Chances are you know at least one person in the UAE who has diabetes. According to the 2015 UAE National Diabetes and Lifestyle Survey, almost one-fifth of the country’s population is living with the disease. Three residents share their stories.
Emirati Saleha Al Kaabi, 30, lives in the village of Al Shweeb, near Al Ain. She was diagnosed with type 2 diabetes last March.
“My diabetes was discovered during routine tests I had in hospital when I was suffering from a bug. It wasn’t an easy thing to discover, but it wasn’t a complete surprise – I was overweight and my father was diabetic. I’d been drinking a lot of water and although I was eating my meals as normal, I was feeling hungry all the time and sleeping for long stretches.
“My first reaction was that I didn’t want to be just another diabetes story in my family. My father lost his sight and had many other problems related to his diabetes, and this encouraged me to take care of my health.
“I refused to listen to people who said the only way to monitor the diabetes is to reduce the amount that you need from sugar. Instead, I chose to change my lifestyle completely. I’d never done any sports before my diagnosis, and now I started to embrace an active lifestyle.
“I registered with a local health club, so now I spend almost an hour and a half walking and working out three times a week, and I also walk almost every evening around a path in my neighbourhood. Until recently, there weren’t any facilities in my area for Emirati women to exercise, so I’m really glad this is now possible for me. Being more active not only helps me monitor the diabetes, it has also given me the positivity I need to overcome it.
“I start my day by drinking a lot of water. I used to eat a lot, especially at the wrong times. Now I’ve reduced the snacks I have between meals and stopped eating sweets, soft drinks and fast food in general – I eat salads and fruits instead. I used to eat rice just before bedtime, whereas now I eat at fixed times. Before, I weighed 110kg and now I’m 79kg.
“For the first few months, it was essential for me to take [insulin] injections as my glucose level was very high – 12 mmol/l, compared to 4 or 5 for normal people. The intensive treatment was for almost eight months and after that, I took insulin tablets with meals. I’m not taking insulin tablets anymore – only glucophage, a blood sugar regulator. I pushed myself to overcome this problem and accept it deep inside. With all these changes, I’ve learnt to live with this ‘new friend’.
“When kids are very young, some people in the UAE feed them a lot. They think if you eat a lot, you’ll be healthier. This mindset should change. If you start educating the young generation at home, they’ll take it with them wherever they go.
“My advice to young people is to find out if you have this disease as early as possible, to avoid the effects of the later stages. We need to stop the continuous queue of diabetes patients in the clinics.”
Georgina Keen, 11, was diagnosed with type 1 diabetes at the age of 5, when her family was still living in the United Kingdom. Georgina, a student at Brighton College, lives in Khalifa City. Her Portuguese-British mum, Fatima Keen, who is an executive secretary, gives her perspective as the parent of a diabetic child.
“Over the space of a week, Georgina lost weight, was really thirsty and kept vomiting and using the toilet. I just thought it was a bug – it didn’t cross my mind that it was diabetes. The doctor tested her urine and found glucose in it. She then tested her blood, after which Georgina was rushed to hospital. Two hours later, she was diagnosed as a type 1 diabetic, meaning her body had stopped producing insulin.
“The diagnosis was a complete shock to me. Diabetes wasn’t something I’d ever read about and it doesn’t run in our family.
“For the first month, I’d go to the school every lunchtime to check on her. To start off with, she was on needles. Every three months the nurse made a home visit to sit down and chat about how she was getting on. We postponed our move to Abu Dhabi because we weren’t sure if it would be wise, given Georgina’s diabetes. But in 2011, when Georgina was 6, we made the decision to move. Georgina has been on an insulin pump for the last three years and this gives her more independence. The pump attaches onto parts of the body where you have fat – the tummy, or the tops of the arms and legs, and it’s changed every three days. She has a sensor that comes with the pump for peace of mind, so at night-time, if her sugars drop, the sensor talks to the pump and cuts off the insulin altogether. During the day, the sensor tells her ‘your sugars are high’ so she needs to give herself more insulin, or ‘your sugars are dropping’ so she needs to have a juice or a piece of fruit. And every time Georgina does some exercise, she has to check her sugars.
Georgina doesn’t let her diabetes stop her from doing anything. In fact, she does more exercise than most people. As well as PE lessons, she plays tennis and golf, she dances four times a week and she swims.”
Georgina says she can’t remember life before her diagnosis. “I can’t remember ever not having diabetes. It’s no big deal, but what I dislike most is pricking my finger to check my blood glucose. People think you can’t eat everything because you’re diabetic, but you can – you just can’t have treats like sweets and chocolate every day.”
David Evans, 53, a safety manager from the United Kingdom, who lives in a houseboat in Abu Dhabi, found out he had type 2 diabetes four years ago, after moving to the UAE.
“I started getting a funny feeling in my feet first, as though I had sand in my shoes. I kept taking my shoes off to try to knock the sand out. I went online and read about diabetes, but when I saw all the other symptoms I thought ‘I don’t have any of that’. There was no sudden weight loss or gain, raging thirsts, or constant need to go to the toilet. I was working offshore at the time as a life-support supervisor, and a routine glucose test for my company revealed my blood sugar was very high – 320mg/dl. My father and my grandmother were diabetic and definitely in my case, it was also due to my lifestyle. I was overweight, I love chocolate and I wasn’t getting any exercise.
“I’ve also got hypertension, which is fairly common with diabetes. If your cholesterol starts climbing, there’s a fair chance your endocrine system is compromised and diabetes might shortly follow. Or, diabetes is there and that’s why the cholesterol is climbing. My doctor told me my cholesterol was off the chart and there was so much fat in my blood, it was actually tinged yellow.
I started running on the treadmill for about a year, but then I had three or four heart attacks while running, although at the time I didn’t realise that’s what they were. I’d stop, not breathe for a few seconds, take a big breath and hold my breath, then I’d be OK. I was taking Janumet for medication, and a lot of people report an increase in heart attacks with Janumet, because not enough oxygenated blood reaches the heart.
“I went to the doctor and had a stress test. I was put on a treadmill with an ECG. And while this was happening, I had a heart attack and was rushed to A&E [Accident and Emergency]. I had a 90 per cent blockage in my descending artery. Instead of running, I now do 30 kilometres three times a week on the stationary bike.
“I’m supposed to avoid everything high cholesterol, but I’m not very disciplined. I take a hormone to increase my insulin production (Trulicity), and one of the side effects is it makes me feel nauseous every time I eat, which makes me lose weight.
“I do have regrets about the past. I worked for 30 years offshore and my job was sitting down for 12 hours a shift, so I tended to only exercise in bursts. The food offshore is usually fatty and there’s not much choice – there’s always salad, but it’s never a particularly exciting option. I also tended to get bored and ate sweets, which wasn’t smart.
“My cholesterol and my diabetes are both now under control. When I go on the bike, my blood glucose level goes down to absolutely normal, which lets me have a bit of freedom to eat what I like, but I don’t indulge as I used to. I’ll eat sensibly five days a week and have a couple of treat days.
The worst thing about diabetes, apart from having to take medication every day, is the feet, and most diabetics say the same. Most of the time when I’m walking, I feel like I’ve got marbles under the soles of my feet. The peripheral nerve damage is why a lot of diabetics end up having their feet amputated – you don’t realise you’re hurting your feet when you’re rubbing against something, or you get infections and don’t notice them. Also the blood supply gets cut off. At the moment, it’s more annoying than painful. Crocs shoes are the best thing, because they massage my feet.”
Know the signs
Dr Safdar Naqvi of Imperial College London Diabetes Centre in Abu Dhabi highlights symptoms that could signal diabetes.
• Frequent urination: The average person will urinate four to seven times per day depending on the state of their hydration. If a person is going much more, it could be a sign that they have diabetes. Your body reabsorbs glucose when it passes via the kidneys but for someone with diabetes, with elevated blood sugar levels, your body may find it difficult to bring it all back in and so will produce more urine to get rid of the excess.
• Increased thirst: This is a side effect of frequent urination, which results in loss of fluids in the body and the feeling of constant thirst as your body needs to replenish the fluids.
• Unexplained weight loss: Losing weight without any change to normal food intake, exercise/activity or emotional factors could be a warning sign of diabetes. What happens is that insulin is not transporting glucose to the cells in the body where it can be used for energy. In turn, the body thinks it is going into starvation and starts breaking down other fuel sources, such as fat and protein, for energy resulting in weight loss.
• Weakness and fatigue: This could be a sign of diabetes related to high blood glucose levels and its associated effects, which contribute to weakness and fatigue.
• Numbness or tingling in hands, legs or feet: Diabetes can cause damage to the nerves in the extremities causing weakness, numbness or pain. If you suspect any unusual feeling in your hands, legs and feet, it is best to get them checked out by your doctor.
• Blurred vision: Sight problems, such as blurring of vision, may be a sign of diabetes due to the effects of sugar on the lens.
• Frequent infections: High blood sugar levels can affect a patient's immune system, leaving them more vulnerable to infections.
• Slow healing of cuts and bruises: Blood is needed to heal cuts and bruises, so when blood vessels are being damaged by the increased levels of glucose in the body, the healing process may be delayed.
• Itchy skin: This can be a sign, especially if it is localised, as fungal infections are common in diabetes but sometimes is related to dry skin, which is also common.
• Constant hunger: Related to fluctuations in blood sugar, constant hunger may also be a sign of diabetes.
Dr Safdar Naqvi, executive and medical director, consultant physician and endocrinologist, Imperial College London Diabetes Centre, Abu Dhabi