ABU DHABI // Up to half of diabetics may be skipping vital medication because their treatment programme is too complex or they fear side effects such as weight gain, a new study suggests.
Doctors told researchers that 50 per cent of their diabetic patients were unable to control the condition because they could not properly manage treatment at home.
If not controlled, diabetes can cause cardiovascular disease, stroke, chronic kidney failure, foot ulcers and blindness.
There are 415 million diabetics in the world. Of those, 35.4 million are in the Mena region, and a disproportionate number are in the UAE – 14.6 per cent of the adult population, or more than a million cases in 2015.
“Sometimes people don’t take their medication as prescribed or stop taking it altogether, or they’re resistant to healthy lifestyle changes,” said Dr Amel Bushra El Tayeb, a consultant endocrinologist in Dubai.
Dr Tarek Fiad, also a consultant endocrinologist in Abu Dhabi, said: “A substantial number of people with diabetes struggle with the long list of medicines and start missing doses.
“Besides the heavy load of therapies, patients may skip taking their medication because of undesirable side effects.”
Some patients require a large amount of medication to control their diabetes, often taken several times a day.
“I understand that some become dissatisfied with their medication and elect to stop their treatment,” Dr Fiad said.
“However, it is crucially important to maintain this in order to prevent complications and enjoy a long, healthy life.”
Dr Fiad called for new strategies to help patients who felt overburdened or confused by the responsibility, such as medication that did not exacerbate weight gain, or prescribing fewer but more effective medicines.
“In the past few years we have witnessed the introduction of treatments that do not lead to weight gain or very low blood sugar levels. Another milestone in diabetes therapy was the recent introduction of agents that help lower sugar levels without being reliant on the ability of the body to produce insulin.
“They also help in losing some weight.”
Abbas, 24, a business student in Dubai, has diabetes and has to take several medicines three times a day.
“I don’t miss them. I can maintain having all of these throughout the day,” he said, although he was warned by his doctor that the medication could trigger gain weight.
“Exercising is not a problem, but it’s difficult for me to eat healthily. I am in the habit of eating junk food and chocolate.”
Abbas visits his doctors every three months and has not had to change his medication in the past 14 years.
The study of 200 doctors with diabetic patients was carried out last year by the pharmaceutical company AstraZeneca UAE.
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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