Dubai, UAE: Despite a slew of diabetes health awareness campaigns, the prevalence of the disease is soaring as the globe observes World Diabetes Day today.
Type 2 diabetes is caused due to a decadent lifestyle and bad nutrition and the rate is not only climbing but it is expected to get far worse in the Middle East, with Gulf Cooperation Council (GCC) countries heading the list, according to latest data released by the International Diabetes Federation (IDF) this week.
One in 10 people in the Gulf States is living with it.
The number of cases is expected to increase by more than 80 per cent from 36.8 million people today to 67.9 million in 2035 making the Middle East and North Africa (Mena) region one of the world’s fastest growing regions for diabetes, says IDF.
The latest research reveals that seven of the top 20 countries with prevalence of diabetes are from the Mena region with the Gulf States leading the unfortunate statistics. While Saudi Arabia takes the top spot in the region with almost 24 per cent of its population diabetic, Kuwait comes a close second with 23.1 per cent followed by Bahrain (21.9 per cent), Qatar (19.8 per cent) and the UAE stands at 19 per cent.
Commenting on the prevalence of diabetes, Dr Fathiya Al Awadhi, head of endocrinology at the Dubai Hospital said: “Realising the importance of combating this challenge, the Dubai Health Authority (DHA) had included the reduction of non communicable ‘lifestyle’ diseases such as diabetes a part of its health strategy for 2012-2013. There are several steps being taken by the government such as increasing more walking and cycling paths, introducing food guidelines in school canteens, educating people about the importance of good nutrition and exercise and now there are plans to introduce labelling of food which has low or no sugar and low or no sodium so that consumers can make the right choices.”
Professor Adel Al Sayed, Regional Chair, Mena region for IDF said: “Prevention of diabetes needs work rather than just money. There are simple measures that people need to take. Healthy, wholesome food that is eaten in rural areas is not expensive and exercise such as walking or taking the stairs is easily available. It is available to everybody.”
Understanding that the disease is here to stay on the occasion of World Diabetes Day, today (November 14), Gulf News spoke to leading stake holders in the battle against diabetes – the International Diabets Federation (IDF), endocrinologists and other specialists at the DHA and Dubai Health Care City (DHCC) and other private hospitals to demystify, some top complications that those with diabetes are likely to have, the top 10 tips for diabetes management and the latest cutting edge research happening around the world to get us a step closer to a cure.
Diabetic retinopathy is the most common diabetic eye disease and can cause blindness. It is caused by changes in the blood vessels of the retina due to uncontrolled diabetes says Dr Kiranmayi, member of the Beat Diabetes advisory panel and specialist ophthalmologist at the iCare Clinics. “In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. Diabetic retinopathy usually affects both eyes. People who have diabetic retinopathy often don’t notice changes in their vision in the disease’s early stages. But as it progresses, diabetic retinopathy usually causes vision loss that in many cases cannot be reversed,”
Dr. Ahmad Al Khashab, Ophthalmology and Retina specialist, Eye Consultants Centre, DHCC, cautions that it is important to undergo regular eye screening with dilated retinal examination for all diabetic patients to catch early signs of diseases like cataract and glaucoma. “If you are a diabetic, you can help prevent or slow the development of diabetic retinopathy by taking your prescribed medication, sticking to your diet, exercising regularly, controlling high blood pressure and avoiding smoking,” he advises.
Diabetic neuropathy is a complication of diabetes mellitus or Type II diabetes. High sugar levels in the blood, for long periods of time, results in damage of the nerves cells. This would then result in a disorder of the nervous system. Any part of the body can be affected by this diseases but it shows its effect on the feet first. This disease affects the peripheral nerves which transmit signals to the brain by the spinal column. In this disease, nerves do not function properly and hence the signals are not transmitted to the brain. Diabetic neuropathy is a relatively early and common complication affecting approximately 30 per cent of diabetic patients, explained Dr Atul Anant Aundhekar, member of the Beat Diabetes advisory panel and Chief Medical Director at iCare Clinics by Landmark Group.
Raised blood sugar in pregnancy is associated with complications — the baby is more ‘delicate’ and does not respond as expected to the ‘stresses’ of late pregnancy and delivery. The mother can have medical complications such as high blood pressure. If not monitored properly it can naturally lead to complications during delivery resulting in possible trauma to the baby and increase in the risk of Caesarean section. In addition, in the first few days of life of the baby will have issues with blood sugar control and can need NICU observation, according to Dr Rosalie Sant, Consultant Obstetrician and Gynaecologist at Primavera Medical Centre, DHCC.
Dr Sant pointed out that the new research also indicated that uncontrolled sugars in can lead to childhood obesity as the ‘normal’ values for the future metabolism of the baby are being set. So the baby’s body is going to think that high sugar levels are the norm. “To prevent this doctors recommend starting pregnancy at a good weight, closely monitoring of weight gain, doing regular exercise and following a healthy eating pattern with emphasis on increasing protein and decreasing carbohydrate intake, to delay the onset of the problem,” said Dr Sant.
These are exacerbated in both adults and children with the onset of diabetes. Crawford Bain, Professor of Periodontology and Director of Post-Graduate Periodontics, Dubai College of Dental Medicine, DHCC said: “Individuals with diabetes are mostly unaware of the importance of maintaining good oral health as part of their diabetes management regimen. We have long known that diabetes increased the risk of getting periodontal (gum) disease. Recent research has shown a two-way relationship whereby improving the periodontal health of diabetics is likely to improve blood sugar levels and even prevent pre-diabetics from developing the disease.” A study conducted at DHCC demonstrated that children with better oral hygiene had better long term control on their diabetes, said Dr Manal Al Halabi, Paediatric Dentist and Program Director, Dubai College of Dental Medicine, DHCC
Urological complications of diabetes
Diabetes damages small blood vessels and nerves leading to urological complications said Dr Shawket Al Khayal, specialist urologist and medical director at the Al Khayal Medical centre, DHCC:
“Nerve damage from diabetes can cause bladder problems, such as overactive bladder, poor control of continence due to sphincter dysfunction and urine retention. Urinary tract infections are more common in diabetics due to poor bladder emptying and high sugar in the urine as well as lower immunity,” he said.
Going beyond urological problems poorly controlled diabetes can also cause sexual dysfunction in both men and women, he added. Individuals with diabetes can lower their risk of sexual and urologic problems by controlling glucose, blood pressure, and cholesterol numbers; being physically active and maintaining a healthy weight; and putting a stop smoking.
Tongue twisters made easy: typical conditions that diabetics face:
Dawn Phenomenon:This refers to the spike in blood sugar levels early in the morning caused independently, on account of the natural hormonal activities within the body, such as the release of the growth hormone or cortisol. This causes insulin resistance and can be treated by maintaining a relatively carb-free diet for dinner and closely monitoring insulin levels between 2.00 to 4am according to Dr Menon.
Somogyi Effect, which is named after Dr Michael Somogyi who successfully demonstrated that excessive insulin can hamper diabetes management, is a defensive reaction by the body to prolonged levels of untreated hypoglycemia which results in an instant increase in blood glucose, and stress hormones cause insulin resistance for several hours, and this in turn leads to elevated blood sugar. It can be combated by regular blood glucose testing using a blood glucose testing kit, to detect low blood sugar levels before a rebound occurs. This is especially relevant in the night. The key to dealing with it is to keep blood glucose levels stable, said Dr Suresh Kumar Menon
Nocturnal Hypoglycaemia: Hypoglycaemia is a state in which the concentration of glucose levels in the blood falls to an abnormally low level, can be a frequent incidence for people with diabetes at night. Nocturnal hypoglycaemic episodes can be a real cause of concern for people living with diabetes and their families, impacting a patient’s sleep patterns, their relationships and their ability to work, causing night sweats, night convulsions and chronic fatigue among other things, according to Dr. Mohammad Hassanein Consultant in Diabetes and Endocrinology, Dubai Hospital has raised his concern with regards to the issue:
Some important mass campaigns:
Dubai against Diabetes: November 27 at Burj Khalifa. The Dubai Health Authority is going to make some important announcements which will be revealed at the venue.
Beat Diabetes Walkathon: December 12, at Zabeel Park, Dubai. Those interested can register online at www.beatdiabetes.me before December 6. Dh20 per head for adults, Dh10 per head for 8-15 years old and children below 8 walk free. All funds raised will be donated to Al Jalila Foundation and will be utilised for diabetes research.
© Gulf NewsNov 2014