Warning of Dh4bn bill for diabetes sufferers in UAE

Doctors predict a third of the population will suffer from the disease by the end of the decade at a total cost of more than Dh31bn.

ABU DHABI // Diabetes could cost the country nearly four billion dirhams a year by 2020, doctors warned yesterday.

By then, the disease will affect one person in three - Emiratis and expatriates - unless drastic action is taken, according to a report presented in the capital.

The report, Diabetes in the UAE: Crisis or Opportunity, has been prepared by UnitedHealth, an international healthcare provider. It was presented on the last day of the World Health Care Congress for the Middle East.

It estimates that within 10 years, type 2 diabetes and its precursor, prediabetes, will affect 32 per cent of the population, at a total cost of about Dh31.3bn.

It puts the blame on the country's obesity epidemic, noting that two-thirds of men and almost three-quarters of women in the UAE are overweight or obese.

Simon Stevens, the president of global health at UnitedHealth Group, said that if nothing is done to reverse the situation, then "a crisis is on hand".

"People don't know they have prediabetes," he said. "It is a silent condition with no symptoms that is only now being recognised as a clinical condition."

However, between a third and two-thirds of people with prediabetes go on to develop the full-blown disease within six years - against one in 20 of those who do not have prediabetes.

According to UnitedHealth, the UAE already spends Dh2.4bn on medical costs related to diabetes and prediabetes. It predicts that will rise by 58 per cent to Dh3.82bn by 2020.

The report was based on two large studies, one from 2000 based on the whole country, and a smaller one in Al Ain in 2007.

Both cover only type 2 diabetes, the type most commonly linked to obesity; no direct figures are available for type 1 diabetes or prediabetes.

The figures for prediabetes also came from the nationwide 2000 study, using the number of people reporting impaired glucose tolerance, an indicator which the report noted was likely to be conservative.

The cost estimates were based on the typical cost of medical treatment in the UAE relative to the US. They included only the direct medical costs, and not the wider economic impact of the disease.

"The estimated costs are provisional," said Mr Stevens, "We need to see more of the cost data produced by government agencies over the next several years to get conclusive answers [on] just exactly how much diabetes treatment will cost."

The good news, he said, was that type 2 diabetes was largely preventable, and the UAE had already taken some steps towards stepping up its prevention efforts - particularly in Abu Dhabi's aggressive screening programmes.

He said programmes needed to be specifically designed for the UAE.

Equally, however, experience of what works elsewhere can help. He called for better primary care clinics, equipped for and trusted by diabetics.

He also said health insurance plans should include incentives "to nudge people to do the right thing for their families' health".

With no "magical drug or pill you pop", the solution has to mean lifestyle changes. For that reason, he said, "progress is much slower".

Dr Maha Barakat, consultant endocrinologist and medical director at the Imperial College London Diabetes Centre in the capital, echoed the call to encourage healthier eating and more exercise.

"Strong evidence has proven that one can prevent the transition from prediabetes to diabetes with modest reduction in weight," she said.

Weight loss of just five to seven per cent has been shown to cut the chance of getting diabetes by more than half.

On the sidelines of the conference, the Health Authority-Abu Dhabi announced a new "Innovator's Forum" to encourage academics, government departments, non-governmental agencies and private companies to come up with ways of tackling chronic ailments such as diabetes and heart disease.

So far it has signed agreements with two big drug companies, AstraZeneca and Eli Lilly.