DIABETES IN EGYPT

Fouad Kandeel, MD, PhD

City of Hope, California

Diabetes mellitus, a metabolic disorder that deranges blood glucose and is characterized by excessive urination and thirst, is not a new problem; the Ancient Egyptian physician Hesy-ra described it in approximately 3000 B.C.  In fact, Ancient Egypt was the first civilization known to have studied medicine extensively, and the earliest written reference to diabetes is attributed to the Upper Egyptian Ebers Papyrus circa 1550 B.C.

Identified as one of the most serious health threats of the modern era, type 1 (insulin-dependent, or juvenile) and type 2 (insulin-independent, or adult-onset) diabetes currently affects 246 million people worldwide¹— projected to include 366 million in 2030².  This considerable rate of increase will be substantially exceeded in the Middle East, where many of the largest and fastest-growing adult diabetic populations reside.  In Egypt alone, 2,623,000 people are already affected, with the expectation of 6,726,000 in 2030³.  Because as many as half of all diabetic patients remain undiagnosed, these already sizable figures are likely gross underestimations. 

Since the discovery of insulin in 1922, there have been many major advances in diabetes management, including the development of novel pharmaceutical agents, glucose monitoring and insulin infusion systems, and cell and gene therapies.  Further, recent studies have shown that with proper intervention, insulin resistance underlying the development of type 2 diabetes can be reduced; consequently, the onset and complications of disease can be delayed or prevented.  Additional evidence suggests that in the future, even the autoimmunity responsible for type 1 diabetes can likely be circumvented.

Currently updated and projected diabetic health statistics for Egypt are strongly needed, including the rates of diabetic complications and co-morbid diseases, the impact on the health of the adult workforce and national productivity, the costs of care, and measures of treatment success.  The future of diabetic care in Egypt rests on the acquisition and importation of new knowledge (public education), expertise (the design and implementation of superior diagnostic, prevention, and treatment strategies), and resources (research funding, medications, and modern technologies).  With these assets, we can progress strategically towards overcoming this epidemic problem by means such as:

• Establishing an organization dedicated to the promotion of diabetic care and research in Egypt, capable of competing for highly needed national and international resources

• Developing educational programs focused on the prevention and delay of diabetes and its complications via behavior modification, exercise, diet, and weight management in both school-age and urban adult populations

• Embracing state-of-the-art interventions, including home glucose monitoring, insulin infusion pumps, artificial pancreatic systems, islet transplantation, embryonic and adult stem cell research for production of insulin secreting cells, and gene modification for augmenting cellular insulin secretion and/or action.

1. International Diabetes Federation, 2007.

2. World Health Organization.

3. World Health Organization.