On World Diabetes Day, Burjeel hospitals across the UAE are holding a special campaign titled Sweet Days Aren’t Over. The prevalence of type 2 diabetes in adults is increasing worldwide due to sedentary lifestyles, changes in dietary behaviours, obesity and ageing population. Patients with diabetes are susceptible to cardiovascular disease and complications that affect the eyes, kidneys and nervous system. With the goal of preventing the complications of diabetes, Burjeel Medical City, Abu Dhabi, and Burjeel hospitals in Abu Dhabi, Sharjah, and Al Ain, and Burjeel Day Surgery Center, Al Reem Island, embrace a culture of collaboration by maintaining a proactive approach to diabetes management across a range of disciplines.
Experts from Burjeel hospitals talk to GN Focus and lay down a five-pointer plan to guide you in understanding, diagnosing and managing your diabetes.
Why should patients take diabetes seriously?
Dr Rajesh Kumar Gupta, Specialist, Internal Medicine, Burjeel Specialty Hospital, Sharjah, answers
Diabetes is a chronic condition in which the body cannot effectively use the insulin it produces. The complications that arise from uncontrolled diabetes are many. The disease can affect the heart, eyes and kidneys and even lead to neurological problems in some patients. Diabetes can affect the vascular system and cause serious health issues like atherosclerosis, micro thrombosis and embolism that can lead to myocardial infarction, stroke and gangrene in the legs. Diabetes also causes changes to the eye, leading to conditions like diabetic retinopathy, neovascularisation and bleeding. Diabetic nephropathy occurs when diabetes damages the kidney until it completely shuts down, leaving the patient needing dialysis. Apart from these conditions, diabetes can cause damage to the immune system and affect the patient’s immunity. People with diabetes are also at a higher risk for infection after surgery than others.
What actions should someone who is diagnosed with diabetes take?
Dr Tarek Yacout Saleh, Consultant Endocrinologist, Burjeel Day Surgery Center, Al Reem Island, answers
Awareness is the key to diabetes management. Burjeel Day Surgery Center adopts a multidisciplinary approach to managing diabetes by encouraging patients to consult a team of doctors including endocrinologists, diabetes educators, clinical dieticians, ophthalmologists, nephrologists and dentists. It takes teamwork to manage diabetes, with the patient being the most crucial team member. The first step towards managing diabetes is knowing and controlling the ABCs.
A stands for the haemoglobin A1C test, which shows your mean average blood glucose over the past three months. It is essential to get these tests every three months to understand if your blood glucose level is under control. B is for blood pressure. In people with diabetes, controlling one’s blood pressure is just as important as maintaining their blood glucose. High blood pressure puts the patient at risk for other problems like kidney disease. C stands for cholesterol. Patients with diabetes must control their blood cholesterol, as high cholesterol can increase their risk of heart attacks or strokes. In general, someone with diabetes must aim for A1c levels below 7 per cent, blood pressure below 140/90 mmHg or lower, and LDL cholesterol below 100 mg/dL. Your doctor will make a plan to keep your diabetes under control that you can implement through healthy eating, taking medication on time, and making lifestyle changes like exercising and losing weight.
What are diabetic risk factors and how do we assess them?
Dr Job Simon, Consultant Endocrinologist, Burjeel Hospital, Abu Dhabi, answers
There are predominantly two types of diabetes – type 1 and type 2. Type 1 diabetes is known as juvenile diabetes or insulin-dependent diabetes and is a condition in which the pancreas makes little or no insulin. Risk factors for type 1 diabetes include having a family history of diabetes, genetics, exposure to illnesses caused by certain viruses, and injury to the pancreas. The risk factors for type 2 diabetes include being overweight, having prediabetes, following a sedentary lifestyle, etc. Gestational diabetes is diabetes that you develop during pregnancy. The risk factors for gestational diabetes include being overweight, having a family history of diabetes, having PCOS, having had gestational diabetes in an earlier pregnancy, etc. At Burjeel hospitals, we offer comprehensive screening to assess diabetic risk factors in patients. HbA1c, glucose, insulin, C-peptide, and microalbumin-creatinine ratio are some of the tests included in the comprehensive panel used for diabetes screening and identifying insulin resistance. Our comprehensive tests help in the early diagnosis of diabetes, leading to improved disease management and health outcomes. You can also avail of the special screening packages we are offering throughout the month as part of the Sweet Days Aren’t Over campaign.
What comprehensive solutions do Burjeel hospitals offer for diabetes care?
Dr Abubaker Al Amin Ahmed, Consultant Endocrinologist, Burjeel Medical City, Abu Dhabi, answers
Burjeel hospitals provide comprehensive, patient-centred, world-class and high-quality diabetes care to improve the lives of people with diabetes. We offer innovative care to prevent and control diabetes and its associated conditions and complications. Diabetes care is provided according to approved international standards and delivered by specialised multidisciplinary teams that include consultant endocrinologists in addition to diabetes educationists, dieticians, podiatrists, and psychologists along with a group of experts in a variety of medical specialties, including ophthalmologists, nephrologists, cardiologists, and weight management specialists. At Burjeel, we offer specialised diabetes care for pregnant ladies, adolescents, children, obese patients, and those with foot problems. Our Endocrine Clinics also provide a comprehensive, up-to-date, evidence-based management plan for all patients with endocrine disorders.
Burjeel hospitals offer the latest diagnostics and treatment for diabetes care and management. Sudoscan test, Fibroscan test, ankle brachial test, six-minute walk test, ambulatory blood pressure monitoring, weight management, management of hyperlipidemia, pre-bariatric and post-bariatric patient management, etc., are some of the offerings available for patients with diabetes. Burjeel Medical City also offers cutting-edge solutions such as hyperbaric oxygen therapy in managing many complex diabetic conditions, including diabetic ulcers and diabetic foot.
What do you do if you are diagnosed with prediabetes?
Dr Maliha Hameed, Specialist Endocrinologist, Burjeel Royal Hospital, Al Ain, answers
Prediabetes is when the patient’s blood glucose level is higher than it should be and, if left untreated, can turn into diabetes. Haemoglobin A1C and fasting blood sugar tests are used to confirm this condition. Prediabetes increases the risk of developing other systemic diseases like type 2 diabetes, heart disease and stroke. As it doesn’t have symptoms, prediabetes can go undiagnosed for years. The risk factors for the condition include being overweight, being older than 45 years, having a family history of type 2 diabetes, not being physically active, having had gestational diabetes, etc. It is recommended that people with these risk factors meet with their doctors and undergo testing. Losing some weight and doing regular exercises can help reduce such patients’ risk of developing type 2 diabetes later.
Type 2 diabetes is related to insulin resistance, mainly caused by obesity. It is a systemic disease that can contribute to the damage of organs. Patient compliance regarding following a proper diet and taking medication on time is essential to manage diabetes. In some cases, it is best to eradicate the root cause of the disease that leads to insulin resistance. Drug resistance, obesity-related insulin resistance, and a problem with pancreas functioning are some cases that call for a different treatment method, like a surgical approach. Throughout November, Burjeel Medical City, Burjeel Day Surgery Center, Al Reem Island, and Burjeel Hospital, Abu Dhabi, have endocrine and specialised clinics to provide world-class care to patients with diabetes. Our hospitals aim to set a benchmark in offering surgical solutions, including endocrine surgeries, to manage patients with complex cases of diabetes.
In obese patients, bariatric procedures will help reduce weight and make their bodies capable of regulating blood sugar. Sleeve gastrectomy bypass, biliopancreatic diversion and duodenal switch procedures can not only improve diabetes but also offer a better cure rate.
These procedures may even eliminate the need for insulin or medication. In such cases, the surgeries can be tailored based on BMI, the patient’s age, the severity of diabetes, etc. Today, the guidelines allow bariatric procedures in patients with uncontrolled diabetes with a BMI of 35 and above. However, bariatric procedures are also recommended based on the complexity of diabetes, the extent of secondary organ damage, etc. For type 1 diabetes, a pancreatic transplant is sometimes done. This is performed in programmes wherein people need kidney transplantation. Kidney and pancreatic transplantation are done together in those with diabetes to avoid secondary damage to the transplanted kidney because of diabetes.
Type 2 diabetes is related to insulin resistance, mainly caused by obesity. It is a systemic disease that can contribute to the damage of organs. Patient compliance regarding following a proper diet and taking medication on time is essential to manage diabetes. In some cases, it is best to eradicate the root cause of the disease that leads to insulin resistance. Drug resistance, obesity-related insulin resistance, and a problem with pancreas functioning are some cases that call for a different treatment method, like a surgical approach. Throughout November, Burjeel Medical City, Burjeel Day Surgery Center, Al Reem Island, and Burjeel Hospital, Abu Dhabi, have endocrine and specialised clinics to provide world-class care to patients with diabetes. Our hospitals aim to set a benchmark in offering surgical solutions, including endocrine surgeries, to manage patients with complex cases of diabetes.
In obese patients, bariatric procedures will help reduce weight and make their bodies capable of regulating blood sugar. Sleeve gastrectomy bypass, biliopancreatic diversion and duodenal switch procedures can not only improve diabetes but also offer a better cure rate.
These procedures may even eliminate the need for insulin or medication. In such cases, the surgeries can be tailored based on BMI, the patient’s age, the severity of diabetes, etc. Today, the guidelines allow bariatric procedures in patients with uncontrolled diabetes with a BMI of 35 and above. However, bariatric procedures are also recommended based on the complexity of diabetes, the extent of secondary organ damage, etc. For type 1 diabetes, a pancreatic transplant is sometimes done. This is performed in programmes wherein people need kidney transplantation. Kidney and pancreatic transplantation are done together in those with diabetes to avoid secondary damage to the transplanted kidney because of diabetes.
