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How to build consensus guidance on tackling significant regional health and cultural challenges

The increased prevalence of type 2 diabetes in MENA has made it a key priority to the region’s governments’ health agenda.

According to the 9th edition of the International Diabetes Federation Diabetes Atlas, the prevalence of diabetes in adults in the MENA region is 12.2 per cent and in Africa is 4.7 per cent. Over the next 25 years, diabetes prevalence is expected to increase in all countries, with the greatest increase expected in middle-income countries, rising to 13.9 per cent in the Middle East & North Africa and 5.2 per cent in Africa. The increased prevalence of type 2 diabetes in the region has made it a key priority to the region’s governments’ health agenda. Lifestyle interventions and adherence to medications are central to disease prevention and management.

“As type 2 diabetes and its complications continue to overwhelm our healthcare systems, healthcare professionals, including members of the Middle East & Africa (MEA) Ramadan Expert group, have been working closely together to identify gaps between clinical ambitions and reality. However, in practice we are often faced with barriers to the successful implementation of guidelines preventing optimal care for people with Type 2 Diabetes,” explains Dr. Mohamed Hassanein, Senior Consultant in Endocrinology and Diabetes at Dubai Hospital; the Chair of the Scientific Committee of the Arab Association for the Study of Diabetes and Chairman of Diabetes & Ramadan International Alliance.

“Success in any guidelines depends on addressing all the possible contributing factors. Hence, it is crucial to engage all stakeholders to address the various health-related issues. Indeed, addressing cultural difference has a serious impact on diabetes management and it has to be taken into consideration as well.” 

Creating a successful diabetes management programme

While the Middle East has one of the highest prevalence of diabetes globally, rates of obesity, physical inactivity and smoking are high. The geographical location of the Middle East is also reflected in different lifestyles particularly from the Mediterranean region as well as from the Indian Sub-continent. It is crucial to address all the possible factors to have a successful diabetes management programme; especially in the face of unprecedented challenges such the COVID-19 pandemic.

According to Hassanein, there are different ways in which these networks have to be agile and adapt while we are in lockdown. “Technology has helped to sustain communication with the various stakeholders despite the lockdown and face to face discussions were replaced with digital meetings. Indeed, one benefit of lockdown is proving that once the will is there, the tools could be utilised for a successful outcome.”

Meanwhile, Dr. Elmas Malvolti, Medical Director for the Middle East and Africa at AstraZeneca says that these challenging times have facilitated faster adoption of digital tools and have challenged traditional ways of engagement. “We are witnessing how digital, data and AI are transforming the workplace, business processes and collaborations. Virtual meetings, virtual masterclasses, virtual advisory boards are just a few examples of this change. In addition, digital technology is putting more information in the hands of patients and empowering them to play a larger role in managing their own health.

“Even before the lockdown caused by COVID-19, care has started shifting from reactive and acute to proactive and chronic as new treatments and technology allow better long-term management of diseases such as diabetes,” he adds.

So, what then, is involved in the process of coming to a consensus on issues related to healthcare as different countries have different priorities at any given time? “The key in any consensus is compromise and setting the priorities in the beginning. Once the agreement is there for the main issues, then it is easy to accommodate differences on the lower priority issues,” says Hassanein.

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