancy and by the child, was associated with a higher prevalence of type 2 diabetes. Heavy consumption of nuts by the child was associated with a higher prevalence of type 2. Conclusion: Genetics and environmental factors including diet may play important roles in the causation of both type 1 and type 2 diabetes in Kuwait.

(140) Prevalence of chronic pain and comorbid medical conditions associated with diabetes in Kuwait: a random sample telephone survey

There is good reason to suspect that chronic pain is a serious health issue in Kuwait and is associated with comorbid medical conditions like diabetes, though a national survey has never been conducted. The aim of this study is to examine the incidence of pain and medical comorbidities among a random sample of patients treated at a large diabetes center in Kuwait. A list of 1000 patients was created from the Institute medical record system and a telephone survey was conducted on 75.9% who responded to the phone call, of which 67.5% agreed to participate. Those who stated that they had pain every day for the past three months were invited to answer additional questions about their pain. Of the 512 patients who were contacted 55.5% (N=284) reported experiencing chronic pain (4.7±2.9). Total average age was 49.2±14.5, 45.5% were female, and 70.5% were Kuwaiti nationals. Most (74.3%) reported having diabetes (80.8% were Type II) and a third (32.2%) showed evidence of neuropathic pain characteristics (DN4=2.8±1.7). Other comorbid medical conditions were prevalent (48.4% hypertension, 30.4% arthritis, 22.6% heart disease, 20.4% asthma) with an average of 2.3±1.3 medical problems per person. These patients tended to be older, female, unemployed, and overweight (BMI=32.6, p<0.01). The pain was mostly located in the lower extremities and those with neuropathic pain tended to report a higher intensity of pain and a higher frequency of seeking treatment for their pain in a clinic or hospital (p<0.05). Most relied on over-the-counter medications for their pain (38.1%). Very few were taking prescription medication for their pain. This survey suggests that chronic pain is more prevalent in a medical population in Kuwait than previously anticipated. Healthcare services and behavioral interventions to improve lifestyle changes in Kuwait and other Arab countries are needed to positively impact pain and reduce other comorbidities.

A Comparison of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Insulin Injection in Children with Type I Diabetes in Kuwait: Glycemic Control, Insulin Requirement, and BMI.

Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) are two methods currently used to manage type I diabetes mellitus (T1DM). Here we compare our experiences with CSII and MDI in a large cohort of pediatric patients in Kuwait. Data on 326 patients with T1DM who were started on CSII between 2007 and 2012 were retrospectively compared with those of 326 patients on MDI. They were matched for sex, age at diagnosis, T1DM duration, glycemic control, insulin requirement, and body mass index (BMI). Data were collected at baseline and every three months and included glycated hemoglobin (HbA1c), insulin dose, and adverse events (severe hypoglycemia, diabetic ketoacidosis, and skin problems). The main reason for switching to CSII was to achieve better glycemic control (37%), followed by reducing hypoglycemia, and improving the quality of life (13.3% each). Although HbA1c decrease was most significant in the first year, it continued to be significantly lower in the CSII group compared to the MDI throughout the study period. Total daily insulin requirements were significantly lower in the CSII group. BMI increased in both groups, but the difference was significant only at the end of the fifth year. There was no significant change in the rate of diabetic ketoacidosis in either group. The CSII patients had more severe hypoglycemic episodes at baseline; however, it significantly decreased throughout the study period. Only five patients discontinued CSII therapy and two of these restarted within three months. CSII is a safe intensive insulin therapy in youngsters with T1DM and achieved markedly fewer severe hypoglycemic episodes and lower daily insulin requirements.

Prevalence of Thyroid Autoantibodies in Children, Adolescents and Young Adults with Type 1 Diabetes in Kuwait

Objective: To investigate the prevalence of thyroid autoimmunity among children and adolescents with type 1 diabetes in Kuwait. Subjects and Methods: In a mixed cross-sectional and longitudinal study, anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) were measured in 232 subjects (118 males and 114 females) with type 1 diabetes. Results: The mean age of the total study population was 10.9 ± 3.6 years (range 1-21), and the median diabetes duration was 3.9 years (range 0-16). At the initial screening, 57 out of 232 (24.6%) patients had positive antibodies, and of the remaining 175 patients, who were antibody negative,131 (74.3%) were followed up for 4-9 years. 23 out of these 131 (17.7%) patients became antibody positive, with a cumulative prevalence of elevated antibodies of 34.5%. Anti-TPO was present in 34 (14.7%), anti-TG in 23 (9.9%) and both antibodies in 23 (9.9%) patients. Thyroid antibodies presented early within the first 5 years of the onset of diabetes (63.2 vs. 36.8%, p < 0.05). The prevalence of elevated thyroid antibodies increased after the onset of puberty in both females and males (p < 0.0001). A total of 58.7% of the patients with positive antibodies were females compared to 41% males (p < 0.0001). The basal thyroid-stimulating hormone was higher in subjects with positive antibodies (5.1 ± 10.7 mIU/l) compared to those who were antibody negative (1.79 ± 0.87 mIU/l, p < 0.001). Furthermore, 30 out of 232 (12.9%) patients developed thyroid dysfunction. Conclusion: In this study, a high prevalence of thyroid autoimmune antibodies was found in patients either at the onset of type 1 diabetes or within the 4-9 years of follow-up.

Pharmacists’ contributions to the delivery of pharmaceutical care to patients with type 2 diabetes in Kuwait

This study was designed to identify pharmacists’ potential contributions to the delivery of pharmaceutical care to patients with type 2 diabetes in Kuwait, and to identify and explore barriers that were preventing them from providing care to this specific group. A pretested self-administered questionnaire was distributed to all pharmacists registered in the Kuwait Pharmaceutical Association’s email registry (N = 250). Invitations to a focus group interview were then sent to all pharmacists (N = 50) who had responded to the questionnaire. Seven pharmacists accepted the invitation and participated in the focus group interview. Of the 50 respondents to the questionnaire, 31 (62.0 %; 95 % CI: 47.2–75.4) indicated that they were “comfortable” and “extremely comfortable” in discussing patient’s blood pressure target and annual screening with physicians rather than discussing smoking cessation advice or specific medication-related care issues. More than 75 % of the respondents were “comfortable” and “extremely comfortable” in sharing and verifying the patient’s drug history, blood pressure, cholesterol and stability of blood glucose with the healthcare team, and to maintain a pharmaceutical care plan for patients with diabetes. Overall, pharmacists indicated that they were more comfortable in undertaking clinical activities than discussing care issues with physicians. The focus group interview identified issues related to pharmacist-physician interaction, pharmacists’ confidence, pharmacists’ image by patients and physicians and barriers to implementing pharmaceutical care. This study shows that pharmacists in Kuwait perceive that their contribution to the delivery of pharmaceutical care could develop further with increased partnership between pharmacists and physicians and provision of further education, training and continuing professional development support.

Quality of Life of Children and Adolescents with Type 1 Diabetes in Kuwait

Objectives: To evaluate the health-related quality of life (HRQoL) of children and adolescents with type 1 diabetes (T1DM) in Kuwait using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale and PedsQL 3.0 Diabetes Module, and to identify the risk factors associated with unsatisfactory QoL and their effects on metabolic control. Subjects and Methods: A total of 436 patients (2-18 years) with T1DM (>6 months) and 389 healthy controls, with the parents of both groups, completed the Arabic Generic Core Scale. Those with T1DM also completed the Arabic Diabetes Module. Results: The mean total score of the PedsQL Diabetes Module was 70.2 ± 9.8 reported by children and 59.9 ± 11.1 reported by parents (higher scores indicate better QoL). Young age and long duration of diabetes were associated with poor QoL (p < 0.001). Boys had better total scores than girls in most age groups (70.3 ± 9.3 vs. 52.3 ± 7.2, p < 0.001); however, girls did better than boys regarding treatment barriers and adherence (71.3 ± 7.8 vs. 68.1 ± 6.2, p < 0.005). Higher HbA1c values were associated with lower QoL scores (31.1 ± 5.1 at HbA1c of 15% vs. 82.5 ± 6.1 at HbA1c of 6%, p < 0.0001). Conclusion: HRQoL of children and adolescents with T1DM was consistently poorer than controls. Parents consistently reported poorer QoL scores than their children. We recommend that more support should be provided for the care of children with diabetes in Kuwait.

Evaluation of adherence to international guidelines for treating patients with type 2 diabetes mellitus in Kuwait

Clinical guidelines derived from scientific evidence provide the basis of consistent standardized prescribing. Despite an alarming increase of diabetes in Kuwait, no studies related to the quality of prescribing in diabetes were found. Before pharmaceutical care can be implemented to improve the quality of care of patients with diabetes, it is important to determine whether prescribers are compliant with comprehensive international guidelines for cardioprevention and glycaemic control. To evaluate the adherence to clinical guidelines for treating patients with type 2 diabetes mellitus in primary care centres and secondary care centres (hospitals) using a developed and validated medication assessment tool with reference to international guidelines. Outpatient diabetes clinics in 8 primary care centres and 4 secondary care centres across four healthcare regions in Kuwait. A quantitative, cross-sectional study involving a sample of 652 Kuwaiti patients with type 2 diabetes, who were selected using systematic sampling from the study settings. Data were collected retrospectively from the patients' medical records using a validated 43-criterion medication assessment tool (MATKW) designed to assess cardioprevention and treatment in patients with type 2 diabetes. Descriptive and comparative analysis was conducted using SPSS version 17. Frequency of prescribing adherence to agreed definitions of criteria derived from international guidelines. Overall adherence to prescribing diabetes guidelines was 77.7 % (95 % CI 76.7-78.6 %). Significantly higher prescribing adherence was found in the secondary care facilities, 82.4 % (95 % CI 81.2-83.6 %) compared to primary care 72.5 % (95 % CI 71.0-73.9 %) (p < 0.001). Nineteen criteria out of 43 achieved an adherence >80 % in secondary care compared to ten criteria in primary care. The documentation of patients' records was found to be inconsistent at the study healthcare facilities. Nonoptimal achievement of target goals for HbA1c, blood pressure and BMI was prevalent among the study population. A tool such as MATKW highlights areas for review and possible improvement in prescribing adherence. Our findings reveal problem areas in prescribing practices and documentation of patients' records. Cost-effective multifaceted interventions are needed to improve current prescribing practices and documentation.

Quality of life in children with type 1 diabetes in Kuwait

Recent research has shown that health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes is markedly affected, resembling that of children with other chronic diseases, like malignancies. The objective of the study was to investigate the HRQOL in children and adolescents with diabetes in Kuwait.

Association between apolipoprotein E-polymorphism and Ischemic heart disease patients with or without type 2 diabetes mellitus: a preliminary study in Kuwait.

We investigated the association between apolipoprotein E polymorphism and ischemic heart disease with or without type 2 diabetes in Kuwait and examined the impact of apolipoprotein E polymorphism in diabetic patients. The present study was conducted from January 2005 to June 2006 in the Diabetic Clinic of Al-Amiri and Al-Sabah Hospitals in Kuwait City. Apolipoprotein E polymorphism was assessed in 250 subjects of which 83 were ischemic heart disease patients (41 diabetic and 42 non-diabetic) and 105 were diabetic patients without ischemic heart disease. Results were compared with 62 healthy controls. Apolipoprotein E polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism. Apolipoprotein E3 allele was the most commonly occurring form. The frequency of apolipoprotein E4 was higher in ischemic heart disease patients with type 2 diabetes (39%) and the non-diabetic (31%) group, but lower in the diabetic (20%) and control groups (16%). Apolipoprotein E4 allele may be related to the development of ischemic heart disease in patients with or without type 2 diabetes in Kuwait. However, future studies with larger population sizes are needed to establish such relationship.

Reasons for hospitalizations in adults with diabetes in Kuwait

BackgroundA large proportion of hospitalizations for diabetes are preventable. We carried out this study to determine the prevalence and reasons for hospitalization in adults with diabetes in Kuwait. Materials and methodsA cross-sectional study was conducted of all hospital admissions in the Department of Medicine at Al-Sabah Hospital in Kuwait during a 2-month period. Admissions were classified into three groups: (i) medical history of diabetes; (ii) unrecognized diabetes or new hyperglycemia (i.e., an admission for fasting blood glucose ⩾7mmol/l or random blood glucose ⩾11.1mmol/l); and (iii) no diabetes. ResultsDiabetes was the principal or secondary diagnosis in 40.6% of hospitalizations. Unrecognized diabetes or new hyperglycemia was found in 12.9% of the patients. Patients with diabetes or new hyperglycemia were significantly older and had longer hospital stay compared to non-diabetic patients. The three most common reasons for hospitalizations in patients with diabetes were diseases of the cardiovascular system (53.6%), diseases of the respiratory system (22.8%), and diabetes as a principal diagnosis (6.3%). The five most frequent specific causes for hospitalizations in patients with medical history of diabetes as a secondary diagnosis were acute coronary syndrome (27.2%), pneumonia (14.3%), heart failure (11.2%), cerebrovascular accident (10.3%), and chronic obstructive airway disease (3.6%). ConclusionDiabetes imposes a great burden on secondary health care in Kuwait. Effective primary care and hospital outpatient preventive and treatment strategies, including education, multifactorial intervention for cardiovascular risk factors, and influenza and pneumococcal immunizations for patients with diabetes may reduce these hospitalizations among diabetic patients.

Screening for diabetes in Kuwait and evaluation of risk scores

This study aimed to develop a simple risk score to identify individuals at high risk for undiagnosed diabetes in the Kuwaiti adult population and to assess the performance of previously published diabetes risk scores. A cross-sectional survey with a sample of 562 Kuwaiti public sector employees was carried out in 2007. Data were collected through a self-administered questionnaire and a blood glucose test. The overall prevalence of diabetes using American Diabetes Association 2003 criteria was 21.4% (4.1% newly detected). The proposed score had 87% sensitivity and 64% specificity in predicting undetected diabetes using only 4 questions (age, waist circumference, use of blood pressure medication and diabetes in a sibling). Most previously published risk scores were not applicable to this population.

P-162 Screening for undetected diabetes in Kuwait and evaluation of non invasive risk scores

P-162 Screening for undetected diabetes in Kuwait and evaluation of non invasive risk scores

Polymorphism of p53 gene codon 72 in Kuwaiti with coronary artery disease and diabetes

Background and aim Polymorphism in the p53 gene at codon 72 has been linked to the development of certain diseases including cancer. A possible association between such polymorphism and the development of coronary artery disease (CAD) and diabetes is being investigated, but no conclusive evidence has been reached yet. Our study is the first pilot study to be conducted on Kuwaitis suffering from CAD and diabetes, aiming at investigating the possible existence of the above association. Materials and methods We analyzed the genotype distribution and allele frequency of p53 gene at codon 72 in 158 CAD samples and 110 controls, and in 142 diabetic and 130 controls. Results Analysis of CAD patients revealed an alarming significant association between the disease and the existence of diabetes ( P = 0.0007). Also, the CAD patients had significantly higher level of triglyceride ( P < 0.0001) and cholesterol ( P < 0.0001) as compared to control. As for the polymorphism in p53 gene codon 72, we could not detect any association with the genotype Pro/Pro, Pro/Arg or Arg/Arg distribution ( P = 0.28) or allele (Pro or Arg) frequency ( P = 0.25) in the CAD patients. Similarly, no association was found with the genotype Pro/Pro, Pro/Arg or Arg/Arg distribution ( P = 0.44) or allele (Pro or Arg) frequency ( P = 0.26) in the diabetic patients. Conclusion CAD seems to be strongly linked to diabetes in Kuwait. Polymorphism in the p53 gene at codon 72 revealed no significant association with the development of CAD or diabetes in Kuwait, which confirms other similar results obtained in the US and Asia.

Further evidence for the rising incidence of childhood Type 1 diabetes in Kuwait.

To provide age-gender standardized incidence rate, temporal trend and seasonal variation of Type 1 diabetes in Kuwaiti children aged < or = 14 years. Data were prospectively collected over a period of 6 years (1992-1997) according to the DiaMond Project protocol using the capture-recapture method of ascertainment. Data ascertainment varied between 90% and 96%. The incidence rate of Type 1 diabetes was 20.1 per 100,000 children 0-14 years (95% confidence interval (CI) 18.0-22.1); age-standardized incidence rate 20.9 (95% CI 18.8-23.0). The incidence rate among boys, 21.1 per 100,000 (95% CI 18.1-24.1) was slightly higher than that among girls, 19.0 per 100,000 (95% CI 16.1-21.8). The age-standardized incidence rate was 21.9 (95% CI 18.9-24.8) in boys, and 19.9 (95 CI 17.1-22.8) in girls. Incidence rates increased with age in both sexes (boys chi(2) for linear trend = 13.5, P < 0.001; and for girls chi(2) = 27.8, P < 0.0001). There was a significant trend towards increase in overall incidence during the 6-year period (chi(2) = 6.210, P = 0.013), and in age group 5-9 (chi(2) = 10.8, P = 0.001). Seasonality was demonstrated overall, in boys and girls (P < 0.001). The incidence of Type 1 diabetes in Kuwait is high compared with the neighbouring Arab countries, and it appears to be increasing as in many European populations.

Non-insulin-dependent diabetes in Kuwait: prevalence rates and associated risk factors

Non-insulin-dependent diabetes mellitus (NIDDM) is a major clinical and public health problem in Kuwait. The objective of the study was to determine prevalence rates of NIDDM among a representative sample of the Kuwaiti adult population aged 20 and older in two out of five governorates and identify the associated risk factors for the disease. A total of 3003 subjects (1105 men and 1898 women) were interviewed and examined by the research team during the period September 1995 to June 1996. A specially designed questionnaire was completed and the physical examination included height, weight and blood pressure measurements. Fasting blood samples were withdrawn, centrifuged immediately and refrigerated. Interpretation of oral glucose tolerance tests were based on the World Health Organisation diagnostic criteria for diabetes mellitus (1985). The denominator used for computing the prevalence was obtained from the 1995 Kuwait census. The overall prevalence of NIDDM in this study was found to be 14.8% (14.7% in men, 14.8% in women). Diabetic subjects presented at a relatively young age, prevalence rate in the age group 20–39 was 5.7% (95% confidence interval, 4.4–7.0) and in the age group 40–59 was 18.3% (95% confidence interval, 16.1–20.6). Obesity was found to be a significant risk factor, P<0.001. The strong association of family history of NIDDM (adjusted odds ratio=1.80, P<0.001) suggests a genetic component. Hypertension was markedly associated with NIDDM and IGT ( P<0.001). With the demographic transition which already started among the Kuwaiti population and if the prevalence of NIDDM remains the same, aging of the population will contribute to even more upward trends in prevalence of abnormal glucose tolerance with its serious impact on morbidity and mortality among the Kuwaiti population. The strong association between hypertension and NIDDM may suggest a common approach to the prevention and control of these two conditions.