Can type 2 diabetes impact cardiovascular, renal, and metabolic systems?Can type 2 diabetes impact cardiovascular, renal, and metabolic systems?

Over 300 healthcare professionals from India, the Middle East, and Africa recently joined international experts to share knowledge and best practice about the importance of taking a multidisciplinary approach to managing type 2 diabetes (T2D) at the ‘CRM 360 Meeting’ hosted by Boehringer Ingelheim.

In an interview, one of the moderators at the event, Dr. Jalal Nafach, American Board-Certified Endocrinologist, University of Nebraska Medical Center, US, and Consultant Endocrinologist at Dubai Diabetes Center, Dubai Health Authority, UAE, highlighted some key diabetes statistics in the UAE and shed light on the interconnectivity of T2D with cardiovascular, renal, and metabolic systems.

What are the most prominent statistics on diabetes in the UAE?

First, let’s look at matters from a regional perspective. Nearly 73 million adults live with diabetes in the MENA region. This number reflects the highest proportion of people living with the disease compared to other regions and is based on the International Diabetes Federation’s most recent study published in 2021.

In the UAE, 1 in 8 people aged between 20 and 79 have type 2 diabetes, marking an alarmingly high rate for the population’s overall health as this is a chronic illness that needs to be managed effectively. Additionally, 4,343 deaths are associated with diabetes on an annual basis in the UAE.

However, the total number of people living with type 2 diabetes in the UAE could be a lot higher due to many people being undiagnosed due to showing no symptoms in the early stages of the disease. It is important to be aware of the statistics around type 2 diabetes in the UAE so that more efforts can be placed towards prevention and improved health.

Given the high rates of type 2 diabetes in the UAE, are there certain warning signs that people should be aware of to protect their health?

Protecting your health begins with knowing what can put you at risk of developing type 2 diabetes. As a specialist, my aim is to raise awareness of the factors which may put anyone at risk of developing type 2 diabetes now or in the future. The most common factors include a family history of diabetes, pre-existing conditions such as high blood pressure and carrying extra weight. The risk also increases with age and is amplified with an unhealthy lifestyle, such as smoking or having an overall sedentary lifestyle.

Knowing the risk factors helps people make a change in their lifestyle at an early stage and prevent the onset of type 2 diabetes. Whether you have any other risk factors or not, if you’re over 40, your risk of type 2 diabetes and other conditions is higher. As a healthcare expert, I urge patients to check their blood sugar levels by getting advice from their specialists and committing to regular health checkups, including blood sugar tests.

Why is it important to know about the interconnectivity of T2D with cardiovascular, renal, and metabolic systems, and how are they interconnected?

The body is made of complex systems that work together to create a state of balance. With type 2 diabetes, conditions of the heart, the pancreas and the kidneys are primary examples of this interconnectivity. They have the potential to both positively and negatively impact each other.

Let’s take the renal system as an example. Having type 2 diabetes can damage blood vessels in the kidneys, which makes them not function as well as they normally would. Eventually, this can lead to chronic kidney disease, and should the condition worsen, it could ultimately result in kidney failure. To add to the extent of this interconnectivity, if a patient has high blood pressure, then kidney damage could worsen, and chances of having a heart attack and stroke would increase.

Dr. Jalal Nafach

Is a holistic approach to treating diabetes recommended?

Traditionally, managing type 2 diabetes was delivered through a single specialist setting with a primary focus on controlling blood sugar levels. However, now that the landscape for treating type 2 diabetes has evolved, it’s become vital to seriously consider the possibility of preventing cardiovascular, renal and metabolic (CRM) conditions as well.

CRM conditions affect more than one billion people worldwide and account for up to 20 million deaths annually, making them the leading cause of death globally. In the Middle East and North Africa alone, the prevalence of diabetes is at 55 million adults and is set to double by 2045.

Given the magnitude of the regional reality, it goes to show how seriously the interconnectivity should be taken and the need for a multisystem control to be in place.

Further to that, the market currently offers treatment solutions for multi-organ protection. When combined with a multidisciplinary approach to care, this can boost clinical practice and positively impact patient outcomes on their journey to better health.

What were the most important takeaways from the CRM 360 meeting regarding this issue?

The CRM 360 Meeting emphasized the management of this complex multisystem condition by multiple healthcare providers from both primary care and specialist settings. The meeting reflected just how necessary it is to bring together diverse and regional medical talent to discuss the latest scientific guidelines that can improve treatment outcomes and transform the lives of patients. The overarching takeaway was that a true sense of collaboration between multidisciplinary medical professionals has the power to offer patients optimal care.

Allowing health care professionals to coordinate treatments for patients from a collective standpoint means that managing type 2 diabetes and its related conditions can be more effective.

What advice would you give when it comes to preventing severe health issues as a result of diabetes?

It’s important to take comfort in the notion that life can be lived to the fullest for those diagnosed with T2D and who have associated heart and kidney conditions. With that said, it is vital for patients and their caregivers to, first of all, understand the diseases and how best to manage it through having regular and coherent conversations with their doctors. Following a strict treatment regime by taking prescribed medications and committing to certain lifestyle habits is also a priority, and that is focusing on a healthy diet, staying active and quitting smoking

If the above habits are instilled and consistent, it is possible to reduce the risk of worsening the condition or facing multiorgan failure.

References

IDF Diabetes Atlas 10th edition, Key global findings 2021,

GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016;388(10053):1459–544.

Members, R., Africa, M. and MENA, D., 2021. Diabetes in MENA. [online] Idf.org. Available at: https://www.idf.org/our-network/regions-members/middle-east-and-north-africa/diabetes-in-mena [Accessed 27 September 2022].

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