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Q: Why is diabetes such a huge problem in this region? A: Diabetes has unfortunately reached epidemic proportions on a global level. The reason for posing such a huge burden in particular to the Gulf region is mainly the fast and substantial lifestyle change – namely changes in nutrition and a lack of exercise. Due to this change, obesity is increasing. Hence, diabetes – and in particular type 2 diabetes affects more and more and even young people in the region.


«Diabetes has reached epidemic proportions on a global level»


26 www.lifesciencesmagazines.com


with Professor Oliver Schnell, Diabetes Research Institute, Munich.


Diabetes prevalence exceeds 20% in some countries and the numbers are continuing to grow. Today various treatment options exist that help to keep sugar levels under control, but the challenge of getting patients to actively take control of their disease still remains a issue for physicians across the region.


Professor Schnell from the Diabetes Institute in Germany spoke to Arab Health magazine about how the disease is affecting the Middle East population and what can be done to raise awareness about treatment and prevention.


Q: What opportunities are available to physicians treating people with diabetes? A: Today, various very useful drug options exist to achieve good glycemic control in diabetes patients. But the challenging part of successful diabetes management still remains: This is the motivation and empowerment of people with diabetes to actively take control of their disease. Notably, this applies to the Gulf region


where we currently do not have adequate diabetes care structures available we would need to optimally manage the increasing number of patients. Motivation and empowerment of the


patient is crucial, as it is the patient who has to constantly adapt his daily routines and behavior based on the blood glucose values obtained by self-monitoring of blood glucose (SMBG). Patients are often frustrated, as they do not understand the value of the SMBG results and do not know how to translate them into appropriate therapy intervention. Hence, we have to support them in understanding the values and provide them with the structures of care and the tools to support them in their everyday diabetes management. This can be achieved with structured education programs as e.g. the Accu-Chek®


Assist program. Within such programs, people with diabetes learn in a


structured and tangible way, how e.g. food intake and the metabolic response are related and how easily they can influence their glycemic control by changing their behavior or routines.


Q: How can structured testing improve control and communication? A: The over-arching goal of any diabetes therapy is keeping blood glucose levels as close to normal as possible. To achieve this, a detailed overview of blood glucose levels over time and the analysis of individual patterns are essential. Basing therapy decision solely on the HbA1c is not enough, as the caregiver will not get the entire picture of the metabolic situation. Two patients with identical HbA1c levels may have very different glucose profiles – hence being exposed to various risk factors for secondary complications. This is mainly due to the fact that HbA1c fails to capture glucose excursions e.g. the post-prandial fluctuations. The innovative diabetes management concept of structured SMBG including data documentation and visualization showed to be effective, as the patients who followed this approach had significantly greater reductions in their HbA1c and their pre- and postprandial glucose levels at all times. The visualization and joint analysis of the blood glucose patterns significantly improved the patients’ understanding on how lifestyle affects the metabolism. This


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