Table of Contents
Overview of Diabetes
Causes of Diabetes and its Related Social Determinants of Health
Pathological Impacts of Diabetes
Diagnosis of Diabetes in Qatar
Diabetes Treatment and Management
Levels of Prevention and Health Promotion
Healthy Public Policy in Qatar
Diabetes in Qatar has seemingly become an enormous challenge to public healthcare systems. Qatar is one of the GCC countries which are known to have the highest diabetes incidence rates. In a global ranking, Qatar is ranked six whereas the United Arab Emirates and Saudi Arabia who are members of the GCC countries are ranked second and third, respectively in regard to incidence rates of diabetes (Dwevedi & Goyal, 2010).
Current epidemiological reports indicate that an estimated 16 percent of the adult population in Qatar is suffering from diabetes, in which type 2 diabetes is the most prevalent compared to type 1 diabetes. However, other clinical reports indicate that diabetes prevalence among children below the age of five years in Qatar has also assumed upward trends. For instance, prevalence rate for diabetes among children was reported to be 13.7% in 1997, but this rate has more than doubled to reach 28.2% in 2007 (Dwevedi & Goyal, 2010).
From an epidemiological perspective, the burden of diabetes to Qatar’s healthcare system seems to be overwhelming. Therefore, it has become a significant concern in community health nursing because the number of Qatari diabetic patients seeking for medical treatment has increased significantly. This situation has been worsened by the rising trends of obesity prevalence rates. Currently, 45% of the population in Qatar is obese in which 55% of diabetic patients are obese (ANSA, 2013). Therefore, this correlation in incidence and prevalence rates of the two diseases complicates prevention and health promotion measures in Qatar. As a result, Qatar’s efforts to reduce the prevalence of diabetes have been faced with enormous challenges. However, the country is optimistic that the Qatar Diabetes Project and Stem Cell Projects will be successful.
In regard to the risk factors, the unprecedented increase of diabetes prevalence is attributable to lifestyle and genetic factors. Clinical studies reveal that most people in Qatar have changed their cultural lifestyle to western-related lifestyle, and this is believed to have contributed significantly to the current diabetes crisis. However, genetic factors have also been found to have contributed to the high prevalence rates.
In general, diabetes issue in Qatar needs appropriate epidemiological measures to reduce its burden to the country’s healthcare system in which social health determinants and epidemiological indicators will help in addressing the issue. Therefore, this research paper will provide an overview of diabetes in Qatar.
Overview of Diabetes
Diabetes mellitus is a metabolic health condition which is characterized by increased blood glucose, a condition referred to as hyperglycemia. It is popularly known as diabetes. There are two forms of diabetes: Type 1 diabetes (Insulin-dependent Diabetes) and Type 2 diabetes (Insulin-independent Diabetes). Type 1 diabetes is also known as Juvenile or childhood diabetes because it occurs during childhood and persists into adulthood (CDC, 2010). In contrast, type 2 diabetes occurs during adulthood; therefore, it is referred to as Adulthood diabetes.
Diabetes is believed to occur due to absence or insufficient production of Insulin by the β-cells of the Islets of Langerhans located in the pancreas. Insulin is a hormone which is responsible for the regulation of glucose in the blood circulation. Type 1 diabetes occurs due to genetic disorders that cause defects in the pancreas or in the Insulin receptors that are located on the surface of body cells (Masharani, 2008). On the other hand, Type 2 diabetes occurs due to Insulin resistance by the body cells.
Causes of Diabetes and its Related Social Determinants of Health
Diabetes is caused by high calorie intake especially carbohydrates. Research shows that consumption of high amounts of simple sugars such glucose lead to increase in blood glucose. High levels of glucose in the blood circulation after a heavy meal trigger the production of insulin from the β-cells of the Islets of Langerhans. Insulin is released into the blood circulation and then it gets transported to the body muscles, where it binds with the insulin receptors that are located on the surface of the body cells. Binding of insulin to the insulin receptors triggers a signal transduction in the intracellular region of the body cells, leading to the opening of glucose channels on the cell membrane (Coddington & Hisnanick, 2001). Glucose enters into the body cells where it is oxidized to generate chemical energy.
Excessive stimulation of the pancreas to release insulin leads to production of high amounts of insulin, which in turn, causes insulin resistance by the body cells. This condition is referred to as glucose intolerance because body cells do not take up glucose from the blood circulation. Therefore, glucose accumulates in the circulation leading to energy deficiency in the body cells.
Diabetes affects all the body cells especially the active muscle cells that are usually involved in generation of ATP energy in the body (Brandt & Churchill, 2003). However, its signs and symptoms are manifested in the kidneys, eyes and the circulatory system. It also affects the brain, the nervous system and the heart.
It has been found out that most causes of diabetes are influenced by several social determinants of health which have led to the increase of the prevalence rates in Qatar. Ordinarily, diabetes and the other non-communicable diseases are caused by socially determined behaviors and lifestyles. For instance, nutritional paradox such as eating habits and tobacco smoking are some of the contributing factors to the increased prevalence of diabetes among the Qatari population.
Some of the most significant social health determinants which are believed to have caused the prevalence rates of diabetes in Qatar include unhealthy environments, lack of social protection, lack of universal primary healthcare, challenges of childhood development and low literacy level.
Qatar and the other GCC nations have been experiencing challenges in designing efficient strategies to ensure childhood development enhances disease control. As a result, most children in Qatar are not protected against childhood diseases. This is probably the reason as to why prevalence trends of diabetes seem to have increased significantly among the young generation.
The second social determinant of health, which seems to have contributed significantly to the increase in diabetes prevalence in Qatar is unhealthy environments (Siddiqi & Watts, 2008). Qatar is one of the fast growing countries in the Middle East, in which oil resources have led to the emergence of rural urban centers. As a result, a large percentage of the national population has migrated to the urban centers where community health is relatively compromised by the growth of slums. It has been reported that slums are increasing rapidly in most urban centers in Qatar. Ordinarily, unsafe environment, which is characterized by overcrowding of people in the slums has been found to be one of the most significant factors causing obesity among children and adults. This is so because; slum areas lack adequate space for physical exercise and recreational facilities. Therefore, Qatar’s urban population faces a high risk of becoming obese and overweight both of which are predisposing conditions for diabetes.
On the other hand, Qatar is characterized with inefficient employment settings. For instance, youth unemployment in Qatar has been an enormous social and economic challenge. In addition, informal sector employment has also been found to be high in Qatar (Siddiqi & Watts, 2008). As a result, Qatar’s population comprises of a high percentage of the low-income population leading to the rapid expansion of slums in urban centers. Epidemiological studies indicate that socio-economic factors are related to the occurrence of obesity and diabetes. Therefore, informal sector employment and unemployment are some of the contributing factors towards the increase of diabetes among the Qatari population.
Moreover, lack of universal primary healthcare has also led to the increase of diabetes case in Qatar. Qatar’s healthcare system has been quite unsustainable owing to the scarcity of healthcare resources and services. As a result, out-of-pocket healthcare expenses have become an enormous burden to the Qatari population. It has been found out that most people in Qatar do not receive adequate healthcare services (Siddiqi & Watts, 2008). Therefore, disease screening services are relatively unavailable for patients. Ordinarily, screening for diabetes enhances disease prevention and control strategies. Therefore, the unprecedented lack of screening services in healthcare facilities has compromised prevention approaches, despite the government’s efforts to address the issue.