Diabetes: It’s time to be making big noise about the silent killer

A look at how diabettes has become a global health time bomb, and advice on how to detect and avoid the condition.

Being overweight is a factor that can cause diabetes. Pawan Singh / The National

Diabetes, a silent killer that can creep up on its victims over decades, is a disease of our time – a deadly downside of affluence and good living.

Type 2, by far the most common form of the condition, “is mainly brought on by an unhealthy, inactive lifestyle, excessive weight gain and genetic predispositions”, says Dr Saf Naqvi, consultant endocrinologist and medical director at Imperial College London Diabetes Centre in the UAE.

Last year, according to the International Diabetes Federation, globally the disease claimed the lives of more than four million people. Worldwide, 387 million are living with the condition, and with type 2 diabetes on the rise in every country, this figure is expected to hit 592 million by 2035.

Nowhere is the growth of this worldwide epidemic of more concern than in the UAE, where it affects 19 per cent of the population, placing the country 16th in the IDF’s worldwide diabetes league table. By comparison, the prevalence in countries such as Norway, the United Kingdom, Belgium and Sweden is less than 5 per cent.

In the UAE, 803,000 people between the ages of 20 and 79 were battling the disease in 2014, and 1,335 people died. It’s a similar picture throughout the GCC – the disease affects an even higher proportion in Saudi Arabia, Bahrain, Kuwait and Qatar. Figures released this month show that so far in 2015, about 175,000 patients have been seen at the two branches of the ICLDC in Abu Dhabi and Al Ain – about 20,000 a month.

In one sense, diabetics in the Gulf are victims of the region’s success – just a few generations ago, pre-oil-era Emiratis and others were living in far leaner times. “There seems to be a genetic predisposition to diabetes in the region,” says Dr Naqvi. “It is widely recognised that a sedentary lifestyle and unhealthy diet have all contributed to increased obesity, which in turn has fuelled diabetes in the Gulf.”

Worryingly, given that diabetes normally catches up with victims between the ages of 40 and 59, both worldwide and locally, increasing numbers of children are being diagnosed with the disease.

The cause, says Dr Naqvi, is “obesity linked to physical inactivity and unhealthy diets”. In the past year in the UAE, 7 per cent of the patients who attended ICLDC were children.

The tragedy, he says, is that “type 2 diabetes can be avoided, prevented, managed and even reversed if caught early and a healthy lifestyle is adopted and maintained”.

Diabetes is a failure of the body to properly process the energy it needs, which comes from the carbohydrates found in foods including potatoes, beans, rice, pasta, fruit and sugary snacks and drinks. In the stomach, these carbohydrates are broken down into glucose, a type of sugar, which is then carried by the bloodstream to the countless cells in the body that need it. On its own, glucose is useless. But as the level in the blood rises, so the pancreas releases a hormone called insulin, which helps the cells absorb the glucose.

With a healthy diet and a properly functioning pancreas, the volumes of glucose and insulin in the blood are balanced. But if this system breaks down, diabetes develops.

There are two types of diabetes. Type 1, which affects only 10 per cent of people with the condition, is caused by the body’s own autoimmune system attacking and killing off the cells in the pancreas that make insulin. No one quite understands why this happens, but type 1 sufferers are usually born with the condition – the innocent victims of a genetic lottery. There’s no cure, but the condition can be controlled with regular doses of insulin.

Type 2 is a different story, and in the vast majority of cases, the starting point isn’t genetic bad luck, but the good life – too much good food and too little exercise, causing obesity. In type 2 diabetes, the pancreas produces insulin as it’s supposed to. But “fat interferes with the body’s ability to use insulin”, says Dr Naqvi. As a result, the cells are unable to absorb as much glucose as they need.

This triggers a vicious cycle. As the level of unused glucose in the blood increases, so the pancreas produces more insulin, until eventually the overworked pancreas can fail.

Whether the diabetes is type 1, caused by a failure of the body to produce insulin, or type 2, an inability to properly use the insulin it produces, the symptoms can often be the same – tiredness, thirst, weight loss and more frequent urination.

In type 1, these symptoms develop in a matter of weeks and are usually very obvious. In type 2, they appear much more slowly and are easily mistaken for signs of other conditions. Worse, says Dr Naqvi, “many people have diabetes without having any symptoms and without knowing they have it”.

This is why diabetes is often called the silent disease. It’s also why “it is so important for people to have screening tests if they are at risk”.

Ignoring diabetes can have fatal consequences. In the long-term, the excess levels of glucose in the blood caused by diabetes can cause serious damage to vital organs, including the heart, kidneys and eyes. As with type 1, there’s currently no cure, and the best defence against type 2 diabetes is to prevent it taking hold in the first place.

“Making lifestyle changes is the most important ‘treatment’ for pre-diabetes, as it is for diabetes itself,” says Dr Naqvi. These changes include losing weight, exercising frequently and eating balanced, healthy meals.

Taking these simple steps, he says, “can help delay or even prevent the onset of diabetes. Even if you do develop diabetes these changes will help manage the condition and delay the need for medications to control blood sugar and delay the development of diabetes complications.”

Parents, he says, need to act now to prevent their children becoming tomorrow’s diabetes statistics.

They should give them “a healthy diet, which includes low-fat and nutrient-rich foods such as fruits and vegetables, and limit sugary foods and drinks such as sweets, chocolate and fizzy drinks”. The most important thing parents can do, he says, “is to encourage their children to lead a very active lifestyle with regular exercise” – anything from playing a sport regularly to a daily brisk 30-minute walk together.

Get them started on November 13, when thousands are expected to take to the Formula One track at Yas Marina Circuit for ICLDC’s annual Walk 2015, or join one of the weekly walking groups hosted by ICLDC around Abu Dhabi emirate.

• Full details, and lifestyle and exercise tips, can be found at www.diabetesuae.ae