Diabetes: a Very Arabian Epidemic


The statistics are frightening. In Saudi and the Emirates, the incidence of type 2 diabetes is expected to increase by over 200% over the next decade. One in four on the Arabian Peninsula over 30 is currently estimated to be diabetic or glucose intolerant and it may be present in 25% of the total Saudi population. And even more frightening is the fact that this is a conservative estimate, as up to half of them don’t even know their diabetic.

So why are the people of Arabia prone to one of the most chronic conditions of our time? And why are they dying in their droves from a disease that is essentially preventable? Why are so many Saudi’s suffering daily from morbidity of its complications and many of them in silence too?

Modifiable Risk Factors

The modifiable factors are obvious. There is no doubt that the sudden impact of the wealth generated by the oil industry has changed the lifestyle of the Saudis and their compatriot Arabians. With money comes choice, and as, you might expect, and, as seen in other countries, a more sedentary lifestyle. Cars, computers, mobile phones, TV remote controls have made us all lazy, and less likely to be active. This, of course, leads to a propensity to obesity, which is a major risk factor for diabetes.

In Saudi hospitals, the consequences of diabetes are all too prevalent. The complications of diabetes caused by nerve damage and foot disease has led to an awful figure of up to three limb amputations a day as a direct result of diabetes. Many are at increased risk of cardiovascular disease because of their diabetes exists as part of the cluster of metabolic syndrome symptoms.

Changing Lifestyles

With increased wealth on the Arabian Peninsula, food becomes more plentiful and available. Food portions have increased dramatically in recent times, and so has the choice of food available, and this undoubtedly is one of the attractions of living in the region. Choice, however, also means a greater variety of fast food outlets too, as well as healthy options. And, with this increase in choice and size of portions, plus the sedentary lifestyle comes the increased risk in obesity. Unfortunately, because of the convenience of fast foods, many Saudis are becoming more obese, and this adds to the scary diabetes statistics.

Saudis, on a whole, drink too many high-sugar drinks. The climate is arid and very hot in most of the country and there is no doubt that hydration is critical. A reliance of a huge variety of sugary juices and sodas as thirst quenchers is undoubtedly a precipitator of pre-diabetic symptoms.

Smoking and Diabetes

Smoking is another cause of diabetes in that it is associated with higher blood glucose levels. So smokers are at increased risk of becoming diabetic. This is independent of other factors, although the mechanism of action is unclear.

Desert Climate

The climate of Saudi Arabia also impacts directly on the opportunities to exercise or even to be active. Most people just quickly alternate between the various air conditioned environments when it is hot. There are a limited number of options to exercise. The gyms are excellent when they are available but they are expensive and they can get very crowded at certain times, especially at night. In the summer, it is almost impossible to exercise outdoors with the unforgiving high temperatures.

Genetic Contribution to Diabetes

Type 2 does have a genetic component, and despite the various modifiable risk factors contributing to an abnormally high incidence in Saudi, there does seem to be some sort of independent genetic component. Saudi is number three in the world in incidence, the Emirates is number two, and it cannot just be modifiable risk factors that reflect such a high incidence. The, relatively, constant gene pool in the Gulf does seem to concentrate what seems to be some sort of genetic contributor to type 2 incidence in the region.

What is the Future

So what can be done to improve things? Education and prevention are the key approaches. This involves the continued work of health professionals (including the excellent continuing CADISS research) and the government in their health promotion messages. And in the education of those with diabetes, their families and those who are at increased risk for various reasons such as the obese and smokers. As seen in all countries, modifiable risk factors that include lifestyle factors are particularly difficult to change.

In the case of the Gulf, lifestyle change to promote better health is particularly hampered by tradition, an as yet unquantifiable genetic component to type 2 disease and, of course, the particularly inhospitable summer weather.

Conor Caffrey is a writer on health, science and medicine

Other articles by Conor Caffrey about diabetes

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4 Responses to “Diabetes: a Very Arabian Epidemic”

  1. This is very interesting news and views on this slow-killer disease. In a very recent review paper, Ng SW et al (Obesity Rev. 2011 Jan; 12(1):1-13) highlighted the prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States (Bahrain, Kuwait, Qatar, Oman, Saudi Arabia and the UAE). This study showed that obesity is common among women; while men have an equal or higher overweight prevalence. Among adults, overweight plus obesity rates are especially high in Kuwait, Qatar and Saudi Arabia, and especially among 30-60 year olds (70-85% among men; 75-88% among women), with lower levels among younger and elderly adults. The rate of increase in obesity was pronounced in Saudi Arabia and Kuwait. Prevalence of obesity is high among Kuwaiti and Saudi pre-schoolers (8-9%), while adolescent overweight and obesity are among the highest in the world, with Kuwait having the worst estimates (40-46. Among nutrition-related non-communicable diseases, hypertension and diabetes levels are very high and increase with age, with the UAE performing the worst because of a rapid rate of increase between 1995 and 2000. It has been suggested that additional monitoring of the prevalence of metabolic syndrome and cancers is necessary. Nationally representative longitudinal surveys with individual, household and community-level information are needed to determine the importance of various factors that contribute to these troubling trends.

    • Dear Dr Dermine
      I will have a look at this paper thank you.

      Has there been any research to see if Arabians can be categorised as healthy obese or unhealthy obese?

      Do you think it is relevant to look at populations in the gulf in terms of Western ideas of what is normal weight?

      conor

      • Very interesting questions, we are carrying a large program on obesity and diabetes. hopefully we will be able to answer many hidden question including the ones you have proposed.
        Said

  2. Nice article, thanks.
    http://www.mysticmedicine.com/blog/284-diabetes-in-the-muslim-world Check this short video out on the same subject.

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