Diabetes, A Bitter Illness

An old diabetic Palestinian cigarette vendor sits next to his artificial limb as he receives treatment at a prosthetics centre in the West Bank. REUTERS/Ammar Awad

WHO says that diabetes can be prevented

BY Dr. Ala Alwan

The number of people suffering from diabetes in the Middle East and North Africa region (MENA) may more than double by 2040, but we can prevent that.

People with diabetes lose their ability to properly regulate their blood sugar, and the illness can lead to nerve damage, heart attack, stroke, blindness, kidney failure and lower-limb amputation.

Globally, nearly one in 10 adults suffer from diabetes. But in some Middle Eastern countries, that number is as high as one in five adults and it is rising. By 2030, the number of people with diabetes in the Middle East region is expected to increase from nearly 33 million today to almost 60 million. Managing the disease could cost up to two percent of the region’s gross domestic product.

Increasing physical activity to maintain a healthy weight is one of the most important steps to prevent diabetes, and is highly recommended by the World Health Organization (WHO).

But the Middle East is the least physically active region in the world, the international organization adds. According to recent studies, less than half of men and only about quarter of women in the Gulf Cooperation Council countries are physically active for that amount of time.

Based on recent studies, there is a clear evidence that diabetes can be prevented.

Reversing the number of people who get diabetes takes three things: engaging in regular physical activity, reaching and maintaining a good weight and eating healthy food.

Exercising, and even walking at a brisk pace is sufficient. Children should engage in at least 60 minutes of vigorous activity a week.

One of the main challenges in tackling diabetes is that, in the early stages of the illness, it may show no symptoms. In many countries in this region, up to half of those with diabetes only learn they have the condition when their vision is impaired, they suffer a heart attack or stroke or it is discovered when they visit a health facility for another reason.

We recommend governments to implement cost-effective interventions to reduce the consumption of salt, sugar and saturated fats and to eliminate industrially produced trans-fats from foods. This recommendation also discourages the production and marketing of foods that contribute to unhealthy diets. Food advertising is often for products that are laden with fat, sugar or salt and much of it targets children. We must insist this stops. Our recommendation on the marketing of Foods and non-alcoholic beverages to children can guide policy makers on what is acceptable.

For those who already have the disease, complications can be prevented by diagnosing the condition early and by optimal control of blood sugar and reducing other risk factors.

We also need national health systems to boost efforts to diagnose diabetes before it takes its grim and avoidable toll. The tests are inexpensive and can save significantly in money, health care costs and lives. People who are at high risk for diabetes including those with high blood pressure, or elevated lipids, overweight, or smokers should be tested for diabetes when they go to health facilities.

Large sectors of the population do not have access to optimal treatments of diabetes, including life-saving medicines like insulin. It is essential that governments strengthen health care for people with diabetes.

Oman is an example of a country that instituted this approach in 1997, when management of high blood pressure and diabetes was integrated into the primary health care system across the country. Today, some other countries in the Middle East have followed in this direction.

The impact of the disease has been viewed with concern by governments around the world.

In September, global leaders took another major step forward at the UN General Assembly when they set a new global target: To reduce by one-third the number of deaths attributed to noncommunicable disease, including diabetes, by 2030, as part of the Sustainable Development Goals.

Because of the importance of moving quickly to address this disease in the Middle East and other regions of the world, WHO is focusing on diabetes as its theme for World Health Day on April 7, 2016.
If we can succeed in our efforts to encourage physical activity, healthy eating and early diagnosis along with effective health care in every country in this region, we can prevent millions of people from developing diabetes and we can help many of those who do have it to live long, healthy and active lives.

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