Diabetes mellitus is becoming a major public health problem worldwide, including in the WHO Eastern Mediterranean Region. Due to the lack of physical activity as well as dietary changes, the incidence of diabetes is increasing at an alarming rate. Diabetes affects more than 230 million people worldwide. If the current trend continues, 370 million people worldwide are expected to have diabetes by the year 2030.
In the WHO Eastern Mediterranean Region the numbers are alarming, especially in Gulf Cooperation Council and Arab states (15%–25%). Diabetic retinopathy is the most common complication of diabetes and a leading cause of visual loss in the working age group. People with diabetes are estimated to be 25 times more likely to develop blindness than people without diabetes.
It has been estimated that at any given time, 33% of the total diabetic population will suffer from some form of diabetic retinopathy, and a third of these will have sight-threatening complications. The recognition of diabetic retinopathy in its earlier, asymptomatic stages is important, and can save many eyes from blindness. Available data in many randomized clinical trials have proven that the risk of visual impairment and blindness is substantially reduced by a care programme that combines methods for early detection with effective treatment with laser photocoagulation.
Many studies have observed that early detection and treatment of diabetic retinopathy is hampered by the lack of awareness among diabetic patients about the potential of sight threatening eye complications and poor compliance with periodic eye examinations. Thus, prevention of visual disability from diabetic retinopathy must go beyond the purely clinical domain to include patient education and early detection, including screening of target populations. Screening priority should be given to known diabetic populations. Effective detection and management of diabetic retinopathy can be accomplished only with the full cooperation of all members of the diabetic care provider team.
Aware of these facts, concerned international agencies such as WHO, the International Agency for Prevention of Blindness and IMPACT/EMR along with the International Diabetic Federation and others are working to develop a regional strategy to prevent loss of sight due to diabetes. To this effect, a workshop will be held at the WHO Regional Office for the Eastern Mediterranean from 20 to 22 November 2006. The workshop will be attended by HRH Prince Abdel Aziz Bin Ahmed Al Saud, Regional Chairperson of IMPACT/EMR and IAPB, and H.E. Dr Hatem El-Gabali, Minister of Health and Population, Egypt along with Dr Hussein A. Gezairy, WHO Regional Director for the Eastern Mediterranean. The workshop will focus on patient education and early detection as well as screening of target populations and integrating diabetic care provider team into the management system of diabetic retinopathy.
Participants in the workshop will include experts from 14 countries with a known burden of diabetes: Bahrain, Egypt, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Libyan Arab Jamahiriya, Morocco, Pakistan, Saudi Arabia, Sudan, Syrian Arab Republic, Tunisia and Yemen. Also attending are representatives from WHO collaborating centres and regional and international nongovernmental organizations, such as IMPACT/EMR, IAPB, International Diabetes Federation, Al-Noor Foundation, Lions Clubs International Foundation, Sight Savers International, The Fred Hollows Foundation, Al-Bassar International Foundation, Al Manhal Charitable Organization, Layton Rahmatullah Benevolent Trust, Al-Shifa Trust Eye Hospital, King Khaled Eye Specialist Hospital, Federation Of Islamic Medical Association and Arab Medical Union.
“Prevention of blindness due to diabetic retinopathy is an important issue and a priority area in need of urgent attention from all of us, we need to work together as team to fight blindness”, notes Dr Gezairy. Diabetes and sight threatening complications pose health and financial burdens on countries affected by high diabetes prevalence. For example, such conditions cost Saudi Arabia more than US$ 400 million a year. Recently, the WHO Regional Office in collaboration with HRH Prince Abdulaziz Bin Ahmed Al Saud held a workshop in Qatar on prevention of sight loss from diabetic retinopathy in the Member State of the Gulf Cooperation Council.
Many countries of the Region, including Egypt, are currently focusing greater attention on preventing blindness, including diabetes-related blindness. H.E. Mrs Suzanne Mubarak, First Lady of Egypt, is patronizing the avoidable blindness programme VISION2020 “Right to Sight” under her direct auspices.
The most important message of the workshop is that “unless we pay urgent attention to primary prevention, diet, physical activity, tight blood glucose control and tight blood pressure control, blindness due to diabetes will continue to rise”.