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Diabetes education is seen as key to fighting the Arab world’s invisible enemy

DUBAI: Controlling sweet food is not the only lifestyle that can determine whether a person will be diabetes-free for life. The alarming increase in chronic disease worldwide over the last decade is linked to sedentary lifestyles, poor diet and obesity.

Lack of knowledge in many countries about the prevention and management of this disease has led the International Diabetes Federation to make “diabetes education an opportunity” as the theme of World Diabetes Day for the third year in a row.

Every year on November 14, campaigns around the world help raise awareness of the disease, which affects 537 million adults between the ages of 20 and 79 worldwide by 2021.

The theme of World Diabetes Day is ‘Access to Diabetes Education’. (Shutterstock)

In recent years, the incidence of type 2 diabetes has increased in certain regions, including the Middle East and North Africa – especially in the Gulf Cooperation Council region. Countries such as Kuwait, Saudi Arabia and Bahrain are now among the top 10 countries with the highest prevalence of type 2 diabetes.

One in five people in the UAE have diabetes, with type 2 being the most common, according to the Cleveland Clinic in Abu Dhabi. This number is expected to double by 2040.

In response to the increased incidence, health professionals are examining everything from lifestyle trends to technological advances and healthcare systems to determine what can be done to slow the spread, and to what extent genetics play a role.

According to Dr Sarah Suliman, consultant endocrinologist and diabetologist at the London Diabetes Center at Imperial College Abu Dhabi, variables such as urbanisation, climate change, mobility and food availability affect diabetes rates in different regions.

“As one of the wealthiest regions in the world, the GCC has seen increased car use, easier access to food, including high-calorie foods, and is one of the world’s leading regions. diabetics are worried,” he told Arab News.

The situation in other countries of the Middle East and North Africa is also worrying. Data from 2021 shows that 73 million adults (aged 20-79) are living with diabetes in the MENA region — a figure that will grow to 95 million by 2030 and 136 million by 2045.

“Recently, we have put a lot of things on the gene. We know that if one parent has diabetes (type 2), then a person has a 40% chance of developing diabetes, and if both parents have diabetes, they have an 80% chance of developing it, he said. Suliman. .

In fact, type 2 diabetes is not only preventable, but can also be reversed through a complete lifestyle change. Unfortunately, this is not the case for type 1.

Because genetics only accounts for 5 to 10 percent of cases, type 1 diabetes is caused by an autoimmune reaction in which the body attacks itself and destroys the cells in the pancreas responsible for producing insulin.

Dr. Sarah Suliman. (equipped)

“The treatment for type 1 diabetes is insulin and will always be insulin. But with type 2, we have different options,” Suliman said.

It’s no secret that excessive consumption of sodas, energy drinks, sugary juices, and processed junk foods tops the list of diets that cause high blood sugar (or blood glucose) levels.

A poor diet, lack of regular exercise, less than seven hours of sleep a night and poor hydration significantly increase the risk of obesity and type 2 diabetes, Suliman said.

“Obesity is another big problem in the Gulf countries,” he said. “For example, 50 percent of children in Kuwait are currently either overweight or obese.”

FASTTHE FACTS

* In 2021, there will be 537 million adults living with diabetes, increasing to 643 million in 2030 and 783 million in 2045.

* 3/4 ​​of adults with diabetes live in low- and middle-income countries.

* 6.7 million deaths from diabetes in 2021 — 1 every 5 seconds.

Source: International Diabetes Federation

Studies predict that by 2030, more than one million children will be obese in at least 10 countries in the MENA region.

Looking at the problem from a different angle, Dr. Ihsan Al-Marzouki, founder and managing director of Glucare Health, says that while bad habits can significantly affect diabetes rates, there is another side to the story.

“While it is easy to blame patients for lifestyle choices, we attribute this increase to the fact that over the past 40 years, medical professionals have not changed the model of care to address the root cause of disease,” he told Arab. The news.

“Despite all the advances we’ve made in health care, the system still treats patients episodically — 15 minutes with your doctor every quarter — with an emphasis on prescription drugs.”

Describing diabetes as “primarily a behavioral problem,” Al-Marzouki emphasized the need for healthcare providers to focus on innovative care models that provide a consistent follow-up approach that focuses on behavioral change.

“The system still treats patients episodically — 15 minutes with your doctor every quarter — with an emphasis on prescription drugs,” said Dr. Ihsan Al-Marzouki. (equipped)

To achieve this, providers must consistently record a new set of personal data for each patient, says Al-Marzouki, a practice that has not taken off in MENA countries.

Criticizing current care models, he said patients have little knowledge of the health impact of their actions, adding that this has led to a high number of poorly controlled diabetics in the GCC.

“We believe that most patients are not empowered about their own health because they cannot contextualize how their lifestyle choices can affect their diabetes outcomes,” she said.

Meanwhile, “providers are constantly advising their patients on lifestyle changes, but no one is following through on their advice.”

According to Al-Marzouki, the result is evident in the data collected, which shows that almost 75 percent of GCC managed diabetics with access to care are classified as “poorly controlled”.

Highlighting predictions of a region-wide “tsunami” of health care bills as a result of the situation, he says diabetes should not be an expensive disease to manage.

Historically, diabetic patients had no choice but to prick their finger several times a day to control their blood sugar. (Shutterstock)

“The consequences of poorly controlled diabetes result in almost a quarter of the health budget being spent on diabetes,” he said.

To end this cycle, Al-Marzouki said, governments should incentivize healthcare providers by rewarding them for clinical outcomes, as opposed to current payment models.

If a value-based reimbursement model is implemented, he argues, providers who introduce and invest in new approaches like digital therapy will have a better-engaged and better-managed population. This, in turn, can reduce future complications and thereby lower overall costs.

Instead, Gulf governments are trying to raise awareness about the disease. Early education and training on managing the condition and promoting healthy lifestyles is now widespread in schools and universities across the region, says Suliman.

Some governments have set up public walking paths and jogging paths and outdoor gyms and ministries for municipalities to launch nationwide fitness campaigns to encourage people to be active.

Another example of government intervention is the sugar tax announced in the UAE in 2019, which applies a 50 percent tax to all sugary drinks.

From a technological perspective, diabetes treatment has also come a long way, says Suliman. Historically, patients with diabetes had no choice but to prick their finger several times a day to control their blood sugar and self-inject insulin when needed.

“We are now spoiled for choice,” he said. Significant progress has been made in the development of glucose sensors and insulin pumps. These devices allow patients to monitor their sugar levels with live updates from their mobile phones.

In addition, patients who require daily insulin may choose to install a sensor and pump device that can monitor and administer the correct dose to avoid the traditional injection method.

“At least there are signs that we can flatten the curve,” said Suliman, who believes the younger generation is more focused on making better lifestyle choices.

“The problem is that the rise in diabetes has become alarming and will be even more alarming if the pessimistic predictions come true.”

He added: “We all have to move in the same direction.”

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