Doctor says diabetes estimate is too low

As the Ministry of Health launches a plan to combat the disease, questions are raised about its figures that say 24% of Emiratis are sufferers.

The laboratory at the Imperial College London Diabetes Centre.

ABU DHABI // One of the country's top diabetes doctors has said the number of UAE nationals with the disease or at risk of contracting it may be higher than a new government estimate. On Sunday, the Ministry of Health said it believed that 24 per cent of Emiratis have diabetes as it proposed a 10-year plan to combat the epidemic. Dr Bachar Afandi, the head of the endocrine division at Tawam hospital in Al Ain, said a study his hospital conducted last year in conjunction with UAE University suggested that rate could be several percentage points higher, meaning the total of nationals with diabetes or at risk of it could be more than 50 per cent. He said the ministry's estimate might be conservative since only 15 per cent of the population were believed to be aware they had the condition. The hospital's study showed that "on top of that there is another 14 per cent of people who do not know that they have diabetes. And on top of that you have another 24 per cent with impaired glucose intolerance - we call it prediabetic," he said in an interview yesterday. He suggested the country was facing a substantial public health crisis. Dr Afandi's study was based on a survey of randomly selected residents in the Al Ain area. "It cannot be any worse. Many of the patients will present some kind of complication - maybe heart attacks, renal failure, maybe another disability and that is a huge burden on the nation," he said. The effects of that kind of prevalence of a disease could have serious implications for the economy. As the disease progresses, patients' complications increase, making them less able to hold down jobs and requiring more expensive medical intervention. "I could imagine some poor countries, if they have a prevalence of 25 per cent, they might go bankrupt because of diabetes." Daman, the national health insurer, has estimated that if diabetes continued to rise at its current rate, by 2020 it will cost the country Dh10 billion (US$2.7bn) a year to treat. "You're talking about a disease in which you'll have increased amputations, increased blindness, renal failure causing patients to go on dialysis, heart attacks and so on," said Dr Afandi. He said public awareness was the key to lowering its prevalence. "You need to alert the public to the prevalence of diabetes, the prevalence of complications, and also to talk about how to prevent it. If you endorse lifestyle modifications, and if you educate children at school, you can do many things." The ministry's plan aims to increase testing for diabetes and would attempt to work with the community to support patients with the condition. It plans to launch a publicity campaign to spotlight Type 1 diabetes. Childhood diabetes, or Type 1, cannot be avoided. Children are born with the inability to regulate their blood sugar naturally. Adult-onset diabetes, or Type 2, is often the result of an unhealthy lifestyle. While some people are more prone to the disease than others it can be avoided by sensible diet and regular exercise. Last year it was reported that children in the UAE were being diagnosed with adult-onset diabetes. "There is an underestimation about the prevalence of diabetes for the future," the doctor added. Dr Afandi noted that the Government estimated in 1999 that the disease would affect 24 per cent of the population, the rate it announced this week, only by 2025. It is not just a UAE problem. "What we are experiencing is a phenomenon that is affecting many countries in the world," said Dr Maha Taysir Barakat, medical and research director at the Imperial College of London Diabetes Centre in Abu Dhabi. "Whereas before people may be more active, and have a healthier diet, people are now exercising less and eating more high fat and high-sugar foods. We're seeing a phenomenon that's affecting many countries in the world and is going side by side with a change in lifestyle." The UN estimates that more than 250 million people suffer from diabetes worldwide. In 2007, the International Diabetes Federation launched the Unite for Diabetes campaign to try to co-ordinate efforts at fighting the disease. Dr Barakat said everyone at risk of developing the condition should make changes to lifestyles: "Try to keep a normal body weight, try to keep active and eat a healthy diet." Those who believe they are at risk should consult a doctor. Symptoms of diabetes include frequent urination, excessive thirst and weight loss. [e-mail]