Type 2 diabetes patients are massively uncontrolled in Middle East

Those were the main messages from a media seminar held on Wednesday May 28th 2008 in Dubai, prior to "Developing actions for better Outcomes in Diabetes care - Devoted 2"— a major professional symposium on diabetes treatment.

The seminar provided insight into developments in the field, including evolutions in treatment strategies advocating the early use of insulin as well as overviews on how the disease influences the daily lives of patients.

Six countries in the region - the United Arab Emirates, Bahrain, Kuwait, Saudi Arabia, Egypt and Oman - have their current diabetes prevalence among the world's 10 highest3.

As with many other countries with high diabetes prevalence, the onset of Type 2 diabetes, which generally develops in adulthood, tends to occur at a relatively young age.

Key regional and international speakers at the seminar included Dr. Madani, Head of the Emirates Diabetes Society; Dr Azar, Professor of Endocrinology at the American University of Beirut - Medical Center; Dr. Dailey from the American Diabetes Association - and the Division of Diabetes and Endocrinology at Scripps Clinic in California.

The seminar also included a multidisciplinary Round Table focusing on diabetic patients moderated by Lebanon's Future TV Medical Reporter Riwa Atrash.

The session featured presentations by Dr Mahghamsi from the Medicine Department at King Khalid Eye Specialist Hospital in Saudi Arabia; Ms Manal Al-Adham, a specialized nurse from Jordan's National Diabetes Center; and Dr. El Zaheri, specialist in Clinical Medicine at the University of Jordan in Amman.

The Devoted initiative was launched in the Middle East in 2007.

Each participating country has drawn-up a local call to action to improve the management of diabetes.

Among the initiatives that were common to most of the participating countries:

1. Increase public awareness on diabetes and early use of insulin
2. Guarantee the availability, accessibility and affordability of treatments via an evidence based review of treatments and their cost-effectiveness
3. Diabetes self management education
4. Education of primary care physicians
5. working with decision makers to improve quality fo care and life of patients with diabetes

Diabetes Mellitus disease

Diabetes mellitus (diabetes) is the term used to describe a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced.

Diabetes mellitus is characterized by abnormally high concentrations of glucose in the blood. The WHO criterion for diagnosis of diabetes mellitus is a level of fasting plasma glucose of 7.0 mmol/L (1.26 g/L) 4.

Diabetes treatments are aimed at lowering glucose levels in the blood, in order to delay the appearance of complications.

Insulins are given as a substitute (Type 1) or a supplement (Type 2) to natural insulin secretion.

A key goal of diabetes treatment is to prevent complications because, over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves, although the person may not know damage is taking place.

It's important to diagnose and treat diabetes early, because it can cause damage even before it makes someone feel ill.

The prevalence of adult diabetes is projected to rise markedly in both developed and developing countries.

Diabetes is now considered by the World Health Organization (WHO) as an "epidemic", and represents a huge burden for societies worldwide.

Thus, the WHO and the IDF (International Diabetes Federation) estimate that the number of diabetic patients in the world is currently between 194 and 246 million, and that this figure should rise to between 333 and 380 million individuals by 2025 3,5,6.

Diabetes prevalence in some countries of the Eastern Mediterranean and Middle East Region (EMME) is among the highest in the world (9.2% in 2007).

This vast region extends from Pakistan in the east to Morocco in the west, and the population is a mosaic of several ethnic groups.

The age distribution pattern of the population is pyramidal with about 50% of the population below the age of 20 years.

According to the IDF, the number of people aged 20 to 79 with diabetes in the EMME region will increase from 24.5 million in 2007 to 44.5 million in 20253.

Moreover, the number of people with impaired glucose tolerance (pre-diabetes) will increase from 22.4 million to 38.6 million during the same period.

Devoted initiative "Developing actions for better Outcomes in Diabetes care"

The Devoted initiative was launched in the Middle East in 2007. Since then, this initiative has mobilized key medical opinion leaders and stakeholders with the aim of improving the management of diabetes in the region.

Every year, the meeting groups together more than 70 specialists from Egypt, the Gulf, Iran, Jordan, Kazakhstan, Saudi Arabia and Lebanon, Participants hail from various disease management related fields, including Endocrinologists, Diabetologists, Nurses and Nutritionists, as well as local decision makers such as access players, governments and private sector representatives, in addition to Pharmaceutical and Therapeutic committees, Nurses and Patient association representatives.

"Devoted is a unique opportunity to pool together and learn from different experiences and opinions from countries of the Middle East, as well as identifying concrete actions for implementation on a country by country basis, thus contributing to the improvement of diabetes care in the region," said Dr. Hisham Mahmoud, Medical Director, Sanofi-aventis Gulf.