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The Diabetes Challenge

According to the World Health Organisation (WHO) and the International Diabetes Federation (IDF), diabetes is the twenty-first century’s leading healthcare challenge.

Diabetes complications and mortalities create social and economic challenges that affect individuals, families, businesses and societies across the globe and in Qatar.

What is diabetes?

Insulin is a hormone our bodies produce to help us regulate our blood sugar.

Diabetes occurs when a person’s body is unable to produce or use insulin effectively causing high blood sugar.

Long-term high blood sugar has shown to increase one’s risk of a number of health conditions including cardiovascular disease, nerve damage, kidney failure and blindness.

There are two main types of diabetes. Type 1 is typically diagnosed in children and young adults and occurs when the body produces very little or no insulin. The most common type of diabetes is type 2, which occurs when the body is unable to affectively use the insulin it produces. Type 2 diabetes usually affects people over the age of 40, although more and more younger people are also being diagnosed.

A healthcare crisis

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According to a public screening campaign held in July 2013 in Qatar by Action on Diabetes, an estimated 16 per cent of the adult Qatari population between the ages of 20 to 79 years has diabetes.

Meanwhile, the International Diabetes Federation (IDF) estimates that more than 200,000 people in Qatar have diabetes. This is one of the highest rates in the world. Around 10 per cent of the country’s total health care budget is being spent on diabetes care, says the IDF. By 2030, it is estimated that the number of people with diabetes will almost double. But Qatar is not alone; the IDF projects that by 2030, the number of people with diabetes in the Middle East North Africa (MENA) region will almost double, reaching 59.7 million among the world’s top 10 countries with a prevalence of diabetes and impaired glucose tolerance. Currently one in every 10 adults in the MENA region suffers from diabetes.

The disturbing statistics and frighteningly high numbers of adults being diagnosed in Qatar have prompted huge amounts of in-depth research and investigation into why this particular condition is on the rise.

Dr. Ghada Nasrat, paediatric endocrinologist at the Feto Maternal Medical Centre, said that bad eating habits and poor diets remain the major contributors to the prevalence of diabetes and obesity in the region.

"It has been found that more people in this region are ignoring traditional healthy meals and favouring Western fast food, which is high in empty calories: oil, fat and sugar and mainly carbohydrates with no minerals, vitamins and less fibre. Coupled with this is a general lack of exercise and active role models for children who are inheriting fast food eating habits with no daily exercise schedule. It is important that diabetes is diagnosed as early as possible. Diabetes cannot be cured, but treatment aims to keep your blood glucose levels as normal as possible to control your symptoms and minimise health problems that develop later. In some cases of type 2 diabetes, it may be possible to control your symptoms by altering your lifestyle, such as eating a healthy diet."

Dr. Abdulla Al-Hamaq, director of the Qatar Diabetes Association, said, "Diabetes screening tests are a good preventive method for catching the development of diabetes at an early stage. If you have pre-diabetes it does not mean you will develop type 2 diabetes. For some people with pre-diabetes, lifestyle changes and early treatment can actually return blood glucose levels to the normal range."

Understanding diabetes

The Qatar Biomedical Research Institute (QBRI) hosted the symposium Systems Biology of Diabetes: Towards Precision Medicine in January 2014 that brought together leading scientists from around the world to discuss new developments in the field of systems biology and genomic medicine for the understanding and treatment of diabetes. The goal was to identify opportunities for creating a global network for type 2 diabetes research. Executive Director Dr. Abdelali Haoudi said, "Type 2 diabetes is a serious problem in Qatar and QBRI is focused on better understanding this disease and finding innovative treatments for it. The best approach for such research is not to work in isolation, but to collaborate with other researchers from local stakeholders’ institutions and around the world who are focused on innovative research for diabetes right here in Doha."

"Changing one’s life style, although it sounds easy, is actually very hard," says Dr. Ghada.

"Many children and families fail to adhere to recommendations of healthy eating, exercise, etc. and from obesity they develop many complications which include type 2 diabetes. You have to consider the socio-cultural factors that profoundly influence diabetes control. In Qatar, rapid urbanisation has leaped across decades of development in a short time with poorly designed pedestrian-friendly streets and left behind the physically demanding life of the desert for air-conditioned comfort, servants and fast food. Also vitamin D deficiency appears to have a negative influence on diabetes control as well," says Dr. Ghada.

Organised public responses and research have argued that as the diabetes crisis continues to grow, the need for more collaborative and effective efforts to improve health and well being increases. The Supreme Council of Health has invested a dedicated network of stakeholders, including public and private organisations to conduct tailored interventions that are both culturally appropriate and can engage all sectors of society to create immediate, sustainable impact to the general public. Though public, private and civil sector organisations across the country have worked hard in the last five years to positively impact the escalating numbers, it is clear that more remains to be done to raise the level of action in Qatar.

Treating diabetes

"Initiatives such as the Action On Diabetes screening campaign are trying to lower the numbers through education, early detection and intervention," said Dr. Mahmoud Zirie, head of endocrinology at Hamad Medical Corporation (HMC).

Several hospitals under HMC have diabetic clinics that offer free of charge insulin pens, insulin pumps, disposable insulin pumps, glucometers, glucose strips, and diabetes clinic visits with diabetologists, diabetes educators, dieticians and more. There is also the National Diabetes Centre, a "one-stop shop" that offers all specialties and services from initial screening to treatment, health education and the provision of medication and equipment.

Taking action

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In recognition of World Diabetes Day 2013, HMC held a series of events designed to increase awareness of the effects of diabetes and its complications. Their website, offers information of how to live a healthy lifestyle and stories of how the employees of HMC adopted a healthier lifestyle in order to lose weight and avoid diabetes.

As part of a treatment plan, every patient diagnosed with diabetes at HMC’s National Diabetes Centre meets with a nutrition expert who provides guidance and education on an appropriate meal plan. According to Clinical Dietician Supervisor Zohair Ali Al Arabi, dietary guidance is tailored to the patient’s needs and the importance of physical exercise is highlighted. He says, "Physical exercise helps in lowering blood sugar levels and improves the body’s ability to use insulin."

HMC holds family education very high on its agenda, because it is the parents, or other primary caregivers, who teach children life skills, organise their meals, provide opportunities for exercise and often administer their medication. Educating a child from an early age will give them the best possible chance of leading a healthy life and properly managing the condition as they grow and enter adulthood.

The Qatar Diabetes Association (QDA), founded in 1995, supports the local health system and is part of Qatar Foundation. It is dedicated to providing useful and up-to-date information with the aim of helping patients understand the reality of diabetes. Its events and resources also raise awareness and offer advice on how to make the lifestyle adaptations, as well as promote the correct choices that should be taken to prevent type 2 diabetes.

There are also several awareness programmes offered throughout the year attributing to the cause, such as National Sports Day in February, the World Diabetes Day Walkathon held in November and several other programmes from the Olympic Academy, ASPIRE Academy Multi-Sport Skill Development Programme (MSSD) and several others. Meanwhile, large private organisations such as Qatargas have gone one step further and partnered with QDA to host a Diabetes Awareness Day at their Winter Camp in March 2014.

Mansour Rashid Al Naimi, Qatargas Public Relations Manager, said, “We were very pleased to partner with the QDA to organise this event. Diabetes is a major health concern and requires consolidated efforts from all sections of the society to raise awareness both in terms of preventive measures, as well as how to cope with diabetes and live comfortable lives. As part of the company’s corporate social responsibility programmes, Qatargas believes that supporting such campaigns contributes to building a healthy population, which is a key objective of the human development pillar of Qatar’s National Vision 2030.”

Although these services are imperative, the underlining goal is for everyone to take responsibility and control over one’s health and ultimately, to pass good healthy habits on to their children. It comes down to the individuals to make full use of the abundant and professional support available. Nothing is more important than your health and the health of your children.

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