THE TIMES KUWAIT REPORT
World Diabetes Day (WDD), marked each year on 14 November, is a timely reminder of the growing global prevalence of diabetes and the significant challenge that it poses to the health and well-being of individuals, families and societies worldwide. In Kuwait, the Dasman Diabetes Institute (DDI) is leading the fight against diabetes, employing a multifaceted approach of research, treatment, and raising public awareness.
Diabetes claimed the lives of 6.7 million people worldwide in 2021 alone; in comparison, over a three-year period from January 2020 to the end of 2022, the number of people who succumbed to COVID-19 pandemic was around 6.9 million. Globally, 537 million adults, or one in ten of those aged 20 – 79 years, were living with diabetes in 2021. A further 541 million people were found to have Impaired Glucose Tolerance (IGT), which placed them at high risk of developing type 2 diabetes. And, even more shockingly, almost one-in-two (44.7%) adults currently living with diabetes were unaware of their status before being diagnosed.
While the world population is expected to grow by 20 percent, between 2020 and 2045, the prevalence of diabetes is projected to increase by 46 percent; growing from 537 million in 2021 to 643 million by 2030 and 783 million by 2045. These figures and other dismal facts on diabetes are revealed in the latest iteration of the IDF Diabetes Atlas, an authoritative source on the prevalence of global diabetes, published annually by the International Diabetes Foundation (IDF)..
In the Middle-East and North Africa (MENA) region, the prevalence of diabetes has witnessed a decadal doubling since 2000. The number of adults diagnosed with diabetes in the MENA region, which stood at around 17 million in 2000, rose to 33 million by 2011, and 73 million in 2021. Projections indicate that diabetes in the region is set to soar to 95 million by 2030, and reach 136 million by 2045, or roughly 18 percent of those living with diabetes globally.
Moreover, with 75 percent of adults diagnosed with diabetes now living in low- and middle-income countries, it is not surprising that almost 90 percent of undiagnosed cases of diabetes were also found to be in these nations. Low rates of clinical diagnosis of diabetes in states and territories are often the result of fewer resources available to authorities to conduct diabetes surveillance, lower capacity in existing health systems, and insufficient access to healthcare for individuals.
In Kuwait, we are blessed in that people have ready access to the latest diabetes treatment and management of this condition, as well as to the best after-care. The premier establishment guiding diabetes care in Kuwait is the Dasman Diabetes Institute (DDI), which was established in 2006 under the patronage of the late Sheikh Jaber Al Ahmad Al Jaber Al Sabah, the former amir of Kuwait, and founded by the Kuwait Foundation for the Advancement of Sciences (KFAS).
The DDI functions as a tertiary level medical center dedicated to preventing and treating diabetes and other related conditions, through a combination of research, treatment, training, and health promotion. The DDI applies an integrative research approach that brings together different disciplines to help decipher the complex events that result in the development of diabetes. Moreover, the research projects at DDI have translational and clinical components to drive research findings from the laboratories to bedside and from bedside to community-based initiatives to ultimately improve health outcomes in individuals and in the community.
The current Director-General of DDI, Dr. Qais Saleh Al-Duwairi, has been instrumental in prioritizing diabetes research aimed at preventing and managing diabetes among the public. Since taking office in 2016, Dr. Al-Duwairi has been successfully leading a team of top-class physicians and medical researchers at DDI. Employing a multifaceted holistic approach that includes therapeutics and behavioral interventions, the DDI team has been driving clinical projects and programs that improve quality of healthcare services, patient well-being, and diabetes outcomes.
Diabetes research at DDI has led to shedding light on several new aspects of diabetes in Kuwait, including the role of genes in the development of diabetes. “We recently found a stretch of genes, specific to the Kuwaiti population, that makes them susceptible to metabolic disorders like obesity and diabetes, and high blood pressure. More studies will be conducted to understand how we can use this information in disease diagnosis, management and prevention in the region,” said Dr. Al-Duwairi in a recent media interview.
Another ongoing successful DDI program is Dose Adjustment for Normal Eating, or DAFNE for short, which is a structured education program aimed for people with type 1 diabetes. The program, which targets people with type 1 diabetes who are 18 years and above, helps them to manage and live well with their condition. During the 25-hour program, participants learn how to estimate their carbohydrate intake for each meal and adjust their insulin dose accordingly.
Although such programs are available in the UK, Germany, Ireland, and Singapore, DDI continues to be the only endorsed training center for DAFNE in the Middle East. In addition, DDI provides accredited training and development opportunities for professionals through face-to-face and online platforms, with more than 1967 professionals provided with training and development opportunities in 2022.
Last September, DDI also initiated the Kuwait Adult Diabetes Epidemiological Multidisciplinary (KADEM) study, the first longitudinal study involving people with elevated risk of diabetes in the population.. The study, which is a continuation of the Kuwait Diabetes Epidemiology Program (KDEP) conducted in 2012, aims to create a comprehensive research dataset and detailed characterization that will make it a valuable resource for understanding the prevalence and risk factors of diabetes in Kuwait.
The information gathered will serve as the foundation for crafting more effective prevention and treatment strategies and programs that ultimately improve the health outcomes and well being of the population. This critical information will also help pursue further research into diabetes and its related comorbidities such as obesity and overweight among people in the country.
A related study in the United Kingdom in 2019 found that almost 75 percent of people with type 2 diabetes had at least one comorbidity during their diagnosis, with 44 percent having at least two health conditions alongside diabetes. Studies in the United States have also shown that nearly 90 percent of adults with type 2 diabetes in the country were also overweight or obese.
Despite concerted efforts by the DDI to leverage cutting-edge research and provide innovative protocols to treat and manage diabetes, the latest figures on diabetes from the 2022 IDF Diabetes Atlas reveal the high level of diabetes in Kuwait.Data from the Atlas reveal that Kuwait has a 25.5 percent prevalence of diabetes in adults, with more than 803,400 cases of diabetes among adults in 2021.
Previous studies in Kuwait by local and international health experts have revealed an intricate relationship between high diabetes rate in Kuwait and the prevalence of overweight and obesity among the population. In Kuwait, with childhood obesity rising rapidly, a related study found that if no mitigating measures are taken, 52 percent of adults in the country could be expected to suffer from obesity by 2035, placing the country in the very high-risk category.
The link between obesity and diabetes has also been on the radar of research studies at DDI. In addition to translational research, and its efforts to prevent, diagnose, and treat diabetes, the DDI also organizes various year-long events and activities to raise awareness on the growing health concerns posed by diabetes. Besides providing free consultations and screenings for diabetes, these events also aim to enhance knowledge among the public on prevention and management of diabetes, and its related conditions such as overweight and obesity.
Implementing comprehensive health promotion programs and awareness campaigns is absolutely crucial in preventing and managing diabetes. Investing in these initiatives, and encouraging the participation of all stakeholders, including healthcare providers, the authorities, civil society organizations, and families of diabetic patients, can make a significant difference in the lives of those affected by this condition.
With millions of people having diabetes not having access to essential and appropriate diabetes care, the theme for World Diabetes Day 2021-23 is ‘Access to Diabetes Care’. The specific slogan for the 2023 campaign is, ‘Know your risk, Know your response’. For people living with diabetes, awareness and access to the correct information and best available medicines and tools to support self-care is vital to delay or prevent complications.
For people at risk of type 2 diabetes, knowing their risk and what to do is important to support prevention, early diagnosis and timely treatment. For healthcare professionals, access to sufficient training and resources is required to detect complications early and provide the best possible care. In many cases, diabetes can be delayed or prevented by adopting and maintaining healthy habits.
Unhealthy eating habits and sedentary lifestyles associated with urbanization are among key risk factors contributing to the development of type 2 diabetes. There is overwhelming evidence that lifestyle changes such as maintaining a healthy body weight through a healthy diet and engaging in moderate physical activity can help prevent the development of type 2 diabetes in people at risk of this condition.
Other risk factors associated with type 2 diabetes include family history of diabetes, increasing age, high blood pressure, and ethnicity. Regular screenings and check-ups, especially for people with one or more of the risk factors, can help detect early signs, and allow individuals to make the necessary changes to delay or prevent the onset of type 2 diabetes. Knowing the risk and knowing the response to type 2 diabetes and its complications can mean the difference between leading a healthy life or being overwhelmed by diabetes and its related conditions.
As part of the global fight against diabetes and to mark WDD this year, the DDI in association with the Al Hamra Center is organizing a world diabetes open day at the Exhibition Hall in Al Hamra Shopping Center on 14 November from 11am to 8pm. The day-long event will feature complimentary medical testing and screening, clinical consultations, and nutritional counseling.
Through such awareness events and positive community-wide campaigns, the DDI hopes to encourage individual behavioral changes to address the ongoing diabetes challenge, while inspiring a sustained lifestyle change that will curb related health concerns as well. Holding such events and activities stems from DDI’s mission statement, where health promotion and awareness are a priority, and in line with the Institute’s belief that ‘Prevention is better than cure’.