Diabetes is soaring in the Middle East and Egypt is no exception. The prevalence of diabetes in the country has almost tripled in the last two decades, and it will continue to skyrocket if incident rates remain the same.
Today, 7.8 million Egyptians suffer from diabetes and this number is expected to double by 2035 according to the International Diabetes Foundation (IDF). Given these alarming statistics, Egypt has been ranked among the world top ten countries in the number of patients with diabetes in the Middle East and North Africa by IDF.
Although diabetes is a serious national problem, it is also a global epidemic. According to the World Health Organization, the number of adults living with diabetes has almost quadrupled to 422 million in 2014, with most living in developing countries.
Experts claim that sedentary lifestyles, stress, being over-weight and obese are some of the main factors driving this dramatic rise.
“Many people in Egypt suffer from diabetes because of lifestyle choices,” says Diabetologist Dr. Mohamed Amara. “Eating the wrong foods and being inactive are some of the leading causes of diabetes, particularly type 2 diabetes.”
While both type 1 and type 2 diabetes are on the rise in Egypt, the latter is increasing at alarming rates. To date, about 15% of all adults aged 20 to 79 years suffer from type 2 diabetes, accounting for almost 86,000 annual deaths according to IDF.
Dr. Amara explains that type 2 is a progressive condition in which the body gradually loses the capacity to produce enough insulin in the pancreas, but with increased physical activity and weight loss, one can reduce the risk of this type of diabetes. Meanwhile, type 1 is an auto-immune disease in which the immune system destroys the cells in the pancreas, and it is usually diagnosed during childhood or early adulthood.
Most people living with type 2 diabetes, tend to be from poorer classes. With the government subsidizing bread, flour, rice, cooking oil, sugar and tea, it encourages unhealthy food choices for almost 80 percent of Egyptians who benefit from state-subsidized food commodities.
“Many Egyptians consume foods high in carbohydrates and sugar because it’s cheaper,” says Dr. Amara. And with the current economic crisis pushing up prices for fruits and vegetables, it makes it difficult for the poor to buy more nutritious foods.
Consuming foods rich in carbohydrates and sugar regularly and in large quantities can wreak havoc on our bodies. “Foods high on the Glycemic Index (a measure of how quickly the food we eat affects sugar levels) can lead to a spike in blood sugar levels, “says Angy Aboud, certified nutritionist from the UK.
“As a result, the body responds by producing large amounts of insulin, and over time our blood cells become resistant to insulin and we get stuck in this vicious cycle of high blood sugar and high insulin. In the long term, this roller coaster pattern of blood sugar levels can damage blood vessels supplying key organs in our bodies like our heart, kidneys and eyes,” explains Aboud.
Zeinab, a middle-aged woman living in the outskirts of Cairo, has experienced first-hand how diabetes has affected her family. Her two sons and husband are all living with diabetes. “My sons and husband take their medication daily and try to follow a healthy diet, which consists of limiting carbohydrates, sweets and sugar, but it’s not always easy,” says Zeinab.
Zeinab greatest concern is the health of her family. “My children always complain of tingling sensations in their arms and legs. I’m very worried that diabetes could cause complications in their vision, kidneys, heart or brain. So far, this has not happened and I hope it will never happen,” says Zeinab.
Diabetes does not only profoundly affect the productivity, quality of life and life expectancy of those suffering from this life threatening illness, but it also takes a toll on the country’s public health care system. According to a study published in Annals of Global Health, annual costs of the economic impact of type 2 diabetes in Egypt was estimated at $1.29 billion in 2010. This figure, adjusted with inflation, will be doubled by 2030. With a fast growing population, the health authority in Egypt could face major spending in the coming years if the incident rates of diabetes remain the same.
To date, the ministry of health has launched awareness campaigns, approved new drugs, offered free testing to patients and created a new mobile app to help people detect diabetes and learn about making healthy lifestyle choices. Yet, diabetes continues to skyrocket.
Dr. Amara believes that education among health care practitioners, diabetic patients and the average person is key to combating this epidemic. According to Annals of Global Health, people suffering from diabetes rarely schedule routine eye or foot examinations or go for routine annual check-ups. Diabetic patients also rarely change their eating or exercise habits even after a diabetes diagnosis.
“Although the doctor in the health care center near in our home recommends for my sons and husband to limit carbohydrates and sugar, they don’t always follow his advice,” says Zeinab. “They eat what they want and just increase the dosage of their medication.”
Zeinab’s family is not the only one adjusting medication dosage to suit food cravings and growing appetites. Laila, a young married woman also living in the outskirts of Cairo helps look after her mother-in-law who suffers from diabetes. “I help give her insulin shots and monitor what she eats. But she eats whatever she likes,” says Laila. “If she eats a large meal or has sweets, we just increase the dosage of insulin shots.”
But it doesn’t have to be this way. Nutritionist Aboud has helped many diabetic clients gain control over their health through diet and exercise. “We all know the answer to healthy eating. Avoid junk and fried foods, sweets, and sodas and if necessary consume them in small quantities,” says Aboud. “The best thing anyone can do for their health is to move from white, simple carbs to brown, complex carbs; from high GI to low GI food; and from intense calorie dense food to a balanced diet consisting of a variety of fresh produce.”
She adds that some of her diabetic clients were able to reduce their dependency on medication, and in some rare cases, some no longer needed their medication, particular those who were suffering from type 2 diabetes.
But it’s hard to talk about health and nutrition when many people are struggling in their everyday lives. “It would be very ambitious to suggest nutrition classes in public schools,” says Aboud. The key, it seems, as Dr. Amara suggests is to continue raising awareness on this life threatening epidemic. “More education is necessary. We need to continue increasing awareness about the magnitude of diabetes.”