1. Can I fast during
Ramadan if I have diabetes?
For
the majority of people with type 2 diabetes it is perfectly safe to fast during
Ramadan provided that you prepare well and talk to your doctor. However it is not safe for everyone with diabetes to fast. Your ability
to safely fast will depend on your medication. It will also depend on how well
your diabetes is controlled, especially if you’re prone to either frequent high
(Hyperglycemia) or low blood sugar levels (Hypoglycemia).
You
must realise the importance of your medical assessment before you start, especially if you are taking any
medication. Your doctor will guide you to create a fasting plan which works for
you.
People with type 1 diabetes are at a higher
risk compared to those with type 2 diabetes when fasting during the Holy Month
of Ramadan.
It is
very important that as a type 1 diabetes patient intending to fast you should
be closely supervised and have your blood sugar regularly monitored to mitigate
health risks.
2. Do I need to go on
a special diet during Ramadan, if I have diabetes?
No,
you do not need to eat differently. In fact you should eat normally with the
only difference being the time you eat rather than quantity or type of food
consumed.
ICLDC’s
nutritionist Rahma Al Ketbi says that the Ramadan diet should be kept simple and not much different from your
normal daily diet. It should contain foods from all the food groups including:
Bread, cereals or rice
Meat, chicken, fish or beans
Milk, laban or yogurt
Fruits and vegetables
Iftar is the meal that breaks the fast, just after
sunset. It comes after the long hours of fasting.
However, it is important that it
remains a meal and not become a feast!
You must also be very aware of the need
to drink enough to remain hydrated during fasting hours.
One other thing to be particularly aware
of is the risk of increasing blood sugar levels after iftar, especially with
sweet foods.
- How many people have diabetes,
worldwide, and where does the UAE rank?
2012
figures from the International Diabetes Federation (IDF) suggest that 371
million people are living with diabetes, worldwide.
In
the UAE, diabetes currently affects 18.9 per cent of the population, placing
the nation eleventh worldwide for countries with the highest diabetes
prevalence per capita.
It
is also important to note that diabetes is a regional challenge. Saudi Arabia,
Bahrain, Kuwait and Qatar all feature in the top ten countries, worldwide.
These
statistics indicate that the region has high risk factors for diabetes, mostly
related to rising obesity rates and physical inactivity.
Indeed,
rapid economic growth, sedentary
lifestyle and unhealthy diet have all contributed to increased obesity and have
fuelled diabetes prevalence in the region. It is important that we stay focused
on educating region-wide populations on the management and prevention of
diabetes.
- What is the age range of people
affected?
People
of most ages are affected by diabetes.
Type
1 diabetes is an auto-immune condition where the pancreas is attacked by
auto-antibodies causing it to fail. It mostly develops before adulthood in
younger people and remains with them throughout their life.
Type
2 diabetes on the other hand is mainly brought on by an unhealthy, inactive
lifestyle, weight gain and genetics. Obesity is known to increase the risk of
developing type 2 diabetes in adulthood.
However with the rise in childhood obesity in recent years, the
picture has changed. Recent statistics show that 10 per cent of children and
adolescents - between 16 and 17 years old, suffer from obesity, worldwide. In
the UAE, figures suggest that a third of the population is obese, with many of
those school children.
Indeed, there has been an
increase of type 2 diabetes in younger people due to obesity linked to
physical inactivity and unhealthy diets.
- Which group of people is most
affected age/gender etc?
Most
people living with diabetes are between 40 to 59 years, although recent
research is showing a worrying rise among younger age groups.
As
for gender distribution, the estimates for both 2003 and 2025 showed a female
predominance in the number of persons with diabetes. The female numbers were
about 10 per cent higher than for males.
There
was also a female predominance in the number of persons with pre-diabetes in
the estimates for both 2003 and 2025. The female numbers were about 20 per cent
higher than for males.
- We are seeing more children
with type 2, even though it normally only appears in adults over the age
of 40; Why is that?
Research
has indicated that type 2 diabetes is mainly brought on by an unhealthy,
inactive lifestyle and weight gain. In recent years, we have seen a (rapid)
spread over all age groups.
Among
children, type 2 diabetes is fast becoming recognised as a global public health
issue with potentially serious health outcomes.
In
the UAE we are hopeful that through our public health awareness campaign
‘Diabetes-Knowledge-Action’, we will be able to help children and adults alike
living with, or at the risk of developing diabetes. Also through research we
hope to determine why diabetes occurs at such high levels in the country and
instigate further preventative measures.
- How many people are believed to
have diabetes but are undiagnosed?
According to the International Diabetes Federation’s
Diabetes Atlas in 2012, around half of the estimated 371 million people with
diabetes worldwide were unaware they had it.
There is a similar trend in the UAE as the IDF
estimates that just under half of the people with diabetes are unaware that
they have the disease.
8. What are the main causes of diabetes in the UAE e.g
the triggers and factors contributing to diabetes?
Diabetes is a condition that is characterised by an above normal
level of glucose (sugar) in the blood.
It is characterised by either a relative or absolute deficiency of
insulin.
This is because the pancreas does not make enough insulin or
insulin becomes ineffective. Insulin, a hormone generated in the pancreas,
normally controls blood sugar levels and allows the glucose to enter the cells
in the body to provide energy. In type 2 diabetes resistance to insulin is
aggravated by obesity.
In people with diabetes, high levels of glucose remain in the
bloodstream causing hyperglycaemia (high blood sugar).
Those at increased risk include individuals who have a history of
diabetes in their family, people over 40, those who are overweight or obese and
inactive individuals.
Many
people with type 2 diabetes are overweight and obese and this is an important
factor in causing diabetes.
- Is diabetes a big concern in the UAE - and why?
Yes, diabetes has generally been on the
rise in the UAE. According to the International Diabetes Federation’s World
Diabetes Atlas 2012, the UAE is ranked 11th worldwide, with 18.9 per cent
of the UAE population living with diabetes
There seems to be a genetic predisposition
to the disease among UAE nationals and statistics show that they have a higher
prevalence than other nationalities within the UAE.
Tendencies towards an inactive lifestyle,
weight gain, an imbalanced diet and/or a lack of exercise seem to be major
contributors.
Research is on-going with the overriding
aim to help explain why diabetes occurs at such high levels in the country.
This will also help instigate preventative measures.
- What are some of the serious
effects of diabetes you are seeing in the UAE?
Diabetes
brings with it serious complications related to the heart, eyes, blood vessels,
kidneys, feet and nerves.
Some
of the cases that we have witnessed in the UAE are:
Diabetic
eye disease including diabetic retinopathy is a key cause of blindness,
occurring as a result of long-term accumulated damage to the small blood
vessels in the retina. After 15 years of diabetes, approximately two per cent
of people become blind, and about 10 per cent develop severe visual impairment.
Diabetic
neuropathy is damage to the nerves as a result of diabetes, and affects up to
50 per cent of people with diabetes. Although many different complications can
occur as a result of diabetic neuropathy, common symptoms are tingling, pain,
numbness, or weakness in the feet and hands. Combined with reduced blood flow,
neuropathy in the feet increases the chance of foot ulcers and eventual limb
amputation.
Diabetes
is among the leading causes of kidney failure. Approximately 10-20 per cent of
people with diabetes die from this complication.
Diabetes
increases the risk of heart disease and stroke. People with type 2 diabetes are
over twice as likely to have a heart attack or stroke as people who do not have
diabetes.
Overall,
the risk of premature death among people with diabetes is at least double the
risk of those without diabetes. According to statistics, mortality linked to
diabetes mellitus constitutes 75 per cent of the deaths among UAE nationals and
31 per cent among non-nationals
- Is there much awareness of
diabetes and how to prevent it amongst the UAE population?
Diabetes
is now on the country’s top list of health concerns and is being tackled
through awareness campaigns that focus on lifestyle changes.
We
believe that at governmental level the UAE is taking steps in the right
direction by planning various nutrition and physical activity programmes in
addition to driving public awareness campaigns.
Certainly,
at Imperial College London Diabetes Centre we have contributed with a public
health awareness campaign ‘Diabetes-Knowledge-Action’.
Launched in 2007
under the patronage of Her Highness Sheikha Fatima bint Mubarak,
‘Diabetes-Knowledge-Action’ is our multi-faceted public health awareness
campaign.
‘Diabetes-Knowledge-Action’ is focused
on disseminating knowledge surrounding diabetes prevention, symptoms and
lifestyle support activities.
The campaign aims
to inform the UAE community of the simple smart steps to maintain a healthy
life, the risks of an unhealthy life, the complications that diabetes brings
with it while making available the latest evidence-based treatments.
It aims to help prevent the number of
diabetes patients through education and encourage testing for diabetes on a
nationwide level so that people learn if they are affected or at risk.
The campaign’s
main aim is to communicate how easy it is to maintain a healthy lifestyle by
adopting a balanced diet and taking a 30-minute brisk walk each day.
The campaign
presently has four pillars:
- Eat
for Life
invites children, parents and carers to consider what makes a balanced
diet.
- Cook
for Life
looks to inspire families to cook healthy meals.
- Play
for Life
promotes regular exercise for healthy living to corporate teams.
- Walk
for Life
encourages the community to take at least a 30-minite brisk walk each day.
Now in its seventh year, more than 17,000 people are expected to join in
the nation’s leading annual Walk 2013 on November 15, to pace the five
kilometre main walk around Abu Dhabi’s Yas Marina Circuit.
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