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However, ironically, some positive changes to the Bahraini economy have resulted in the increase in diabetes. Increased affluence, bringing cars and air conditioning and unhealthy high-fat diets, has led to a more sedentary life and an increase in obesity a key risk factor for diabetes.

"Diabetes tends to run in families, so Bahrain's high percentage of intermarriage greatly increases the risk of diabetes on top of the usual factors," said Antoine Kaldany, M.D., Director of International Programs, Joslin Diabetes Center. "Another factor may be the so-called 'thrifty genome-type' theory. Bahrainis typically had slow metabolisms because food was not plentiful. Now that they can afford to eat more, they are penalized because their metabolism is still slow."

Those most at risk for developing diabetes are people who:

• are 45 or older
• are overweight
• are habitually physically inactive
• have previously been identified as having IFG (impaired fasting glucose) or IGT (impaired glucose tolerance)
• have a family history of diabetes
• are members of certain ethnic groups (including Asian American, African American, Hispanic American, and Native American)
• have had gestational diabetes or have given birth to a child weighing more than 9 pounds
• have elevated blood pressure
• have an HDL cholesterol level (the "good" cholesterol) of 35 mg/dl or lower and/or a triglyceride level of 250 mg/dl or higher
• have polycystic ovary syndrome
• have a history of vascular disease

Diabetes-related Costs

Because it is a chronic disease, diabetes management can have an emotional and economic toll on people with diabetes, their families and their health systems.

Emotional
Diabetes is a complex disease and can lead to a variety of adjustment issues
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Contact: Marge Dwyer
marjorie.dwyer@joslin.harvard.edu
617-732-2415
Joslin Diabetes Center
11-Dec-2003