Monthly Archives: January 2015

Talking it out: How diabetics benefit from diagnosis conversations with doctors

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Early conversations between physicians and diabetes patients are not only critical for patients’ emotional well-being but they also predict the degree to which patients keep up with treatment.

There are some 36.8 million diabetics in the Middle East and North Africa, with the highest number of patients in Egypt, and the highest prevalence of the disease in Saudi Arabia, followed closely by Kuwait. In 2014 alone, the region spent a staggering $16.8 billion on healthcare in relation to treating or preventing diabetes –  a strain on the developing countries’ collectives economies. Around 363,000 died last year from diabetes and/or its complications, 53% of which are below the age of 60.

But little changes can make a difference, new information reveals, positively affecting the quality of life (and treatment) of diabetics.

Diagnosis conversations with doctors for one help diabetics accept the fact that the ailment – especially the often-fatal and more prominent Type 2 – is here to stay, in other words a life-time partner; these conversations are also associated with more commitment to the prescribed courses of treatment, reveals “IntroDia” a global survey about type 2 diabetes.

The survey, carried out by Boehringer Ingelheim and Eli Lilly and Company in partnership with the International Diabetes Federation (IDF), launched in 2013 and has since then investigated conversations between over 6,000 doctors and 10,000 patients across 26 countries, including Saudi Arabia and the UAE. The survey is ongoing but the initial results were released in September 2014.

Around 60 physicians from Saudi Arabia and the UAE participated in the survey – which revealed that unfortunately the behavioral changes by patients (or the lack thereof) as well as the preliminary conversations with doctors on the onset of diagnosis are far from enough to curb the damage – both emotional and physical.

Patients revert to old habits, say panelists at Arab Health Congress happening in Dubai this week, and physicians have complained that they need more “tools” to help them make sure that people with type 2 diabetes sustain behavioral changes needed for treatment success.

“They need more time, for instance, with the patients,” explains Karim Al Alaoui, managing director of Boehringer Ingelheim for Middle East, Turkey and Africa, among other things.

During the initial stages of diagnosis, says Abdulrazzaq Al Madani, consultant endocrinologist and physician at the Dubai Hospital and chairman of the Emirates Diabetes society, UAE, patients experience anger, stress and frustration; “it’s the idea that they have to live with this disease forever. It’s a permanent change.”

Treatment success depends on how the patients accept their condition, and the efficacy of medications in equal parts, says Al Alaoui, based on the survey results.

The final conclusions of the survey will be showcased in full later this year. The companies and the IDF are hoping that the insights therein would be used to develop resources to help physicians provide adequate support for patients.

Nobel laureates urge KAUST to openly decry harsh punishment of Saudi blogger

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In an open letter addressed to Jean-Lou Chameau, the president of the King Abudllah University of Science and Technology (KAUST) in Saudi Arabia, a group of 18 Nobel laureates, “friends of KAUST,” pleaded with the country’s leading academics to stand up against oppression of free thought; more precisely to openly decry the public flogging of Saudi blogger Raif Badawi.

Badawi, who created an open platform for discussion and criticised the Kingdom’s religious clerics, was handed down a 10-year prison term, and 1,000 lashes in punishment. A Youtube video taken on a mobile phone showing the flogging went viral; renewing concerns over Saudi Arabia’s human rights track record, and sending shock waves across the international community.

Now, the Nobel prizewinners – from France, Germany, the US, the UK, Australia, Canada, and South Africa – are not only urging KAUST academics to speak up and attempt to influence the sentence, which they hope that Saudi Arabia is already reconsidering, but they’re also suggesting that if they stay silent, it might reflect negatively on the important science and research hub they have built up.

“We write out of concern that the fabric of international cooperation may be torn apart by dismay at the severe restrictions on freedom of thought and expression still applied to Saudi Arabia society,” the letter reads. “We have no doubt that members of KAUST share that concern, aware that the cruel sentence passed, for example, on Mr. Raif Badawi who established a forum for open discussion, sent a shock around the world.”

Despite being firm in demanding an acknowledgement of the harshness of the sentence against the now-prominent blogger, the scientists showed understanding (clear in their wording of the letter) that in a country like Saudi Arabia, “change comes by degrees.” They still insisted that five years into the institution’s history, however, it’s “a crucial time for KAUST” to argue for “freedom of dissent, without which no institution of higher learning can be viable.”

“The undersigned friends of KAUST will be there to support you in asserting the values of freedom that we are all agreed are essential to the future of a University in this twenty first century, and that will determine the success of the extraordinary venture which you lead,” the letter concludes.

The full letter can be read here.

The (biological) spoils of war

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Despite the destruction war yields, there’s a biological benefit for engaging in it, a study that observed nomadic herders in South Sudan and southwest Euthopia reveals.

The Harvard study is lead by Luke Glowacki, a doctoral student under the guidance of Richard Wrangham, Ruth Moore Professor of Biological Anthropology and Curator of Primate Behavioral Biology in the Peabody Museum of Archaeology and Ethnology.

The author explains that in herding tribes in East Africa, those who have participated in raids or engaged in violent conflict, had more wives and in turn a greater opportunity to reproduce successfully; in short, those who “took part in more raids, had more children” over the course of their lives, according to Glowacki, who was quoted in Science Daily.

“The currency of evolution is reproductive success,” adds Glowacki. He says that in his paper, published on 29 December in PNAS, he emphases that it’s not just a case of “biology made me do it.”

“It’s very clear what the pathway to greater reproductive success is — it’s access to livestock, which are obtained through raiding and then used for marriage,” he’s quoted as saying. “But the cultural mechanism is mediated by the elders who control virtually all aspects of the society. After a raid young men give any livestock they capture to the elders and the raider cannot use them at that point even if he wants to get married. Later in life, as the raider gets older he can gain access to them, so there’s a lag in receiving benefits from participating in a raid.

“The overriding question I’m interested in is how humans cooperate, and one type of cooperation is participating in intergroup conflict.”

It’s not clear whether Glowacki’s conclusions can be generalized to the rest of the region, specifically North Africa and the Middle East, where civil conflict is rampant, as well as the idea of polygamy among many Muslim fighters, say in countries like Syria or Iraq – and whether or not religious, as well as cultural, forces play a part here. In Syria and Iraq, for instance, notorious Islamist group IS (Islamic State) cover ground, raiding new towns and villages, and taking over valuable resources, leaving destruction in their wake. They’re field combatants too, perhaps not unlike the study’s subjects: armed Nyangatom men between the ages of 20 and 40. Taking female hostages or forcing themselves upon communities, for instance, IS has been asserting its right to “Jihad marriages” and offing those who refuse.

Is this the same? Can the same link between war and reproductive capacity be applied to them?

According to the paper, evolutionary anthropologists have argued that individuals can benefit from participating in warfare despite the risks they face, but field data to confirm this hypothesis were rare, until this paper; considered the first quantitative study on warfare and reproductive success.

“Greater warriorship gives men increased access to bridewealth over the life course.”

The study however makes it clear that its conclusions, so far at least, are restricted to small-scale societies engaged in warfare; Nyangatom men are essentially villagers, small numbers compared to organised groups like IS. The politics of the conflict and the community dynamics may also be a deciding factor.