FAQs
TOP 20 FREQUENTLY ASKED QUESTIONS
All responses attributed to:
Dr. Maha Taysir Barakat
Consultant Endocrinologist, Medical & Research Director
Imperial College London Diabetes Centre, Abu Dhabi
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1.
What are the statistics on how many people
in UAE have diabetes/what percentage of people
in UAE have diabetes?
Diabetes is currently the fastest growing debilitating
disease in the world. In the UAE it is estimated
that one out of five people aged 20 to 79 lives
with this disease, while a similar percent of population
is at risk of developing it. This year, the UAE
ranked second highest worldwide for diabetes prevalence,
followed by Saudi Arabia, Bahrain, and Kuwait (International
Diabetes Federation (IDF) 2007)
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2. What
is the age range of people affected?
There are two types of diabetes: type 1 diabetes
is an auto-immune condition where the pancreas
is attached by auto-antibodies causing it to fail.
This necessitates treatment with insulin. type
2 diabetes on the other hand is mainly brought
on by an unhealthy, inactive lifestyle and weight
gain. In recent years, we have seen a (rapid) spread
over all age groups. Recent studies show a rise
in obesity cases among school children and young
adults, which is a known cause type 2 diabetes
however the 40-59 age group has the greatest number
of persons for diabetes. (IDF 2007)
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3. Which
group of people are most affected age/gender
etc?
As mentioned earlier, most diabetes sufferers are
between the ages of 40 to 59 years, with research
showing a worrying rise among younger age groups.
As for gender distribution, the estimates for both
2003 and 2025 showed a female predominance in the
number of persons with diabetes. The female numbers
were about 10% higher than for males. There was
also a female predominance in the number of persons
with Impaired Glucose Tolerance (IGT) in the estimates
for both 2003 and 2025. The female numbers were
about 20% higher than for males. Polycystic ovary
syndrome affects up to 5-10% of females in their
reproductive years and is thought to predispose
to glucose intolerance, with studies showing up
to 30-40% being affected by IGT and up to 7-10%
with type 2 diabetes. It may explain why there
are more females with type 2 diabetes amongst adolescents.
(IDF 2007)
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4. How
many people are believed to have diabetes but
are undiagnosed and is under-diagnosis an issue?
In a UAE Ministry of Health study conducted in
2000, approximately half of the people with diabetes
in the UAE were unaware that they suffer from diabetes.
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5.
What are the main causes of the incidence of
diabetes in UAE i.e. the triggers/ factors
contributing to diabetes?
Diabetes is a condition that is characterised by
an above normal level of glucose (sugar) in the
blood. This is because the pancreas does not make
enough insulin or insulin becomes ineffective.
Insulin, a hormone generated in the pancreas, normally
controls blood sugar levels and allows the glucose
to enter the cells in the body to provide energy.
In people with diabetes, high levels of glucose
remain in the bloodstream causing Hyperglycaemia
(high blood sugar). Those at increased risk include
individuals who have a history of diabetes in their
family, people over 40, those who are overweight
or obese and inactive individuals.
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6. Is
diabetes on the rise in UAE - and why?
Yes, diabetes is on the rise in the UAE. There
seems to be a genetic predisposition to the disease
among UAE Nationals and statistics show that they
have a higher prevalence than other Nationalities
within the UAE. However tendencies towards lifestyle,
weight gain, an imbalanced diet and/or a lack of
exercise seem to be major contributors. Research
is ongoing with the overriding aim to help explain
why diabetes occurs at such high levels in the
country. This will also help instigate preventative
measures.
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7. Is
there much awareness of diabetes/how to prevent
it amongst the UAE population? If not, why?
We believe that the UAE is taking steps in the
right direction by planning various nutrition and
physical activity programmes in addition to driving
public awareness campaigns. Certainly, at ICLDC
we have contributed with a public health thrust
‘DIABETES. KNOWLEDGE. ACTION’ and are set to continue
– and grow – this campaign during 2007 and beyond.
Diabetes is now on the country’s top list of health
concern and is being tackled through awareness
and lifestyle changes. Equally important is the
treatment of diabetes and its complications with
the most up-to-date evidence-based medicine which
is now available here in Abu Dhabi at the Imperial
College London Diabetes Centre.
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8. What
are some of the serious effects of diabetes
you are seeing in UAE?
Diabetes brings with it several serious complications
related to the heart, eyes, blood vessels, kidneys,
feet and nerves. Some of the cases that we have
witnessed in the UAE are: Diabetic retinopathy,
a key cause of blindness and occurs as a result
of long-term accumulated damage to the small blood
vessels in the retina. After 15 years of diabetes,
approximately 2% of people become blind, and about
10% develop severe visual impairment. Diabetic
neuropathy is damage to the nerves as a result
of diabetes, and affects up to 50% of diabetes
sufferers. Although many different complications
can occur as a result of diabetic neuropathy, common
symptoms are tingling, pain, numbness, or weakness
in the feet and hands. Combined with reduced blood
flow, neuropathy in the feet increases the chance
of foot ulcers and eventual limb amputation. Diabetes
is among the leading causes of kidney failure where
10-20% of people with diabetes die from this complication.
Diabetes increases the risk of heart disease and
stroke. People with type 2 diabetes are over twice
as likely to have a heart attack or stroke as people
who do not have diabetes. The overall risk of premature
death among people with diabetes is at least double
the risk of their peers without diabetes. According
to statistics, mortality linked to diabetes mellitus
constitutes 75% percent of the deaths among UAE
nationals and 31% among non-nationals.
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9. What
has been the preliminary response to your campaign
for free screening at ICLDC? What sort of responses
have you seen?
The responses have exceeded our expectations, more
than 10,000 people have visited the diabetes awareness
booth at the Marina Mall and more than 1200 people
have volunteered to be screened for diabetes so
far. As part of our outreach program the awareness
booth is now at the Al Jimi all in Al Ain where
we aim to raise awareness, assess diabetes risk
and recommend blood testing for those at defined
as high risk. Risk assessment and testing people’s
knowledge on diabetes through simple quizzes are
some of the methods used to disaminate the information.
In addition to viewing the TV ads and discussing
simple changes in lifestyle that can actually provide
prevention.
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10. How
does ICLDC plan to spread awareness about the
threat of fast food items?
‘DIABETES. KNOWLEDGE. ACTION’, is a nationwide
campaign designed to draw attention to diabetes.
The campaign does emphasise the need to eat a healthy
and balanced diet, while avoiding unhealthy fast
food. In addition, there is also strong emphasis
on increased exercise, such as walking briskly
for at least 30 minutes each day. Under the patronage
of Her Highness Sheikha Fatima bint Mubarak, Supreme
Chairperson of the Family Welfare Foundation and
Chairperson of the General Women's Union ‘DIABETES.KNOWLEDGE.ACTION’
is a partnership between the Emirates Foundation
and the Imperial College London Diabetes Centre
(ICLDC), and endorsed by Health Authority – Abu
Dhabi. ‘DIABETES.KNOWLEDGE.ACTION’ focused on disseminating
knowledge surrounding diabetes prevention, symptoms
and lifestyle support activities. It aims to help
prevent the number of diabetes patients through
education and encourage testing for diabetes on
a nationwide level in order that people learn if
they are affected or at risk.
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11. Is
ICLDC spreading messages about fast food causing
other health problems like obesity, cardio
vascular diseases etc in the awareness programmes?
Spreading healthy eating messages are the campaign’s
priorities since these methods are the most effective
ways to prevent, treat and or manage the disease.
ICLDC’s aim is to help the population move towards
healthier lifestyles and for those who have already
been diagnosed with diabetes to adopt the latest
evidence-based treatments. Through ‘DIABETES.KNOWLEDGE.ACTION’
we are reaching out to people across the UAE through
several activities. We have rolled out I WONDER…,
a public screening programme in which we screen
people at high risk for diabetes. I EAT RIGHT,
an educational initiative aimed at getting children,
mothers and carers to take a look at, and possibly
change, what’s the children’s lunch boxes. We’re
planning I PLAY SPORTS, a fun Corporate World vs.
the Field Professionals football tournament with
the UAE National team hopefully taking on members
of the UAE’s commercial sector. I WALK to bring
the community together in a walkathon to raise
awareness and hopefully raise money that can be
ploughed back into diabetes research public health
initiatives. We’re also working with UAE celebrity
Chefs for I COOK HEALTHILY where we will be producing
a recipe book and DVD to show people how they can
make their own meals healthy. These are just a
few of the plans, you may visit the campaign’s
website www.diabetesuaue.ae to keep informed of
the latest in the campaign. Our aim is to inform
people of the ways to maintain a healthy life,
the risks of an unhealthy life, the complications
that diabetes brings with it while making available
the latest evidence-based treatments. We would
like to help improve people’s quality of life by
armouring them with information rather than scaremongering
and promotion through negativity.
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12. We
are seeing more children with Type 2, even
though it normally only appears in adults over
the age of 40 - why is this?
Type 2 diabetes among children is fast becoming
recognized as a global public health issue with
potentially serious health outcomes. Research has
indicated that type 2 diabetes is mainly brought
on by an unhealthy, inactive lifestyle and weight
gain. In recent years, we have seen a (rapid) spread
over all age groups. We at ICLDC however are hopeful
that through our public health campaign ‘DIABETES.KNOWLEDGE.ACTION’
we will be able to help children and adults alike
living with or at the risk of diabetes. Also through
research we hope to determine why diabetes occurs
at such high levels in the country and instigate
further preventative measures.
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13. Do
you think schools need to do more to combat
the problem?
Schools can definitely help by supporting healthy
eating messages. Schools should serve nutritious
and balanced school meals, fruit instead of vending
machines full of crisps and sweets. Sports activities
should be part of the curriculum, either during
school hours or after hours thus encouraging children
to be physically active. With the Health Authority
– Abu Dhabi (HAAD) endorsement to this campaign
we believe that with the program I EAT RIGHT, an
educational initiative aimed at getting children,
mothers and carers to take a look at what’s in
the children’s lunch boxes, it is possible to help
make sure children are aware and consume healthy
diets.
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14. How
are ICDLC’s screening tests for diabetes different
from the others?
The campaign screening done for those defined at
high risk begins with a detailed questionnaire
that tells us all patient details including ethnicity,
medications, if any, and family history. Our medical
team then measures the patient’s blood pressure,
Body Mass Index (BMI), followed by drawing the
blood from the arm into two different tubes. The
blood is then delivered to ICLDC labs then conduct
the tests:
- Randonm Plasma Glucose to measure sugar
levels in the blood
- HbA1c, to indicate sugar levels in the
blood over the last 3 months
- Random Lipids (Cholesterol, HDL, LDL
and Triglycerides )
The results are delivered to
the patient along with a medical report and recommendations
based on the results and the background information,
written by an ICLDC diabetes specialist.
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15. How
much do fast food outlets contribute to the
obesity problem?
When eaten in excess, any type of food could contribute
to the problems of diabetes and obesity. Unhealthy
fast food is no exception of course, but we have
to remember to distinguish between healthy and
unhealthy fast food. There are now healthy fast
food outlets that provide an alternative to what
we conventionally know as fast food. In my opinion,
increased education on what the ingredients of
unhealthy fast food can do to one’s body would
be helpful and regulation of unhealthy fast food
sales and marketing could also be key. Tackle the
marketing of unhealthy fast food whilst simultaneously
educating people about the risks of consuming such
foods and I think we would see significant positive
changes.
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16. If
banning smoking in restaurants, bars, can help
the health-related problems with smoking, should
levels of trans-fats and calorie content in
fast food also be regulated in places like
the UAE?
Regulation of this sort would definitely and without
a doubt help, not just in the UAE but globally.
As mentioned earlier, regulation and increased
public awareness need to go hand in hand. With
this aim, ‘DIABETES. KNOWLEDGE. ACTION.’ hopes
to draw nationwide attention to diabetes. It is
a partnership between the Imperial College London
Diabetes Centre (ICLDC) in Abu Dhabi and the Emirates
Foundation and has the patronage of Her Highness
Sheikha Fatima bint Mubarak, Supreme Chairperson
of the Family Welfare Foundation and Chairperson
of the General Women's Union with the endorsement
of the Health Authority – Abu Dhabi (HAAD). The
campaign focuses on disseminating knowledge surrounding
diabetes prevention, symptoms and lifestyle support
activities. It aims to help prevent the number
of diabetes patients through education and encourage
testing for diabetes on a nationwide level in order
that people learn if they are affected or at risk.
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17. Are
people in the UAE essentially just lazy?
No, I do not think it would be appropriate to generalise.
People in the UAE work very hard and today’s culture
at work and in general tends to keep people tied
down, to their desks or in traffic jams. This could
pose a challenge for many people but, they should
make time for exercise in spite of it. Studies
have proven that simple exercise such as walking
for half and hour, five days a week can decrease
your risk of type 2 diabetes. The key to prevention
of type 2 diabetes, even in those with predisposing
genes is to maintain a normal body weight and to
exercise regularly. The International Diabetes
Federation (IDF) has stated that, up to 80% of
type 2 diabetes is preventable by adopting a healthy
diet and increasing physical activity.
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18. To
what extent are longer working hours and increasing
numbers of working women contributing to a
shift from the traditional home-cooked meals
to fast/convenience food?
I cannot comment accurately on whether long work
hours or more working women contribute to current
food choices. Convenience, however, might be the
key word here and with healthy convenience food
rare, people tend to settle for what is available.
We hope we can set an example for office cafeterias
and other outlets through our very own café at
ICLDC. We offer healthy food options where all
ingredients are monitored by our nutritionists
from time to time. Whole grain products, vegetables
and fruits and other healthy ingredients form a
major part of our menu thus benefiting patients,
visitors and staff alike.
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19. What
are the other contributing factors towards
the obesity problem in the UAE?
In the UAE and the world over, poor, unbalanced
and unhealthy diet coupled with a sedentary lifestyle
are large contributors to obesity and diabetes.
A genetic predisposition too might contribute in
some cases therefore when screening for diabetes
we always look at family history.
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20. The
UAE has the second-worst record for diabetes
in the world, but Saudi Arabia, Qatar, Bahrain
and Kuwait are also among the top five. What
is it about the Gulf Region that is causing
such a problem?
Estimated prevalence of diabetes according to 2007
world statistics shows the island of Nauru leading
with 30.7 percent prevalence. UAE, number two at
19.5 per cent, Saudi Arabia follows with 16.7 percent
prevalence. Bahrain stands fourth highest with
15.2 percent and Kuwait with 14.4 percent diabetes
prevalence. There seems to be a genetic predisposition
to the disease in the Gulf region, but this risk
may be mitigated if one leads a healthy lifestyle.
An increased prevalence of diabetes among expatriates
in the region as opposed to in their countries
of origin indicate that genes are not the only
factor in play and that environment (lack of exercise
with high fat, high sugar diet) plays a major role
as well.
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