Diabetes takes its toll

The UAE has the dubious distinction of having the second highest rate of diabetes in the world. With Diabetes Awareness Month being observed last month, three students with the condition share their lives with Notes highlighting how it has impacted their lifestyles. Amelia Naidoo and Maysam Ali report

American University of Sharjah (AUS) student and Omani national Shamsa Hamed was only 10 years old when she was diagnosed with Type 1 diabetes. From then on her life was about strict attention to her lifestyle, diet and attitude to the disease.

"I was a happy kid, very young and kind of obese when I started losing a lot of weight over a period of three months. I remember that it was National Day in Oman when I slipped into a coma and ended up staying in hospital for a month in order to stabilise my blood sugar levels and educate me," the fourth-year international studies student said.

Emirati national and AUS student Nada Al Ammari was diagnosed with Type 1 diabetes when she was 14 and experienced drastic weight loss, constant thirst and frequent urination.

"My family and I were in Egypt at the time and my mum was concerned that I was drinking so much water and going frequently to the bathroom. When I went for a medical check-up they confirmed that I had diabetes," Nada said.

Aliah Mohammad is a 22-year-old Indian student studying commerce and human resources at the University of Wollongong in Dubai (UOWD). She was diagnosed with diabetes at age 10, and is insulin dependent.

She said it was hereditary in her case since her grandmother and uncle both had diabetes and she used to have the same symptoms: excessive thirst and frequent visits to the bathroom among other symptoms. "That's when the doctors detected it," she said.

Painful realisation

"It was a shock," said Nada. "No one knew the reason why I got diabetes because I'm the only one in my family who has it. My grandfather and uncles have Type 2 diabetes."

Nada initially had no idea what was in store for her and was horrified to find she had to learn to administer insulin. "I was afraid of needles as a child and not in my wildest dreams did I think I would need to take injections."

At first Shamsa was happy about taking insulin as this eliminated the unpleasant symptoms; but when her parents started monitoring her carefully she realised the disease would be with her for life.

This caused her to rebel against her parents, dieticians and doctors for the next three years. "I couldn't accept this was happening to me and started hating everyone. I would punish my parents and disobey the doctors until I spoke with a psychiatrist who told me that I was not accepting the fact that I have diabetes," Shamsa said.

Acceptance

Once she had accepted reality, Shamsa altered her lifestyle in ways that wouldn't impact her condition.

"I came to accept my condition by taking care of my health, exercising and also researching the disease," she said.

She began volunteering at the diabetic association in Muscat and took particular interest in young children who were also sufferers.

"When you're in the whole mess you're disobedient with parents and doctors and don't realise it's for your own benefit. As a volunteer I knew what the children were going through and would assist the nurse to talk to the children," Shamsa said.

University life

For Aliah, her average day is pretty much like that of any other hard-working student and consists of spending time in classes and on campus. Since she lives in Ajman, Aliah has to leave home very early in the morning to arrive on campus campus at 8am. She attends classes and spends time on campus then leaves for home in the evening to rest, take her insulin shot and have dinner.

"I wake up at 4am, take insulin at 4.30, have breakfast at 5, leave at 5.30 and reach the college at 8am. At 1pm I go to the nurse's office, take my insulin injection and have lunch on campus," she said. The rest of the day depends on the classes she has.

Aliah said she schedules her classes in such a way that she doesn't have to alter her regular meal times and her journey to and from university.

Nada said life on campus and the dorms did pose difficulties. "There are a lot of fast food outlets at university and you tend to sit with friends who are eating junk food while you are eating healthy food."

Nada said it helps to have the support of friends on campus and met Shamsa who told her that eating right and administering the right amount of insulin was not impossible.

"A few years back I would have said my life was hampered by diabetes when I was on injections, but now with the insulin pump (which mimicks the pancreas by continuously injecting insulin into the body) I have no difficulty," Nada said.

She added that students taking insulin injections may find the going a little tough as the shots need to be taken at very specific times of the day.

Shamsa said she struggled to maintain her blood sugar levels when she first got to university as healthy foods were not easily available on campus or in the dorms. She eventually overcame this by telling her friends about her condition and asking for their support in eating healthy and maintaining a healthy lifestyle.

So do diabetics consider their condition debilitating or limiting in any way? Not a chance, they say.

"Diabetes is not a disease that will prevent living your life to the fullest. But the disease will make you organise your life and live healthy," said Shamsa.

Asked whether diabetes affects her life, Aliah said: "Diabetes hasn't hindered me. I live my life as a normal person but with a strict and controlled diet."

Healthy eating

Diabetic people must maintain a healthy diet, with limited sugar intake, to keep their blood sugar under control. Aliah usually relies on cereals and vegetables.

Diabetic students can occasionally suffer from low blood glucose levels, causing them to sweat, feel light-headed and weak and, in extreme cases, faint.

For situations like these, Aliah keeps sweets with her. She said she has had low blood sugar levels before and her friends and the university nurse are familiar with its symptoms. So they know what to do.

Nada eats healthy but doesn't follow any fancy diets. "Even people who are not diabetic should be eating the way I do. You have to count carbs and control portions and also know how much insulin you need to take according to how much you've eaten," she said.

Shamsa prefers preparing her own food in the dorms. "I have my classes organised so that I can take breaks for snacks and lunch. I'm a big fan of salads and sandwhiches but I do crave traditional sweet foods like halawa; I taste just a little bit and that satisfies me."

Universities assist diabetic students

Most universities in the UAE provide diabetic students with a medical centre and extra care if a student requests it. Nurses on campus usually handle these cases.

At UOWD a medical centre keeps students and staff members informed about health issues through seminars, campaigns and health checks held regularly on campus.

Maricel Maravillas, a nurse with its Student Services Department, told Notes: "Diabetes is a growing debilitating disease in this region. The UAE ranked second worldwide in diabetes prevalence. This is mainly due to a sedentary lifestyle, obesity and fatty food ingestion.

"We are aware of this problem and we are conducting awareness about diabetes on campus regularly with free annual blood glucose check-ups for students and staff and health seminars on the disease, its signs and symptoms, the lifestyle intervention, its management and prevention. The clinic is equipped with a glucometre that checks the blood glucose level of students and staff. The medical centre also has a fridge to keep insulin at the appropriate temperature and ready for use for Type 1 diabetic students or staff members," she said.

Maravillas is there to help students at all times. She helps Aliah with her insulin injections and any other glucose tests when needed.

Shamsa said the nurses and doctor at the AUS clinic are very familiar with her condition. "Every student who joins the university requires a medical check-up; when the university doctor found about my condition he asked me about it."

In the three years she has been at AUS she has had two incidents when her blood sugar levels dropped to dangerously low levels. "Thank God, the university nurses came to my room and took me to the hospital," she said.