The Burden of Diabetes: Diabetes Leadership Forum, Qatar
Right this second, there are over 200,000 people in Qatar suffering from a condition that wrecks quality of life, damages the body, and can even prove fatal: Type 2 diabetes. More worrying still, this number is set to nearly double within 40 years. The Diabetes Leadership Forum in Qatar took place on 26 and 27 September 2016 and looked at the burden this modern disease places on the economy, society, and individuals themselves, both globally and at a local level. With diabetes on the increase, the financial and personal costs are spiraling out of control. What can be done to curb the rise of this fatal, yet preventable, disease?
Global Impact of Diabetes
The World Bank’s Practice Manager for the Middle East and North Africa, Dr. Ernest Massiah gave a harrowing review of the global health situation. Worldwide, the burden of disease has shifted drastically in the last twenty years from communicable diseases to non-communicable diseases (NCD’s), such as diabetes and cancer. This is no longer a problem affecting only rich countries; low-income countries have joined in on the trend. In fact, the $1.7 trillion global spend on NCD’s is equally shared; $900 billion are spent in high income countries, $800 billion in poorer nations.
Diabetes in the Gulf Region
Director of the Diabetes Center in King Saud University in Saudi Arabia, Dr. Khalid Al Rubeaan, honed in on the dramatic increase in diabetic patients in the Gulf region. Reminiscing on his days as a medical student in 1977, he recalled that diabetes affected only 2% of the population in Saudi Arabia. Nowadays, the figure is close to 25%. The trend is typical of other countries in the area. In fact, Saudi Arabia, followed by Kuwait and Qatar, are in the top ten countries worldwide with the highest diabetes statistics.
Cost and Social Impact
More than one factor contributes to the cost of diabetes. Hospital stays, outpatient programs, and pharmaceutical drugs are expensive. What’s more, diabetes is often not an isolated condition. Most diabetics will also experience at least one other health condition as a direct consequence, further impacting quality of life and costing thousands per capita to treat. In fact, diabetes is the leading cause of cardiovascular disease, liver failure and blindness. This cocktail of complications sends the healthcare bill shooting to the stars, and puts an extraordinary pressure on medical infrastructure in the Gulf region.
But the cost is also shouldered by diabetics themselves. They are more likely to take time off work, and to be less productive. Reports indicate that diabetics are also less likely to be hired. The time and money needed for transport, medicine, visits to care centers all add to the financial burden of working fewer hours. This puts an incredible amount of stress on diabetics and their families. Relatives may need to reduce their working hours to care for them. It’s a cascade of social and economic costs, felt at all levels.
The most striking factor in diabetes risk is obesity. And obesity is also rising at an unacceptable rate. Nearly 30% of children are obese—most of them will grow up to be adults with poor quality of life and severe health problems, further increasing the pressure on health budgets. While there may be some genetic factors involved in obesity, diet, exercise and social habits play the major part. Smoking is still very prevalent. Calorie intakes are at an all-time high and rising steadily, while physical activity levels are rock bottom. If nothing is done, forecasts estimate that by 2050, one in two people in Qatar will be diabetic.
Current Diabetes Prevention Strategies
Dr. Al Rubeaan, who lost a colleague to diabetes last week, stated that while there are some initiatives, more needs to be done to tackle the growing problem in the area. The health system is free, but quality has some way to go to meet proper standard. The problem is infrastructure—there simply aren’t enough medical staff to cope with the increasing number of people with diabetes. “73% of diabetic patients haven’t had an eye check in 10 years.” Things need to improve, and the focus has to change from diabetes management and treatment, to preventative measures. Dr. Al Rubeaan stated strongly that the priority should be given to primary prevention strategies—education, awareness, and helping people understand how to protect themselves from this disease. “Spending QR1 on prevention saves QR1,000 on future medical costs.”
Diabetes in Qatar
The situation in Qatar is concerning. One in six people has diabetes, one in five is pre-diabetic. Most people, 80%, have a poor diet; 60% have a family history of diabetes. As the population ages, more and more will develop the condition. According to Professor Abdul Badi Abou Samra, Chairman of Internal Medicine at Hamad Medical Corporation, Director of Qatar Metabolic Institute and Co-chair of Qatar National Diabetes Committee, if no action is taken, the number of Qatari nationals with diabetes will quadruple in the next 40 years, and the costs will see a similar rise. In fact, estimates indicate that by 2050, Qatar will spend $130 billion on the treatment of diabetes and its related complications.
Most of this will be spent on pharmaceutical medicines and treating on-set diabetes, rather than prevention strategies. And yet prevention strategies are vital to put a stop to the current trend and to prevent a future where half the population is sick and in need of medical care.
Qatar National Diabetes Strategy
Professor Abou Samra spoke of plans for the implementation of the Qatar National Diabetes Strategy, a program to raise awareness of diabetes and empower individuals to adopt healthier lifestyle habits to manage their condition. The plans include a national screening program, set to launch in 2018, to identify all undiagnosed diabetics and pre-diabetics. People who are not aware they have the condition will be directed to the right care center and will be given tools for self-care, thereby preventing further health complications. The successful implementation of the national diabetes strategy would have a positive impact on two levels. On an economic level, these prevention strategies could slow the spiraling cost, and reduce the projected healthcare bill from $8.4 billion annually to $6.6 billion—a step in the right direction. On an individual level, the program would result in better quality of life and improved health, as well as a more productive workforce.
Prevention is Better than Cure
The world is suffering a diabetes epidemic. Unchecked, unrestrained, this disease could end up affecting over half the population and costing trillions in healthcare costs and lost productivity. The current treatment model is failing to address the reasons why increasing amounts of people are succumbing to diabetes. More needs to be done, in terms of education, changing social, dietary and exercise habits, designing urban spaces that encourage healthier lifestyles and tackling the food industry. Only with a prevention strategy that encompasses all these factors, will we be able to beat diabetes.