A new approach worth trying to tackle diabetes

More attention should be paid to a medical condition said to lead to diabetes, writes Hind Al Noori.

As a teenager with the expected hormonal fluctuations associated with that age, I saw a few gynecologists several years ago.

If I recall correctly, they all told me that I had the same problem. One simply said it was nothing to worry about and that half the female UAE population shared the condition. Another doctor tried to give me medication for diabetes and remarked that I should probably lose some weight.

It was apparent, to the doctors at least, that I had Polycystic Ovarian Syndrome (PCOS), a condition in which many cysts form in the ovaries. But from all I understood at that time, half the women I knew probably had this same condition, so surely it couldn’t be that bad?

“I’ll try to lose some weight,” I thought, not entirely committed to the idea.

I was about 15kg heavier than what was considered the ideal weight for my height. It wasn’t until several months ago that I stumbled upon something that made things click for me.

The UAE has undergone incredible development in the past few decades. With such rapid development, comes a drastic change in the kind of lifestyles led by members of the community. It is not too unlikely that the health problems we face are a consequence of this development.

The diabetes epidemic in the UAE is a serious matter: it is estimated that 19 per cent of residents are diabetic. The health- care system spends billions of dirhams on diabetes-related care. And prevalence rates are only expected to rise.

Despite the increasing number of treatment facilities and awareness campaigns aimed at helping people lead healthier lifestyles, we still have a long way to go. In a region where it’s too hot to be outdoors for a good chunk of the year, staying active is a big challenge. But because Type 2 diabetes is largely lifestyle-induced, it is preventable and even reversible. Small changes in lifestyle, such as eating less carbohydrate-dense foods and exercising moderately, can go a long way.

But while we work on tackling diabetes, we might also want to look at the peripheries. There are other medical problems we face as well. PCOS, which I mentioned earlier, is a problem for about half of women in the UAE. Again, this is much higher than the global prevalence rates. The condition has implications on fertility, can cause weight gain and may also cause insulin resistance, among other health risks. PCOS does have a genetic link, as does diabetes, but it is also easily managed through a healthy lifestyle. The problem though, is that it is under-diagnosed.

Doctors here are well aware of the problem. However, on a typical visit to the gynecologist, a slightly overweight woman may be told that the cysts will resolve themselves if she were to lose some weight – as was my experience. The problem isn’t that the doctor’s suggestion isn’t true. The problem is that the doctors often fail to mention the serious implications of leaving PCOS unmanaged. Perhaps if I were told that neglecting the situation would open a Pandora’s box of health problems I would have been more likely to take action with regards to my health? I’d like to think so.

Insulin resistance decides to come along for the ride with PCOS and is essentially a precursor of diabetes. Now, if we were to focus on correctly diagnosing PCOS more often, we may be able to treat or prevent insulin resistance in many, which will inevitably be an effective way of reducing diabetes even if just a little.

If we assume that half of those with diabetes are women, about half of that group may have PCOS and by treating them we may be able to cut the prevalence of diabetes significantly, by the most optimistic estimates.

At the very least, we should let women who have (or are susceptible to developing) PCOS know that they could easily be on their way to getting diabetes. This way we might easily help prevent the development of diabetes in a group of people who would otherwise become diabetic.

I’m no doctor, but I think this approach is worth trying.

Hind Al Noori is a writer in Abu Dhabi