Type 2 diabetes and pre-diabetes mellitus: a systematic review and meta-analysis of prevalence studies in women of childbearing age in the Middle East and North Africa, 2000–2018

BACKGROUND: Investing in women’s health is an inevitable investment in our future. We systematically reviewed the available evidence and summarized the weighted prevalence of type 2 diabetes (T2DM) and pre-diabetes mellitus (pre-DM) in women of childbearing age (15–49 years) in the Middle East and North African (MENA) region. METHODS: We comprehensively searched six electronic databases to retrieve published literature and prevalence studies on T2DM and pre-DM in women of childbearing age in the MENA. Retrieved citations were screened and data were extracted by at least two independent reviewers. Weighted T2DM and pre-DM prevalence was estimated using the random-effects model. RESULTS: Of the 10,010 screened citations, 48 research reports were eligible. Respectively, 46 and 24 research reports on T2DM and pre-DM prevalence estimates, from 14 and 10 countries, were included. Overall, the weighted T2DM and pre-DM prevalence in 14 and 10 MENA countries, respectively, were 7.5% (95% confidence interval [CI], 6.1–9.0) and 7.6% (95% CI, 5.2–10.4). In women sampled from general populations, T2DM prevalence ranged from 0.0 to 35.2% (pooled, 7.7%; 95% CI, 6.1–9.4%) and pre-DM prevalence ranged from 0.0 to 40.0% (pooled, 7.9%; 95% CI, 5.3–11.0%). T2DM was more common in the Fertile Crescent countries (10.7%, 95% CI, 5.2–17.7%), followed by the Arab Peninsula countries (7.6%, 95% CI, 5.9–9.5%) and North African countries and Iran (6.5%, 95% CI, 4.3–9.1%). Pre-DM prevalence was highest in the Fertile Crescent countries (22.7%, 95% CI, 14.2–32.4%), followed by the Arab Peninsula countries (8.6%, 95% CI, 5.5–12.1%) and North Africa and Iran (3.3%, 95% CI, 1.0–6.7%). CONCLUSIONS: T2DM and pre-DM are common in women of childbearing age in MENA countries. The high DM burden in this vital population group could lead to adverse pregnancy outcomes and acceleration of the intergenerational risk of DM. Our review presented data and highlighted gaps in the evidence of the DM burden in women of childbearing age, to inform policy-makers and researchers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017069231