Six out of the world’s top ten countries for highest prevalence (%) of diabetes are in the Middle East and North Africa Region – Kuwait, Lebanon, Qatar, Saudi Arabia, Bahrain and the United Arab Emirates. The region has the highest comparative prevalence of diabetes (11.0%). Rapid economic development coupled with ageing populations have resulted in a dramatic increase in the prevalence of diabetes1.
Over the past three decades, major social and economic changes have occurred in the majority of the countries in the region. These include progressive urbanisation, decreased infant mortality and increasing life expectancy. With this rapid development, especially among the more wealthy oil-producing countries, come significant changes involving poor nutrition, decreased physical activity, increased obesity and smoking.
Diabetes occurs when the body’s regulation of the levels of sugar in the blood is disrupted.
We all take in sugar, or glucose, from food and drink that contains carbohydrate. The body breaks down food and drink into glucose and the blood carries it to cells throughout the body. Insulin - a hormone produced by the pancreas – then helps the glucose to enter the cells where it is converted into fuel for our body.
In Type 1 diabetes mellitus the body is unable to produce any insulin because the immune system has mistakenly destroyed the insulin-producing beta cells of the pancreas. This form of diabetes often starts in childhood or young adulthood. It is also known as insulin-dependent diabetes mellitus and accounts for between five and 15 per cent of people with diabetes.
In Type 2 diabetes, not enough insulin is produced or the insulin that is made by the body does not work properly. This is known as insulin resistance. Type 2 diabetes tends to affect people as they get older and is the most common form of diabetes.
The result of both types of diabetes is that there is too much glucose in the blood whilst the cells are starved of energy.
If diabetes is not managed, high blood glucose, also called hyperglycaemia, eventually damages nerves and blood vessels. Diabetes is often associated with complications including heart disease, stroke, kidney disease, nerve problems, blindness, gum infections, amputation and even death.
At Roche, our research in diabetes is continuing to develop our understanding of the disease and drive development of new diagnostic solutions and medicines.
Type 1 diabetes develops when the insulin-producing cells in the pancreas have been destroyed. It is not yet known why these cells have been damaged by the body’s own immune system and at the moment you cannot prevent Type 1 diabetes.
There are a number of risk factors for Type 2 diabetes – including having a close family member with the disease, being overweight or having high blood pressure. The more risk factors you have, the greater your risk of developing diabetes.
At Roche, our understanding of people’s predisposition to develop diabetes and the mechanisms of diabetes is integral to our ambition to develop even more personalised solutions to manage and tackle the disease.
The signs and symptoms of Type 1 and Type 2 diabetes can include an increase in thirst and tiredness, weight loss, frequent urination and blurred vision.
Type 1 diabetes will usually develop quickly and become obvious over a couple of weeks. Type 2 can be less easy to diagnose.
It is important to take action quickly if you do have any symptoms because prompt diagnosis and treatment reduces the chance of developing any serious health problems.
Doctors can use a range of tests to diagnose diabetes. A fasting plasma glucose (FPG) test measures blood glucose in a person who has not eaten anything for at least eight hours. An oral glucose tolerance test (OGTT) measures blood glucose after fasting for eight hours then having a glucose drink and testing two hours after. A random plasma glucose test measures blood glucose regardless of when the person last ate.
If a test indicates diabetes, it is then repeated on a different day to confirm the diagnosis.
Although diabetes cannot yet be cured, it can often be successfully managed. The main aim of treatment is to achieve normal levels of blood glucose, blood pressure and cholesterol to maintain a person’s quality of life and prevent or delay any health complications.
Type 1 diabetes is treated with regular insulin injections and a healthy diet plus regular exercise. For Type 2 diabetes, lifestyle changes such as a healthier diet, weight loss and taking more exercise can make a difference. Medications to balance blood glucose levels and insulin may also be needed.
One of the most important elements of managing diabetes is to monitor blood glucose levels through a measurement known as HbA1c. This test measures the amount of glucose carried by the red blood cells. There is consensus that achieving control of blood sugar should be a major goal of diabetes management. However, many people are still not achieving recommended blood sugar targets despite lifestyle changes and pharmacologic therapy.
Efforts to achieve control of blood sugar can sometimes lead to complications such as low blood sugar levels (hypoglycaemia) and weight gain. Hypoglycaemia is a serious complication that can cause a spectrum of symptoms. Given that many people with Type 2 diabetes are overweight, minimising both weight gain and hypoglycaemia should also be considered in managing diabetes.
If appropriate, regular blood glucose testing can be carried out by the person with diabetes themselves. Using a small hand-held meter device and single drop of blood at a time, people with diabetes can check their blood glucose levels within less than a minute. This helps them maintain day-to-day control, detect hypoglycaemia and assess control during any illness.
Roche’s diagnostics team works closely with healthcare practitioners to ensure people with diabetes have access to the most appropriate monitoring systems and devices. We would like to see everyone who could appropriately benefit from self-monitoring to be able to do so.
Roche will continue to invest in research and development to drive further advancements in technology, products and services for diabetes care.
Roche is developing cutting-edge diagnostic technologies combining blood glucose management, insulin delivery and data management. This will ensure that people have the opportunity to manage their diabetes more easily before it is too late and complications have set in.
We will continue to research autoimmune diseases, including diabetes, at a molecular level with the aim of developing more personalised treatments.
We hope that some day there will be a cure for diabetes. In the meantime, Roche will continue to use modern technologies to provide healthcare professionals and people with even more powerful solutions to make living with diabetes easier.
IDF Middle East & Africa
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