High diabetes and obesity rates complicate GCC’s coronavirus fight

High diabetes and obesity rates complicate GCC’s coronavirus fight
People with co-morbidities like heart disease, diabetes and obesity have a higher chance of complications with COVID-19. (Shutterstock)
Short Url
Updated 12 August 2020

High diabetes and obesity rates complicate GCC’s coronavirus fight

High diabetes and obesity rates complicate GCC’s coronavirus fight
  • Study finds people with Type 2 diabetes twice as likely to die from COVID-19 as those without it
  • Diabetic and obese people have an immune system malfunction that particularly endangers them

DUBAI: In the ongoing havoc the coronavirus disease (COVID-19) is wreaking, a double bind has the Gulf region’s health experts worried — the rising cases of diabetes and obesity and the increased risk of mortality this population faces due to the pandemic.

According to the International Diabetic Federation (IDF), more than 39 million adults aged 20 to 79 had diabetes in the Middle East and North Africa (MENA) region last year. The figure is expected to increase to 108 million by 2045.

The IDF Atlas states that 15.4 percent of adults aged 20 to 79 in the UAE are diabetic, while in Bahrain the number is 19.6 percent. In Kuwait and Qatar, the figure jumps to 20 percent.

In Saudi Arabia, it is estimated that 15 percent of the adult population has diabetes, and many more are likely to be either undiagnosed or pre-diabetic, leaving them on the edge of the chronic disease.

These numbers are alarming by themselves, but what is more concerning is that amid the COVID-19 pandemic, some groups face a greater risk than others.

A study conducted by the Imperial College London found that people with Type 2 diabetes are twice as likely to die from COVID-19 as those without it.

The study also found that people with Type 1 diabetes were three and a half times more likely to die from a COVID-19 infection.

What causes such a lethal outcome? According to Dr. Nasr Al-Jafari of DNA Health Corporation, Dubai, the virus can be deadly because of its ability to stimulate a part of the immune system called the “inflammasome.”

“This can often cause an uncontrolled release of pro-inflammatory responses of the immune system, which leads to what has been described as a ‘cytokine storm’ (where the body starts to attack its own cells instead of fighting off the invading virus). The consequences are a potentially severe and irreversible damage to the heart and lungs,” Al-Jafari told Arab News.

“We also know that people suffering from both diabetes and obesity have a chronic activation of this same ‘inflammasome.’

“Therefore, these people are more at risk of developing the above-described inflammatory cascade of events, ultimately putting them at a higher risk of needing ventilatory support, and even a higher risk of death.”

Khadija Kapasi, a Kuwait-based clinical dietitian, says that the problem people with diabetes face is one of “worst outcomes.”

“People with co-morbidities like heart disease, diabetes and obesity have a higher chance of complications with COVID-19, and diabetics are particularly vulnerable because the virus can cause difficulties managing it,” she said.

Echoing the concerns of Al-Jafari and Kapasi, Dr. Asma Deeb, division chief of Pediatric Endocrinology at the Sheikh Shakhbout Medical City in Abu Dhabi, said that the risk of COVID-19 is expected to be high due to the wide prevalence of diabetes in the Gulf region.

“Diabetes can make COVID-19 symptoms more severe and can cause a greater likelihood of mortality,” she said, adding: “Obesity has also been identified as a risk factor.”

In addition to having diabetes, over half of diabetics in the region are reported as having at least one co-morbidity, said Kapasi. In Kuwait and Saudi Arabia, one in five are reported as having two or more co-morbidities.

“Saudi Arabia also ranks in the top 15 countries for obesity, which leads to diabetes and its complications,” Kapasi said. “The UAE, Bahrain, Saudi Arabia, Kuwait and Qatar are listed in the top 15 nations for the highest rate of diabetes per capita.”

Bassam Bin Abbas, professor and pediatric consultant of endocrinology at the King Faisal Specialist Hospital and Research Center in Riyadh, concurred, saying: “Diabetes is a risk factor for hospitalization and mortality of the COVID-19 infection.

“More than a third of the Kingdom’s adult population is obese, and obesity is also a risk factor for severe infection and diabetic complications.”

What is causing this rise in numbers? According to research from New York University Abu Dhabi, Gulf citizens may have a genetic predisposition to diabetes. But that is not the only reason.

“Experts concerned about the rapid increase in lifestyle diseases in this region have looked to history and environmental factors to identify the cause,” said Kapasi.

And the cause, according to her, is clear: “Unhealthy lifestyles and urbanization. Bahrain, Kuwait, Qatar, Saudi Arabia and the UAE are some of the wealthiest countries in the world today, and the lifestyle of the average citizen in these countries is dramatically different from that of the pre-oil era.”

Al-Jafari describes Type 2 diabetes, which accounts for over 90 per cent of the cases, as a “lifestyle disease.”

“The modernized lifestyle adopted by a large part of the population is a perfect storm for developing ‘insulin resistance’, which is at the root of this condition,” he said.

“There is an over-availability of, and dependency on, fast foods and processed foods. The lifestyle has largely become sedentary, particularly during the hotter months.”

According to all the specialists, the need of the hour is to raise awareness among people with diabetes and offer them more education and support to manage their condition during this difficult time.

Diabetics are advised to strictly monitor their blood glucose level at regular intervals to ensure that it is under control.

“They should check not only fasting but also post-meal glucose levels, which are more likely to be higher,” said Dr. Abdul Jabbar, consultant endocrinologist, Medcare Hospital, Al Safa, Dubai.

“They should strictly adhere to their medication schedule, including for control of blood pressure and lipids. Wherever possible, patients should tele-consult with doctors to reduce exposure to the virus,” he said.

Diabetes in COVID-19 patients can also be more difficult to treat due to the fluctuations of blood glucose, concomitant sepsis, and high risk of developing diabetic ketoacidosis and multi-organ failure, said Dr Vikram Hundia, consultant endocrinologist at Al-Zahra Hospital Dubai.

“Ensuring an adequate stock of regular medications, including insulin, is vital during these times when an overburdened healthcare system, shortages in supply of drugs and travel restrictions may pose a challenge,” he said.

“Employers may need to provide special working conditions to those suffering from diabetes to minimize their risk of exposure,” he told Arab News, adding that Gulf Cooperation Council states needed to put in place coordinated and effective measures for diabetic patients to prevent exposure to this infection.

“Working closely with the diabetes management team, optimizing diabetes control, practicing a healthy lifestyle, and staying safe and fit will not only protect patients with diabetes, it will also help them emerge from this pandemic stronger and healthier,” Hundia said.

Many regional governments have taken steps to combat the rise in the numbers of lifestyle diseases such as diabetes and obesity, including the Saudi government’s “Quality of Life Program,” one of the Vision Realization Programs of Saudi Arabia 2030.

“It aims to enhance the quality of life in the Kingdom through lifestyle improvement by increasing individuals’ participation in entertainment, sport and cultural activities,” Bin Abbas, of the King Faisal Specialist Hospital and Research Center, said.

“Other measures, including taxing sugary drinks, fitness initiatives and focusing on preventative care, have already been rolled out to address the rising epidemic.”

Twitter: @CalineMalek


Over 120 wounded in east Jerusalem clashes

Over 120 wounded in east Jerusalem clashes
Updated 41 min 32 sec ago

Over 120 wounded in east Jerusalem clashes

Over 120 wounded in east Jerusalem clashes
  • The violence flared outside one of the entrances to the walled Old City, after police had barred access to some areas where Palestinians usually gather
  • Tensions were fueled by the arrival of far-right Jews at the end of a march during which they harassed Palestinians and chanted “death to Arabs”

JERUSALEM: Over 100 Palestinians and 20 Israeli police were wounded in overnight clashes in annexed east Jerusalem, authorities said Friday, as tensions mount over a ban on gatherings and videos of attacks on youths.
The violence flared outside one of the entrances to the walled Old City, after police had barred access to some areas where Palestinians usually gather in large numbers during the Muslim fasting month of Ramadan.
Tensions were fueled by the arrival of far-right Jews at the end of a march during which they harassed Palestinians and chanted “death to Arabs.”
There have been nightly disturbances in the area since the start of Ramadan on April 13, with Palestinians outraged over police blocking access to the promenade around the walls, a popular gathering place after the end of the daytime Ramadan fast.
Police said that after night prayers at Al-Aqsa mosque in the Old City “hundreds of rioters began disrupting the order violently, including throwing stones and objects at forces.”
Stun grenades were fired and water cannon deployed to disperse the “rioters” and force them toward less central areas of east Jerusalem, police said.
Police said officers attempted to “distinguish between them and those who finished prayers” and were not involved in the events.
The Palestinian Red Crescent said on Friday it had treated at least 105 people, with about 20 of them hospitalized.
Israeli police said 20 officers were injured, three of whom were taken to hospital.
“It was like a war zone; it was dangerous,” a Palestinian who was near the clashes outside the Old City told AFP. “That’s why I left the place.”
Tensions have been high in Jerusalem after a series of videos posted online in recent days showing young Arabs attacking ultra-Orthodox Jews and Jewish extremists taking to the street to bully Arabs in nightly confrontations.
On Thursday night, the Israeli extreme right group Lehava organized a march ending opposite the Old City attended by hundreds to protest the anti-Jewish violence.
Police erected barriers to keep them from entering the mainly Arab location.
The Palestinian presidency meanwhile condemned “the growing incitement by extremist far-right Israeli settler groups advocating for the killing of Arabs, which in recent days manifested in a wave of attacks against Palestinian civilians in the Old City.”
A statement late Thursday on the official Palestinian news agency Wafa urged the international community to protect Palestinians from the “settler” attacks, which it alleged were encouraged by the Israeli government.
Videos on social media also showed Palestinians attacking ultra-Orthodox Jews in the early hours of Friday, with reports of Israeli vehicles being stoned in and near east Jerusalem.
Police reported “a number of incidents overnight in which civilians were attacked, some of whom needed medical treatment.”
Jerusalem mayor Moshe Lion said he tried to cancel the Lehava march, but police told him it was legal, noting that “dozens” of Jews who attacked Arabs had been arrested in the past two weeks.
Speaking with public broadcaster Kan, Lion said he was in talks with leaders of the Palestinian east Jerusalem neighborhoods “to end this pointless violence.”
More than 50 people detained overnight were taken for a remand hearing on Friday morning, a statement from police said.


Houthis abduct three civilians from Yemeni village

Houthis abduct three civilians from Yemeni village
Updated 23 April 2021

Houthis abduct three civilians from Yemeni village

Houthis abduct three civilians from Yemeni village

ADEN: Houthi "terrorists" have abducted three civilians from the Yemeni village of "Beit Al-Jabr" in the governorate of Dhamar, the Saudi Press Agency reported on Friday.

The Houthis took their victims to a detention center in Jabal Al-Sharq district, in the same governorate controlled by the Iran-backed group, the report said.

The raiders claimed they were taking the victims under the pretext of setting up a funeral council, but the official Yemeni News Agency (Saba) quoted a local source as saying there was no such plan to establish a funeral council, SPA said.

According to the Saba source, the storming of the village was consistent with the "systematic policy of harassment" that the Houthi militia follows in dealing with the population in all areas under their control, SPA added.

Houthis earlier abducted Yemeni model and actress Entesar Al-Hammadi and two of her friends on Feb. 20 as they were traveling to shoot a TV drama series.

On Thursday, the captors reportedly placed Al-Hammadi in solitary confinement as punishment for her protest against her initial incarceration and prison conditions.


Credible Palestinian elections crucial for peace and unity, says UN

Credible Palestinian elections crucial for peace and unity, says UN
Updated 23 April 2021

Credible Palestinian elections crucial for peace and unity, says UN

Credible Palestinian elections crucial for peace and unity, says UN
  • Envoy Tor Wennesland said the road will not be easy, and called on all sides to protect voting rights
  • Central Elections Commission praised for “professionalism and integrity” and its efforts to ensure safe voting during pandemic.

NEW YORK: The successful staging of credible Palestinian elections on May 22 is a crucial step toward unity and guaranteeing the legitimacy of national institutions, the UN Security Council heard on Thursday.
Tor Wennesland, the UN’s special coordinator for the Middle East peace process, told council members that the elections, along with Israeli efforts to form a coalition government, will have a “significant implication for the prospects for advancing peace in the months ahead,” and called on the international community to provide support.
“Expectations for the holding of elections in Palestine are high and come after a long wait of almost 15 years … a growing number of young people are expected to participate in shaping their political future, and have the opportunity to vote for the first time,” Wennesland said.
“These elections should also pave the way to uniting Gaza and the West Bank under a single, legitimate national authority, which would be an important step toward reconciliation and could advance Middle East peace.”
He praised the Palestinian Central Elections Commission for its “professionalism and integrity, enhancing trust in the electoral process,” singling out in particular the committee’s efforts to create a safe voting environment during the pandemic.
He also underscored the importance of the role of election observers in ensuring that the results of “credible and transparent” elections are respected.
“All sides must work toward protecting the right of Palestinians across the occupied West Bank, including East Jerusalem and Gaza, to participate in credible and inclusive Palestinian elections, as well as to stand for election free from intimidation,” said Wennesland.
He urged all those involved in the process “to refrain from any arrest, detention or interrogation based on freedom of opinion, expression or association.”
The COVID-19 pandemic continues to pose “a formidable threat” throughout the occupied Palestinian territories, further exacerbating an already dire social and economic situation, Wennesland said as he called for vaccination efforts to be stepped up and for more vaccine doses to be made available.
The Biden administration this month announced its plans for resuming US funding for the UN Relief and Work Agency for Palestinian Refugees (UNRWA), which was halted in August 2018 by President Donald Trump. Wennesland welcomed the move by Washington and called on all UN members to recommit to supporting the agency, whose “services are not only a lifeline for millions of Palestine refugees but are also critical for stability throughout the region.”
The envoy repeated his call for Israel to halt the demolition and seizure of Palestinian properties and to allow the Palestinian people “to develop their communities.”
Denouncing the “daily violence” that has resulted in more arrests, injuries and deaths, Wennesland called on all sides “to de-escalate tensions and maintain calm.”
He added: “I underscore that all perpetrators of violence must be held accountable and swiftly brought to justice. I reiterate that Israeli security forces must exercise maximum restraint and may use lethal force only when strictly unavoidable in order to protect life.
“Particular care should be taken to protect children from any form of violence. In addition, the indiscriminate launching of rockets toward Israeli population centers violates international law and must stop immediately.”


Iraqi military: 3 rockets strike close to Baghdad airport

Iraqi military: 3 rockets strike close to Baghdad airport
Updated 23 April 2021

Iraqi military: 3 rockets strike close to Baghdad airport

Iraqi military: 3 rockets strike close to Baghdad airport

BAGHDAD: At least three rockets hit near Baghdad international airport late Thursday, the Iraqi military said.
A total of eight missiles were fired and three landed near the airport complex, the statement said. It did not detail whether the attack caused casualties.
The rockets struck areas known to contain Iraqi security forces. One hit close to a central prison, the second near an academy of the elite Counter-Terrorism Service, and a third near the headquarters of the Rapid Response regiment.
No one claimed responsibility for the attacks. US officials have previously blamed Iran-backed militia groups.
It is the latest in a string of rocket attacks that have primarily targeted American installations in Iraq in recent weeks. On Sunday, multiple rockets hit an Iraqi air base just north of Baghdad, wounding two Iraqi security personnel.
Last month, a base in western Iraq housing US-led coalition troops and contractors was hit by 10 rockets. One contractor was killed.
Calls from mainly Shiite leaders have grown to oust US troops from Iraq after a US-directed drone strike killed Iranian Gen. Qassem Soleimani and an Iraqi militia leader in Baghdad in January 2020.
Strategic talks between the US and Iraq have focused on the future of US troop presence in the country.


Syrian missile exploding in Israel not intentional: US general

Syrian missile exploding in Israel not intentional: US general
Updated 23 April 2021

Syrian missile exploding in Israel not intentional: US general

Syrian missile exploding in Israel not intentional: US general
  • Israeli media also described the Syrian missile as an “errant” projectile, not a deliberate attack deep inside Israel
  • Dimona, the Negev desert town where Israel’s nuclear reactor is located, is some 300 km south of Damascus

WASHINGTON/JERUSALEM: A senior US general said on Thursday that he believed a Syrian missile exploding in Israel was not intentional, but rather showed a lack of Syrian air defense capability.

“I think it reflects actually incompetence in Syrian air defense ... I do not believe it was an intentional attack,” Marine Gen. Kenneth McKenzie, head of US Central Command, said during a Senate Armed Services Committee hearing

Earlier in the day, a Syrian anti-aircraft missile landed in southern Israel, setting off air raid sirens near the country’s top secret nuclear reactor. In response, it attacked the missile launcher and air-defense systems in neighboring Syria.

Israeli media later described the Syrian missile as an “errant” projectile, not a deliberate attack deep inside Israel.

In recent years, Israel has repeatedly launched air strikes at Syria, including at military targets linked to foes Iran and the Lebanese Hezbollah militia, both allies of Syrian President Bashar Assad. Such strikes routinely draw Syrian anti-aircraft fire. Thursday’s exchange was unusual because the Syrian projectile landed deep inside Israel.

A road sign shows the way to Dimona nuclear power plant in Israel's Negev desert. (AFP / Ahmad Gharabali)

Syria’s state news agency SANA said the exchange began with an Israeli air strike on Dumeir, a suburb of the capital of Damascus. Dumeir is believed to house Syrian army installations and batteries as well as bases and weapons depots belonging to Iran-backed militias. SANA said four soldiers were wounded.

The Britain-based Syrian Observatory for Human Rights, an opposition war monitoring group based in Britain that tracks Syria’s civil war, said the Israeli strikes hit an air defense base belonging to the Syrian military and destroyed air defense batteries in the area. It said the Syrian military fired surface-to-air missiles in response.

The Israeli military described the projectile that landed near the nuclear site as a surface-to-air missile, which is usually used for air defense against warplanes or other missiles.

Dimona, the Negev desert town where Israel’s nuclear reactor is located, is some 300 km south of Damascus, a long range for an errantly fired surface-to-air missile.