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The Rise of Diabetes in the Middle East: An Epidemic Threatens Modernization

“Rapid Increase of Diabetes Strains Middle East’s Health Agencies,” Sara Hamdan, January 12, 2011, The New York Times; “Sun, Shopping and Surgery: Can the Gulf Attract Medical Tourists?” December 10, 2010, The Economist

The Middle East is currently experiencing a major health crisis in tandem with the United States: type 2 diabetes. Both countries are struggling to keep up with the costs and impact of the disease. In the U.S., type 2 diabetes afflicts both rich and poor, but a stronger correlation between lower socioeconomic status and this chronic condition has been established. Less affluent Americans tend to eat more fast food and may not, in general, have access to good preventative care.
In oil-wealthy Middle Eastern countries such as the United Arab Emirates, Bahrain, Kuwait, Oman, and Saudi Arabia, type 2 diabetes affects primarily the most privileged. The International Diabetes Foundation estimates that 26.6 million adults in the Middle East and North Africa have diabetes. The epidemic is eating up 14% of the area’s total annual healthcare spending.
The health consequences of this chronic illness are already taking their toll on the population. Eye disease and blindness, heart attacks, lower-limb amputations, and kidney problems are all on the rise.
As in the United States, lifestyle choices are a significant culprit. Most well-heeled Middle Easterners lead sedentary lives. Dress may have something to do with it as well; some observers point out that the flowing, capacious robes many prefer do not constrict the wearer as much as Western garb like pants or tighter-fitting skirts would. It is thus easy to gain a lot of weight before realizing the extent. Rising obesity rates have also been attributed to a predilection for sugar and the growth of the fast food sector. Finally, tobacco addiction can exacerbate the heart disease that diabetes causes and can contribute to neuropathy (nerve damage).
To finance the growing costs, medical providers in the region have begun to partner with foreign health care providers to lure medical tourists seeking exceptional care. The target consumer audience could include Westerners but also moneyed Gulf citizens in search of the best treatment. Abu Dhabi, for example, in tandem with Britain’s Imperial College, entices visitors with the Imperial College London Diabetes Centre, which is as aesthetically beautiful as it is state-of-the-art. One issue the Centre and similar organizations will face is the rising cost of administering effective care to growing numbers of patients.
In spite of these tangible advances, most Middle Easterners do not regard diabetes as a health problem with serious personal consequences. A November 2010 survey conducted in 10 Middle Eastern and North African countries by the pharmaceutical company Novo Nordisk revealed that although most participants acknowledged that the incidence of diabetes is on the rise, 40% of those at risk did not perceive diabetes to be harmful. 
In an effort to remedy this lack of knowledge, the Emirates have instituted widespread and accessible diabetes screening and are providing updated training for health care personnel. Health care leaders and experts in the region acknowledge the importance of educational campaigns designed to reach out to communities to encourage them to assume better control over their lifestyles and treatment. If such efforts do not succeed, the area’s strides toward modernization could be crippled by an ultimately preventable and highly manageable disease.

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