Road map for better diabetes care

The IDF Middle East and North America (MENA) region is a diverse and unique territory with great ethical and cultural differences and socioeconomic extremes. Approximately 38.7 million adults are living with diabetes and almost half (49.1%) of them are unaware of their condition.1


MENA foot workshop mansouraThe prevalence of diabetes is on a rapid upsurge in the region. Several countries have implemented high-impact prevention approaches to reduce diabetes and its complications. A major preventive initiative is the National Diabetes and Diabetic Foot Program in Pakistan where 115 diabetes clinics have been established and the rate of amputation has been halved.2 Similarly, the Footwear for every Diabetic (FED) project has established ten risk assessment clinics, providing low-cost footwear for people with diabetes thereby reducing ulcer rates. Recently, an IDF MENA Diabetic Foot Workshop was conducted in Mansoura, Egypt,with trainees from Afghanistan, Pakistan, Lebanon, Sudan, Jordan, and Egypt.

For the 2018-19 biennium, the activities calendar developed in the MENA region specifically targets prevention measures and includes: the launch of diabetes mobile units in Bahrain and Palestine; campaigns for the prevention of blindness in Sudan; and the set up of Sweet Smile Clubs for children with type 1 diabetes in Saudi Arabia.

The MENA region is currently in need of a substantial number of trained healthcare providers. A network of 100 mini-clinics led by trained diabetes educators is being created in Sudan, while the Qatar Diabetes Association offers a structured training program for school nurses across the country. Additional activities include continuous education on healthy cooking techniques, guidelines for safe fasting during Ramadan and training programs for safe traveling.

It is extremely worrisome that the MENA region contains five of the top 10 countries with the highest prevalence of diabetes worldwide. There is an urgent need for epidemiological initiatives to address this. Pakistan recently conducted the 2nd National Diabetes Survey of Pakistan (NDSP) 2016-17 which revealed that 26% of the population over the age of twenty has type 2 diabetes. Some other IDF MENA members have started the process of replicating the study in their countries.

Advocacy is another main focus of the IDF MENA region. Influencing international bodies, political platforms, community leaders, and national governments is required to implement practical, real time and long-term solutions to improve the lives of people with diabetes and those at risk. Activities in progress include the launching of the Dia-Ambassador program in Iran; mass campaigns for safe fasting during Ramadan and reducing tobacco use in Morocco and Iraq; and online education courses for people with diabetes in Sudan and Pakistan.

More than half of the MENA region consists of resource constrained countries. Access to insulin and basic diabetes care is a common issue. In Pakistan, the Insulin My Life (IML) project has provided more than 20,000 free insulin vials to over 1,900 children with type 1 diabetes. In Palestine, Diabetes Palestine has registered more than 500 childen with type 1 diabetes and provides free services in Jerusalem and Gaza. Another important initiative is a joint project of IDF MENA and the World Diabetes Foundation (WDF) that provides diabetes care services and free insulin to Syrian refugees in Lebanon. 

In summary, the IDF MENA region is aiming to achieve a strong global presence by promoting advocacy not only for people with diabetes but also for those at risk, emphasizing empowerment for people with diabetes and strengthening awareness of diabetes and IDF. We believe these measures will go a long way in achieving better diabetes care and prevention.

1. International Diabetes Federation (IDF), Atlas 8th edition 2017. Available from: International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org (last accessed on March 24, 2018)
2. Basit A, Nawaz A. Preventing diabetes related amputations in a developing country – steps in the right direction. Diabetes Voice 2013; 58: 36-39.

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