Thursday, Feb 16, 2017

Dubai: “Nearly one million people in the UAE have diabetes and what is more worrying is that nearly 450,000 more are estimated to be undiagnosed cases,” Nam Han Cho, president elect of International Diabetes Federation (IDF), told Gulf News on the sidelines of the 7th Emirates Diabetes and Endocrinology Congress (EDEC) that opened on Thursday.

He cautioned people of the UAE to become aware of ’the tsunami of diabetes’ hitting them.

The three-day congress being organised by the Emirates Diabetes Federation is supported by the Ministry of Health and Prevention, Dubai Health Authority, Emirates Medical Association and Endocrinology Society. The congress was inaugurated by Humaid Al Qutami, Chairman of the board and Director-General of Dubai Health Authority (DHA).

Al Qutami pointed out that nearly 4.5 million people in the Mena region are diabetics and worldwide, they number nearly 35 million.

“The WHO estimates that diabetes will become the seventh major cause of death around the world by 2030. Countries around the world face a huge health-care expense owing to this and we at DHA are working towards combating this major health challenge.”

The DHA has collaborated with the Dubai Statistics Centre to carry out an emirate-wide household survey on diabetes prevalence.

Dr Abdul Razzak Al Madani, chairman of the Emirates Diabetes Federation (EDF) and president of the congress, said the need was to create a wave of awareness to bring individuals as yet undiagnosed into the arena of knowledge. “Type II diabetes, which is widespread, has a genetic predisposition. While we cannot control this factor, we can control other factors such as obesity, sedentary lifestyles, smoking etc to delay its onset and inculcate a culture of good health.”

Dr Al Madani said that currently, children as young as 13 years are getting afflicted by Type II diabetes. “If we encourage people to go in for early screening, we can teach them to manage their condition with right medication, lifestyle changes, good nutrition to prevent complications such as blindness, kidney disease and foot amputations in the longer term.”

Dr Fatheya Al Awadi, head of Endocrinology at Dubai Hospital, head of DHA Diabetes Committee, general secretary of the Emirates Diabetes Society and vice-president of EDEC, said, “Understanding the exact prevalence of undiagnosed cases is important for us to chalk out preventive and curative policies. We have also been working on other extensive data that’s related to diabetes and this includes data on pregnancy and diabetes. By the end of this year, all DHA hospitals will have electronic patient files and we will be able to know the exact number of diabetics across DHA health facilities as well as their co-morbidities and overall health profile.”

Besides focusing on data, the DHA also chalked out a multi-pronged strategy in 2015 which has been implemented to integrate with the overall combat-diabetes strategy. These are:

PDMS (Post Diabetes Management System) across DHA hospitals

Al Awadi said the DHA has introduced unified protocols for managing diabetes across its health facilities so that every diabetic that visits DHA entities receives the same level of multidisciplinary treatment. The system was available at the Dubai Diabetes Centre and now the same level of care has been extended across all DHA entities.

Dr M Hamed Farooqui, director of the Dubai Diabetes Centre at the DHA, said, “Unified multidisciplinary treatment for all patients is vital so that we control and manage effectively the sugar levels of our patients, ensuring that not only their diabetes is in control but also the complications that come along with the disease. In 2015, they achieved an average of one per cent reduction in the three-month average blood sugar levels of all patients — many of whom suffer from morbid obesity.”

Dr Farooqui said according to a UK prospective diabetes study, a one per cent reduction in the average three-month blood sugar levels means a 21 per cent decrease in the risk of developing any diabetes-related complications and a 14 per cent reduction in the risk of having a heart attack. It also means a 12 per cent reduction in the risk of having a stroke and 37 per cent reduction in the risk of developing small blood vessel disease, including blood vessels in the eyes, kidney and feet.

Joint clinics

Dr Mohammad Hassanain, senior consultant endocrinologist at Dubai Hospital and member of DHA Diabetes Committee, said in 2015, the DHA introduced joint clinics for diabetics with complications to ensure they receive the highest level of multidisciplinary care in one location. He said the joint clinics provide an opportunity for diabetics to visit multiple health care experts at the same time rather than taking several appointments, which is time-consuming and inconvenient.

The joint clinic is the first-of-its kind initiative in Dubai. Dr Hassanain said, “For pregnant women who are diabetic, pre-diabetic or have gestational diabetes, we have a joint clinic so that they can visit their obstetrician and their endocrinologist at the same time. This ensures excellent levels of multidisciplinary treatment and is time-saving.”

The clinic is available on a weekly basis at Dubai Hospital and on a monthly basis at Latifa Hospital. Similarly, the DHA also introduced two new joint clinics in Dubai Hospital. The first clinic is a joint clinic with nephrologists and endocrinologists for diabetics with kidney problems. This clinic will take place on a monthly basis. The second clinic is a bi-monthly clinic with thyroid surgeons and endocrinologists. Dr Hassanain said, “In the thyroid joint clinic, patients will undergo an ultrasound and biopsy on the same day and within two weeks they will receive a treatment plan which is based on inputs from multidisciplinary medical experts.”

Dr Hassanain added that feedback from patients has been very positive. It is extremely convenient for patients and importantly, it has reduced the number of admissions to hospitals due to diabetic complications.

Diabetic training for DHA doctors and nurses

Recently, 25 DHA doctors and nurses working in primary and secondary care completed their master’s degree with Cardiff University in the UK in diabetes management. The DHA has collaborated with the university to provide diabetes diplomas and master’s degrees to DHA medical staff members.

Diabetes Transition Care Programme for Young Adults

Al Awadi said paediatric patients with diabetes are moved to the adult clinic when they are 13 years of age. To ease this transition, DHA has introduced a joint clinic with paediatric endocrinologists and adult endocrinologists so that young adults are comfortable in their new health-care environment.

Diabetes app: Hayati.

In addition to these initiatives, the DHA launched in the last quarter of 2015 a diabetes app to educate diabetics on better management of their condition. Al Awadi said, “The DHA is keen to provide the highest level of care to diabetic patients and we will continue to roll out such initiatives which provide patients with convenience and ensure better patient compliance and outcomes.”

by Suchitra Bajpai Chaudhary Senior Reporter

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