EiD Meeting to Address Global Pandemic of 'Diabesity'

February 21, 2014

DOHA, Qatar — The Excellence in Diabetes (EiD) 2014 meeting, to be held in Doha, Qatar, next week, is designed to bring together some of the world's experts in the field to address how best to intervene in what conference organizer, David Matthews, MD, of Oxford University, United Kingdom, says is undoubtedly a "pandemic."

"We're in the middle of a diabetes epidemic that is so serious most people call it a pandemic," he told Medscape Medical News. Initially, it looked like the rise in type 2 diabetes being seen in countries such as the United States and those in Europe "was a condition of Western nations," he explained. Now it is becoming crystal clear that the problem in these countries is only the tip of the iceberg.

In the United States, the prevalence of type 2 diabetes has gone up from about 3% 20 years ago to around 8% to 9% now, said Dr. Matthews. And in the United Kingdom, "there has been a rise in type 2 diabetes from about 2% of the population to estimates that run from 4.5% up to 7%, depending on which part of the country you are in," he noted.

"But this looks trivial in comparison to what low- and middle-income countries are facing," he said. For example, in Colombo in Sri Lanka, "type 2 diabetes in adults is running at about 19%, and in Kuwait, it is running at about 23%."

"The Middle East and many developing countries have a huge problem, it's much worse [than in the West]. And in nations like India, where you have enormous populations and numbers are pushing 20% affected, you end up with extraordinary number of people with diabetes," he noted.

In nations like India, where you have enormous populations…you end up with extraordinary number of people with diabetes.

It is for this reason that the EiD meeting is being held in Qatar this year, in conjunction with the Gulf Group for the Study of Diabetes (GGSD); around 700 attendees are expected. Last year, in its inaugural year, EiD was in Istanbul, Turkey — the point being to draw attention to the fact that type 2 diabetes is not just a Western disease, said Dr. Matthews, who observed, "We won't be running EiD in Copenhagen."

Obesity is the Main Trigger for Type 2 Diabetes

Dr. Matthews explained that "while you can argue about the detail of why people get type 2 diabetes," there is one "generic cause" for the unprecedented rise in this condition across the world, and that is "that we are putting on weight. Obesity is the main trigger for type 2 diabetes." Research shows that going from a body mass index of 21 to 35 increases the likelihood of developing type 2 diabetes "by 37 times, which is a massive risk," he said.

We are putting on weight. Obesity is the main trigger for type 2 diabetes.

However, Dr. Matthews and colleagues in Oxford, who organize the EiD meeting, understand and recognize that tackling the problem will require different approaches in different places.

"This is an epidemic we know we can confront," he explained. "This conference is about saying how we will manage it, including what's new in modern research, how to use the therapies we have, and educating people in all of this, for which we have a spectacular faculty of international speakers. Our aim is to allow people to be exposed to some of the best scientists in the field."

Highlights on the first day of the meeting, Friday, February 28, will include Jaakko Tuomilehto, MD, PhD, from the University of Helsinki, Finland, speaking about "Preventing the epidemic of diabetes and obesity," and a number of other talks on the appropriate use of insulin in type 2 diabetes, including lessons from clinical trials and an update on some of the newer insulins.

There will also be presentations on newer therapies for diabetes that seem to instigate weight loss, with a lecture on glucagonlike peptide-1 (GLP-1) agonists by Jens Juul Holst, MD, PhD, from the University of Copenhagen, Denmark, and one on sodium-glucose cotransporter 2 (SGLT-2) inhibitors by John P. Wilding, DM, FRCP, from the University of Liverpool, United Kingdom.

"So here we are talking about how in particular the risk of diabetes and its treatment can be best managed," noted Dr. Matthews.

Also, the ever-controversial topic of whether bariatric surgery can cure type 2 diabetes will be debated by Roy Taylor, MB ChB, MD, FRCP, FRCPE, of Newcastle University, United Kingdom, and Luc van Gaal, MD, PhD, from Antwerp University, Belgium.

Ways of Intervening Must Be Culturally Sensitive

On Saturday, March 1, Stephen Colagiuri, MD, from the University of Sydney, Australia, will discuss new data on whether "genetics holds the answer to diabesity," while his compatriot Stephen Leeder, AO, MD, PhD, FRACP, FAFPHM, FRACGP (Hon), also of the University of Sydney, will talk about "Obesity and the toxic environment."

You can't necessarily do a prevention program in Kuwait that looks the same as what you've managed in Finland.

Other lectures that day include "Personal responsibility and its limitation in addressing the obesity epidemic" and the "Provision of tools to enable self-management: The role of technology."

Dr. Matthews said that "new ways of intervening," in this epidemic of "diabesity" must be found, "but we must be aware that some of these will be generic and some will need to be culturally appropriate, and we need to be realistic about appropriate interventions. You can't necessarily do a prevention program in Kuwait that looks the same as what you've managed in Finland."

Nevertheless, he says, sharing experiences is a great way to generate new ideas. "Exposing people to what others have done elsewhere gives them a stimulus; it makes them think about what they could do."

Along these lines, a final "Award" lecture will be given by Mohamed Hassanein, MBChB, FRCP, from Cardiff University School of Medicine, United Kingdom, on Sunday, March 2, entitled: "Diabetes and Ramadan: A challenge and an opportunity."


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