Doctors in UAE allay fears of insulin shortage

Dubai - Diabetes now affects nine per cent of all adults worldwide.

Type 2 diabetes, which the vast majority of people have, can be managed by a lifestyle change without the need for insulin, said doctors allaying fears resulting from a research that predicted a shortfall by 2030.
The experts were commenting on a research study that suggested that a global diabetes epidemic is fueling record demand for insulin but tens of millions will not get the injections they need unless there is a dramatic improvement in access and affordability.
Event to help families fight diabetes in Dubai
The researchers said that the vast majority have Type 2 diabetes - the kind linked to obesity and lack of exercise -and the cases are spreading particularly rapidly in the developing world as people adopt more Western, urban lifestyles.
They also said the amount of insulin needed to effectively treat Type 2 diabetes would rise by more than 20 per cent over the next 12 years, but insulin would be beyond the reach of half the 79 million Type 2 diabetics patients predicted to need it in 2030, particularly in Africa and Asia.
The UAE, though, has a high incidence of the disease is not likely to be impacted. Also, health authorities announced in September that the rate of diabetes had fallen from 19.3 per cent in 2013 to 11.8 per cent in 2017 due to the government's efforts in combating and controlling the disease.

Dr Sarla Kumari, specialist physician diabetologist, Canadian Specialist Hospital, said that patients with Type 1 diabetes are dependent on insulin to maintain their blood glucose levels. "Without access to insulin, the disease would prove fatal to the patient. Type 1 diabetes patients who are dependent on insulin will develop life threatening ketoacidosis in one to three days of missing a dose. It isn't even recommended for patients whose bodies is still able to make insulin in the remission phase," she said 
But for Type 2 Diabetes patients, insulin replacement isn't the first line of treatment and a combination of diet, exercise and medication is prescribed to keep the disease in check. "If still the blood sugar levels are erratic, then insulin maybe advised for the patient. For such patients, going without insulin will similarly be fatal but not immediately," she added.
Dr Sarla said that managing diabetes without insulin for Type 1 diabetics is neither recommended nor should ever be practised. While this process isn't easy or fool proof, it's their best bet in times of crisis. "In case of shortage, diabetics who are dependent on insulin need to regularly check their blood for both spikes and dip in the glucose levels. They also need to religiously follow the prescribed lifestyle changes and medication to ensure their disease reaches a point where it isn't insulin dependent anymore." 
Dr Mohammed Shafeeq, specialist internal medicine at Medeor 24/7 Hospital, said that when there is too little insulin, the body can no longer move glucose from the blood into the cells, causing high blood glucose levels.
Quoting data from International Diabetes Federation (IDF) across 221 countries, Dr Shafeeq said that the predicted number of adults with Type 2 diabetes mellitus (DM) will rise from 406 million to 511 million by 2030.
"However, not all people require insulin of that global total of 511 million, 79 million were predicted to be in need of insulin to manage their diabetes. About 20 per cent rise in demand of insulin and only 38 million are likely to have access to it base on current resources," he said. He also said that if there is no way to get insulin due to time of day or cost, patients should go to an urgent care clinic or emergency unit. "The important thing is to act quickly and decisively," he added.
 Dr Maged Shurrab, family medicine specialist from Al Tadawi Medical Centre, said that the most important is lifestyle modification, a decrease in weight, dietary plan and sports.
"To identify the type of diabetes some investigations need to be done along with a proper history check. Insulin is very important for management of diabetes. If it is not available, the patient should see his doctor to be put on a proper treatment plan," he said.
asmaalizain@khaleejtimes.com
A disease that affects 9% of adult population
Diabetes - which can lead to blindness, kidney failure, heart problems, neuropathic pain and amputations - now affects nine per cent of all adults worldwide, up from five per cent in 1980.
Global insulin supply is dominated by three companies - Novo Nordisk, Sanofi and Eli Lilly.
Insulin, however, remains costly and prices can be especially out of reach in poorer countries where poor supply chains and high mark-ups by middlemen often make it unaffordable for many patients.
According to the study published in the Lancet Diabetes and Endocrinology, global insulin use was set to rise to 634 million 1,000-unit vials by 2030 from 526 million in 2018.