The Rise of Diabetes in Middle East and North Africa

Diabetes is one of the leading causes of deaths in the world. The disease that received little attention a few decades ago is now getting the primary focus from governments and private institutions regarding its treatment and management. The World Health Organization (WHO) 2014 estimates put the global figure of the people suffering from Diabetes at 422 million.WTO also indicate that the prevalence rates of the disease among people above 18 years rose from 4.7% in the year 1980 to 8.5% in 2014.Regionally, North America and the Caribbean recorded higher prevalence rate, with a total of 37 million people living with diabetes by the year 2013.The Middle East and North Africa follows with a reported prevalence of 35 million people, and the Western Pacific with a prevalence of 8.6%, although the total number of people suffering from the disease is the highest of all the highlighted regions. The disease has been identified as the primary cause of kidney failure, stroke, heart attacks, blindness and lower limb amputation.

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In the recent times, there has been a tremendous increase in the number of people affected by diabetes in the Middle East and North Africa (MENA).The MENA region is composed of countries of the Pacific Ocean, the Persian Gulf and the extensions of the North Africa shores that span to the sub-Saharan desert. Of the current 34 million living with the disease in the region, more than 17 million cases of diabetes remain undiagnosed, posing an enormous risk of medical complications and poor management outcomes. The International Federation of Diabetes(2015) projects that the diabetes cases in the MENA region will be more than 72 million by the year 2040.The dramatic rise of diabetes in the Arab region is fundamentally due to the enhanced economic prosperity stimulated by the boom in oil, which has, in turn, changed the characteristics of the local populations. Raising awareness among the local communities on diagnosis and management would make a significant contribution to reducing the number of infections as well as the deaths associated with the disease.

Causes of Diabetes in the Middle East and North Africa

The economic boom that has been witnessed in the last two decades is one of the contributors to the rising cases of diabetes in the MENA region. A research conducted by Sherif and Sumpio (2015), show that the economies of the countries in the MENA region have received massive investment in the service industry, making people adopt sedentary lifestyles. A relationship has been established between the increased average incomes of MENA region countries and the drastic rise in the prevalence of diabetes. The new lifestyles have had an implication on the activeness of individuals regarding the physical activities that are known to reduce the chances of predisposing persons to diabetes. Oman, for instance, is one of the Middle East countries classified a high-income nation with an estimated total population of 3.6 million. Although the child and adult mortality rates in Oman are classified as one of the lowest in the world, the country ranked among the top 10 nations of the MENA region concerning the prevalence of diabetes mellitus. Statistics indicate that the mentioned type of diabetes was the 4th leading cause of premature deaths and the 3rd leading cause of disability life in the country in the year 2010(Al-Lawati, 2015).The effect of this phenomenon is outstretched medical facilities and shortages of medical workers in the country(Al-Lawati, 2015)

The prevalence rates in the region, according to Sherif and Sumpio (2015) is compounded by the low level of awareness among the populations of these countries. This situation contributes significantly to the number of undiagnosed cases and the poor management of the disease. When people are not diagnosed early or receive information, the curative and preventive measures against the disease are hampered and avoidable deaths occur. The resultant effect of this situation is increased economic burden on both the governments and the affected families. The awareness disparities, however, are evidenced amongst social groups with their levels of education and incomes. Although there is a lot of information that is available through the media and medical facilities, the penetration rate is still low (Booz Allen Hamilton, 2014).Notably, in Saudi Arabia,27.9% of Saudis diagnosed with diabetes were unaware of the disease in spite of the availability of access to medical facilities(Sherif & Sumpio,2015)

This assertion is consistent with the assessment of the International Federation of Diabetes that many people in the MENA region until recently believed that Diabetes is not a serious disease. The interesting thing to note is that correlation of economic prosperity and steady rise in cases of diabetes in the MENA region does not reflect the same picture in high-income parts of the globe, especially in the United States, UK and Canada (Brixi, Lust, & Woolcock, 2015).The difference between this region can be partly attributed to the differing level of awareness in the said areas. Epidemiological research has also indicated significant disparities in individual states. In Iraq, for instance, the prevalence of the disease in Basra was found to be as high as 19%, way above the national prevalence rate of 7.6 %( Sherif & Sumpio, 2015)

Urbanization as a result of the industrialization of the countries in the MENA region has been cited as a cause for the increased diabetes prevalence. United Arab Emirates (UAE) industrial development has seen a corresponding increase in the number of people with the diabetes-related illness. Research findings show that 31% of all the deaths in the UAE are occasioned by diabetes and related cardiovascular disease (Booz Allen Hamilton, 2014). The effect of industrialization is stressful and sedentary lifestyles which have been linked to the disease. Studies carried out by Sherif and Sumpio (2015) focusing on the prevalence of the disease in Saudi Arabia and Egypt demonstrated that Egypt has the lowest prevalence of 7.2% while Saudi Arabia recorded the highest rate of 21.% in the entire region of MENA. The urban populations in Egypt have a higher rate of diabetes vis-a-vis the rural populations, and the prevalence is not sensitive to the social, economic status of the persons affected. The rural-urban disparities are very broad in Tunisia where the prevalence of diabetes in urban areas is twice higher (12.5%) than the rates in the rural areas (5.8%) (Motala, 2015).These differences show that the issues of urbanization have a significant contribution to the prevalence of diabetes in the MENA region. The prevalence in urban areas can be attributed to the sedentary lifestyle and rising cases of obesity. In Saudi Arabia, the trends that were found among the Egyptians are replicated. The disease is more prevalent in urban areas where prevalence is 25% than the countryside where the average prevalence is 19.5 %( Sherif & Sumpio, 2015)

Genetic studies about the susceptibility of individuals to certain medical conditions have not been extensively explored. This is because race or ethnicity is considered to have developed as a result of cultural, social and geographical modifications and therefore cannot be investigated from biological motivations. However, epidemiological studies have shown vast disparities regarding the resistance characteristics of individuals of different races. For instance, it is estimated that 5% of white people have a higher risk of venous thromboembolic disease, but this variant is rare among East Asians and Africans (Burchard et al., 2003). This means that whites could be more susceptible to the mentioned disease. Similarly, single-nucleotide polymorphisms (SNPs) that are associated with type 2 diabetes due to its effect on insulin sensitivity and secretion have been identified among populations of the MENA region. Arab ethnicities have been found with a rare risk of SNPs for type 2 diabetes. Studies comparing Arabs and Caucasians have shown that Arabs are more susceptible to diabetes. Notably, Iraq immigrants to the MENA region have been found to be exposed to diabetes risk twice more than other inhabitants. The consanguinity among Arabs has played a part in the susceptibility of Arabs to diabetes. Saudis, for instance, were found to have a higher risk of diabetes which is as a result of the genetic effects of fasting blood glucose resulting from consanguinity of the mentioned demographics (Sherif & Sumpio, 2015).The above findings concur with the studies done by Motala(2015) that demonstrated disparities in the prevalence of the disease among various groups in the MENA region. For instance, the research finds that the prevalence is highest among the Emiratis (21.5%) compared to other ethnic groups such as Egyptians (19.5%), Sudanese (17.1%) and Levant (12.1%).The genetic aspect, however, needs to be investigated further because of the limited information available on its correlation with diabetes.

Possible solutions to the problem of diabetes in the Middle East and North Africa

As noted earlier, economic advancement in the Middle East has led sedentary lifestyles of the workforce. This issue can be mitigated through the engagement in various physical activities that help reduce the risk factors. According to Brixi, Lust, and Woolcock (2015) physical activity is recommended for patients with diabetes because exercises have been found to increase sensitivity to insulin among patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM). Although the effectiveness of the physical training in the management of the disease remains unclear, evidence suggests that active societies have recorded fewer cases of NIDDM. Besides, the physical activities reduce chances of persons from suffering from obesity, which is a predisposing factor for diabetes. The workforce in the MENA region can adopt eating lifestyles that do not encourage fats accumulation in the body and thus maintain healthy body weights, which is essential for the smooth circulation of blood to all parts of the body and reduced glucose tolerance. Initiatives from the employers such as physical team building activities can play a role in reducing the risk factors or help in the management of the disease.

Increased awareness among the populations also can make a significant contribution to the alleviation of diabetes problems in the MENA region. Awareness can help to diagnose the disease in its early stages of development, making it easier for medics to administer appropriate interventions that prolong the lives of affected persons or enable those affected live healthy lives (Guthrie & Guthrie, 2009).As indicated in the causes, 17 million cases in the region remain undiagnosed majorly due to inadequate information about diabetes and its effects on the populations. If such cases are detected early, many deaths resulting from heart attacks, strokes, cardiovascular diseases, and hypertension can be avoided. Awareness also is significant in that it can enlighten populations about healthy lifestyle such as dietary foods and regular physical activities (Booz Allen Hamilton, 2014)

A raft of policies by the MENA region governments can play a significant role in tackling the disease. The Economist (2015) recommends that increased investment in healthcare would equip medical facilities with the requisite resources to effectively combat the disease. Investment in health care can enhance awareness and screening, making it possible for health professionals to manage and treat the disease as early when the detection is made. Also, the regions governments should invest in training more professionals as many countries are overstretched due to the drastic increase of dia...