A leading diabetes expert has called for a change in how people in the Middle East live and for people to take control of their health. Dr. Emran Khan, Consultant Endocrinologist and Diabetologist at King’s College London, UAE says: ‘The epidemic of “Diabesity”’ has taken on the world’.
Dr. Khan says a new approach is needed to tackle the type-2 diabetes epidemic: “Because people are not as well informed as they should be, sadly I feel that it is accepted in the UAE society and culture as a norm to eventually develop diabetes. It is accepted that this disease is inevitable, and it does not surprise them at all when it happens because it is so prevalent. Obesity and a high BMI (Body Mass Index) has been accepted as not something unusual and is not considered a serious issue.”
The doctor wants to see people moving more, eating well and if they are overweight or obese, losing weight to avoid getting type-2 diabetes.
What is type-2 diabetes?
Type-2 diabetes is a serious condition in which the insulin made in the pancreas is unable to work properly, or the pancreas cannot make sufficient insulin.
Symptoms include:
• Frequent urination
• Intense thirst
• Sudden weight loss
• Blurred vision
• Tiredness
Left untreated, it can lead to life-changing complications, including:
• Heart attacks and strokes
• Kidney disease
• Vision problems (even blindness)
• Pain or loss of feeling in hands and feet
• Amputations of fingers, toes, or limbs.
What is the scale of the problem?
The UAE ranks third in diabetes prevalence in the Middle East and North Africa. According to the International Diabetic Federation, 38.7 million adults are diabetic. By the year 2040, the figure could rise to 82 million.
UAE nations are among the 15 countries in the world with the highest rate of diabetes per capita. Kuwait, Bahrain, Saudi Arabia and the UAE also rank in the top 15 for obesity. Being overweight or obese can contribute up to 85 per cent of the risk of developing type-2 diabetes.
What are the causes of the epidemic?
Dr. Khan says a key factor in the increase in diabetes is the region’s increase in wealth and an accompanying decrease in physical activity. He said: “This has led to sedentary lifestyles and fast food options replacing more traditional modes of work, travel and cuisine.”
England is no exception. NHS England, the government-funded organisation that delivers healthcare in England via the National Health Service (NHS), believes that ‘tackling diabetes is one of the biggest healthcare challenges of our time’.
What’s the cost?
NHS England says that, at £8.8 billion a year, type-2 diabetes treatment accounts for nearly nine per cent of the annual NHS budget. There are five million people in England at high risk of developing the condition. If these trends persist, one in three people will be obese by 2034 and one in 10 will develop type-2 diabetes. The condition is a leading cause of preventable sight loss in people of working age and is a major contributor to kidney failure, heart attack, and stroke.
Partners in expertise
Dr. Khan says it is ‘extremely encouraging’ to see world-class British-based institutions such as King’s College London coming to the region: “Institutions of great excellence are bringing their expertise, knowledge, skills and governance. They are not only helping patients; they are also contributing towards raising health standards.” Its diabetes clinic is staffed by UK-trained clinicians and nurses and offers screening, diagnosis and treatment.
The Imperial College London Diabetes Centre (ICLDC) is an out-patient facility that specialises in diabetes treatment, research, training and public health awareness. More than 800,000 patients have visited the centre since its launch in 2006.
Dr Khan’s five ideas to address type-2 diabetes
• Provide walking tracks in shopping malls similar to cycling lanes in the West. Users would receive reward points or discounts on their grocery purchases.
• Change food labelling so that the public understand more about what they are eating.
• Harness the power of the entertainment industry – a commercial before each television programme and cinema movie. Print media need to provide easy-to-understand health information. And we need to spread the message via social media.
• We need educational programmes, particularly in shopping malls, pharmacies and supermarkets. We need our food industries to help to promote healthier food options in supermarkets and restaurants.
• Local pharmacists could provide support and free blood tests and weight checks, and perhaps provide a scorecard and education about BMI and the risks associated with ‘diabesity’.
How to prevent type-2 diabetes
You can reduce your risk of developing type-2 diabetes by:
• eating well
• moving well
• losing weight if you’re overweight.
Get support
Ask your doctor about:
• a weight-loss programme or group
• a registered dietitian or exercise specialist
• a prevention programme
Be realistic
Set yourself goals that fit in with your life. Choose the healthy food and activities that you like best.
Patient empowerment: Innovation and support
Diabetes patients spend around three hours with a health professional every year. For the remaining 8,757 hours, they must manage their diabetes themselves.
The NHS is committed to the expansion of self-management services through an online self-management support programme and accompanying education pathway, Healthy Living for People with Type 2 Diabetes.
Originally developed at University College London, the programme provides information and emotional support and helps with adopting and maintaining healthy behaviours. It offers an alternative means of accessing support alongside more traditional group-based, structured education programmes.
A randomised control trial funded by the National Institute of Health Research demonstrated modest but significant improvements among the group using the Healthy Living diabetes tool in HbA1c (haemoglobin) levels.
The NHS is also to begin trials of low-calorie diets for obese people with type-2 diabetes. After a liquid diet of just over 800 calories a day for three months, there will be a period of follow-up support, including food reintroduction and weight maintenance.
