Naila sat quietly in the waiting room of her doctor’s office. She had experienced some strange symptoms lately, but was sure that nothing could be seriously wrong. She had gained weight suddenly, without increasing or changing her diet. Naila felt exhausted. She was constantly thirsty and needed to consume much more water than usual, and thus also needed to visit the restroom much more frequently. After a few months of these strange symptoms, she decided to visit the doctor, expecting him to give her a pill to ease her anxiety. However, the diagnosis she received was completely unexpected.

“Naila,” the doctor told her after completing some tests, “I’m sorry to say, but you have diabetes.”

The Silent Killer

Diabetes is currently one of the most rapidly rising non-communicable diseases in the Middle East and North Africa region (MENA). In MENA, 1 in 10 adults have diabetes¹, and this number is expected to grow. Between 1990 and 2010, MENA has seen an 87% increase of diabetes!² Diabetes, often called the “silent killer,” is difficult to detect because many people suppose the symptoms are not serious. According to a survey conducted in ten countries in the Middle East and North Africa, 74% of people at risk for developing diabetes had never been told that they were at risk for developing the “silent killer” disease.³

Naila is one example of someone who never expected her seemingly minor symptoms to be signs of a serious disease. But what exactly is diabetes? What are its symptoms, and how can you avoid it?

Diabetes – The Sugar Disease

In order to understand how diabetes works, we first have to understand the role of insulin in the body. When you eat, your digestive system converts that food into glucose, a type of sugar that can be delivered to your body’s cells and burned as energy – much like petrol is used in a vehicle. Your body’s cells have a special door-and-lock system to let in nutrients like glucose and keep out dangerous intruders like viruses.

Insulin is a substance created by the pancreas. It acts like the “key” that unlocks the cell doors and lets the glucose-sugar inside. When a person develops diabetes, there is a malfunction with this process, which can happen in two different ways:⁴

Type 1 Diabetes

Type 1 diabetes occurs when your body accidentally mistakes the insulin in your bloodstream for foreign invaders, like bacteria or a virus. Your body’s defense systems, therefore, actually destroy the insulin before it can do its job. Since your glucose has no “key” to enter the cells, your body literally starves due to a lack of nutrition, even though you are eating.⁵ This is typically not reversible, but is treatable, especially if detected early enough.

Type 2 Diabetes

People with type 2 diabetes are able to make some insulin, but the cells do not accept it. When the insulin “key” tries to fit the “lock” on each cell door, it no longer fits. In this case too, the glucose is unable to enter the cells to give you energy.⁶ Unlike type 1, though, type 2 diabetes can be reversed through lifestyle changes such as diet and exercise.

Ten Signs You Might Have Diabetes

Below are ten symptoms you may experience if you have diabetes or are at risk for developing it:

1. Increased urination and excessive thirst

2. Unexpected weight loss or weight gain

3. Hunger

4. Skin problems

5. Slow-healing wounds

6. Yeast infections

7. Fatigue and irritability

8. Blurry vision

9. Tingling or numbness in the limbs

10. Headaches

If you are experiencing several of these symptoms, you should see your doctor as soon as possible. A few simple blood tests can confirm whether you have developed diabetes or not, or if you have an elevated risk for getting diabetes in the future.

Good News About Diabetes

Although diabetes is responsible for a rapidly increasing number of deaths in the Middle East and North Africa, there is good news. Diabetes can be avoided through certain lifestyle habits. Even if you already have this disease, the most common type 2 diabetes can be reversed through your lifestyle choices.

One of the major triggers that causes diabetes is inactivity. Dr. Ala Alwan, the Assistant Director General for Noncommunicable Diseases at the World Health Organization, says that up to half of the adults in the MENA region are physically inactive.⁷ Increasing your daily exercise is a good way to stave off or reverse diabetes. In one study, people with type 2 diabetes who worked their way up to 175 minutes of exercise per week and limited their food intake to 1,200-1,800 calories per day saw the best results. After one year, 10% of these individuals were off their diabetes medicine and no longer tested in the range of diabetic.⁸

Dr. Ghassan Darwiche, head of the Rashid Center for Diabetes and Research at Sheikh Khalifa Hospital in Ajman, UAE, states that there is also a definite link between diabetes and diet. “It is actually cheaper to eat fast food than cook healthy food at home here,” he says, noting that this is contributing to the rise in diabetes. While this is true, it is never too late to begin eating healthy. To win the fight against diabetes, you can make a few crucial diet changes that could turn the battle in your favor:

• Fried Foods: Exchange fried foods, such as falafels or fried potatoes, for their healthier equivalents. Many restaurants are now starting to offer baked falafels and roasted potatoes.⁹

• Sugary Foods: Sugar is one of the worst things you can eat to contribute to diabetes. Instead of sweets or cake, try a natural alternative, such as dates or fresh fruit. Instead of sweetening your tea with white sugar, use honey or stevia, a natural sweetener that is becoming more commonly offered in stores throughout MENA.¹⁰

• White, Refined Grains: Whole grain foods are digested slowly, letting you feel full longer and giving your body time to work with the insulin while transferring the glucose to your cells. Refined white rice, bread, and pasta digest very quickly and put a rush of glucose into the bloodstream, which is hard for diabetics or borderline-diabetics to manage. It’s better to substitute whole grain products, like brown bread, whole-wheat pasta, and brown rice. Many cafes are now offering sandwiches or manakeesh on brown dough.¹¹

• Red Meat: Remember that people with diabetes are also at high risk for heart disease, so you should limit your red meat intake to once per month or less. Instead, opt for white meat like chicken or fish, or get your protein from plant-based sources like peas, lentils, fava beans, chickpeas, and nuts.¹²

If you or someone you love has diabetes, the fight is only beginning. This silent killer can be beaten, but you will need to make serious and consistent lifestyle changes. Visit your doctor to discuss any dietary or exercise programs before you begin. For further information on how you can treat or avoid diabetes, visit our website.

1. “Diabetes in MENA,” http://www.idf.org/regions/mena/regional-data, accessed December 2015.

2. “In Middle East and North Africa, Health Challenges are Becoming Similar to those in Western Countries,” http://www.worldbank.org/en/news/press-release/2013/09/04/middle-east-north-Africa-health-challenges-similar-western-countries, accessed December 2015.

3. Sara Hamdan, “Rapid Increase of Diabetes Strains Middle East’s Health Agencies,” http://www.nytimes.com/2011/01/13/world/middleeast/13iht-M13CDIABET.html?_r=0, accessed December 2015.

4. “What is Diabetes?” http://www.diabetesresearch.org/what-is-diabetes, accessed December 2015.

5. “What is Type 1 Diabetes?” http://www.diabetesresearch.org/what-is-type-one-diabetes, accessed December 2015.

6. “What is Type 2 Diabetes?” http://www.diabetesresearch.org/what-is-type-two-diabetes, accessed December 2015.

7. Hamdan, “Rapid Increase of Diabetes.”

8. Michael Dansinger, “Can You Reverse Type Two Diabetes?” http://www.webmd.com/diabetes/type-2-diabetes-guide/reversing-type-2-diabetes, accessed December 2015.

9. “13 Best and Worst Foods for Diabetics,” http://www.health.com/health/gallery/thumbnails/0,,20864484,00.html, accessed December 2015.

10. Ibid.

11. Ibid.

12. Ibid.