Posted on August 24, 2019

Diabetes remains a major healthcare challenge, not only in the United Kingdom (UK) and Qatar, but globally. Projected increases in diabetes prevalence, coupled with rising healthcare costs, rapidly growing populations and urbanisation are highlighting the importance and urgency of tackling the disease. 

According to the UK’s National Health Service (NHS), there are currently 3.4 million people in England with type 2 diabetes, with around 200,000 new diagnoses every year. In Qatar, 20 percent of the country’s population is affected by type 2 diabetes, almost three times higher than the steadily rising global average of 7 percent. In addition, 20 percent of Qatar’s population experiences increased blood sugar levels after meals, suggesting a higher risk of developing diabetes in the future. Type 1 diabetes, which typically develops in children, is on the increase, but of more pressing concern is type 2 diabetes, accounting for 95 percent of diabetes cases in Qatar. 

Globally, diabetes prevention programmes are part of policymakers’ attempts to tackle the disease. People at a high risk of developing type 2 diabetes are encouraged to lose weight if they are obese, and to participate in more physical activity to prevent the development of the disease. In the UK, NHS England, Public Health England, and Diabetes UK, have jointly launched the ‘NHS Diabetes Prevention Programme’ (NHS DPP) providing support for people in reducing their risk of developing type 2 diabetes. Qatar, Qatar Biomedical Research Institute (QBRI) in collaboration with Qatar Diabetes Association, recently held a targeted awareness campaign with health screenings and diabetes risk assessments, where members of the public had blood sugar levels and blood pressure tested, along with their height and weight. Through a questionnaire, participants had their current lifestyle habits evaluated and were given a risk projection.

Prevention is important, but what can be done when someone already has the disease?

The NHS aims to revolutionise the way in which diabetes is tackled: through a low calorie (800 calorie/day) diet, consisting of drinks and soups for three months. While prevention is not always achievable, studies to date suggest that this programme, coupled with further diet and lifestyle advice, allows about half of those treated to return to good health and puts the disease in remission. This approach is being tested in the UK as part of a long-term plan to improve diabetes prevention and cure. Currently, up to 5,000 patients in the UK are enrolled in the programme, where they will be prescribed very low-energy diets, which are low in energy/calories and used for short periods to assist with weight loss. These diets are designed to make the body shift from using glucose from carbohydrates to burning fat stores as a main energy source.

Patients with diabetes are advised to follow their doctors’ recommendations to control blood sugar, blood pressure and lipids – a group of naturally occurring molecules that include fats – to minimise further health decline. Following the success of NHS DPP, a similar programme called the ‘Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I)’ study is being tested on a limited number of people in Qatar. Clinicians at Weill Cornell Medicine-Qatar (WCM-Q) are testing a low-energy diet combined with physical activity for young adults who have been diagnosed with diabetes in the past three years. 

Attempts to restore good health in patients with diabetes need to be pursued with vigour, in view of projections by the ‘Forecasting the Burden of Type 2 Diabetes Mellitus in Qatar to 2050: A Novel Modelling Approach’ study by WCM-Q last year, that at least one in four adult Qataris will have the disease by 2050. Doubts remain, however, about whether dietary change alone is sufficient, due to difficulties in keeping to the low-energy diet, and whether good health can be restored and maintained in the long-term. The low-energy diet regime is certainly a step in the right direction, but at QBRI’s Diabetes Research Center, there is a belief that more can be done. 

QBRI’s innovative work in tackling diabetes aligns well with the Hamad Bin Khalifa University’s quest to pursue new solutions to global issues, and we have recently begun conducting research into how low-energy diets improve the body’s response to insulin and handling of glucose to restore people with early-stage diabetes to good health. The aim of this project is to provide a further option to enhance – and hopefully improve – the effectiveness of current treatments, and to provide lifestyle guidance. We look forward to collaborating with clinical colleagues, both locally and internationally, on this project.

We are also working on stem cell therapy – applicable to both types of diabetes – and are developing simple blood tests that will identify those at risk of developing diabetes, who may be susceptible to further health decline, and who respond best to different therapies for a personalised approach to diabetes treatment, prevention and cure. We believe that the prevention of type 2 diabetes – along with effective, personalised treatment of patients – is very important. We also believe that restoring patients with type 2 diabetes back to good health is achievable within five years of diagnosis. With further development and implementation of our wide-ranging research programmes, we hope that incidences of diabetes will become less common for the people of Qatar and beyond. 

source: Qatar Tribune