It is January 26, 5:00 pm in Abu Dhabi, United Emirates (that is 8 am in Washington, DC). I am here with a delegation from Children's National Medical Center to share medical strategies with The Health Authority of Abu Dhabi, meet peers from several Abu Dhabi hospitals, visit The Imperial College London Diabetes Center, and primarily to speak at The Arab Health Summit (Ambulatory Treatment of Type 1 Diabetes in Children).
After multiple meetings and shared meals with colleagues, it has become crystal clear that the problems facing our children in our diabetes practice in Washington, DC, are the same as those in the United Arab Emirates. Obesity and the increasing incidence in type 2 diabetes in both adults and children are leading causes of cardiovascular diseases in the Emirates (and the United States). Food options and lack of exercise remain the biggest sources of obesity. Interestingly enough, juice consumption in the UAE is even more of a problem than in the United States due to the high sugar content unique to this area. Carbohydrates are plentiful and "the golden arches" of McDonald's coexist with the towering skyscrapers and mosques in Abu Dhabi and Dubai. In addition, due to the extreme heat during summer months, exercise becomes difficult.
To tackle the burgeoning epidemic of diabetes in the UAE, a unique facility offering "a one- stop shop approach" was developed through the vision of Dr. Barakat, who is a cofounder of the Imperial College London Diabetes Center. Yesterday I had the pleasure of touring the facility. I was most impressed by the comprehensive services that were provided by the enormous support staff at ICDC. The Center utilizes computer based information in which an identification card from each patient can allow the diabetes team member to log on to the computer and obtain the appropriate information necessary for their particular aspect of care. All lab work is done in the facility including blood, radiography, EKGs, stress tests, etc. The lab itself had top of the line equipment and nearly all labs can be analyzed "in house." The Center primarily sees adults, although children are seen (a pediatric endocrinologist is being recruited to take the place of another physician who moved to the Al Mafraq Hospital medical facility where I had the opportunity to guest lecture yesterday, as well). Patients are seen by lab techs, lab work is completed in a timely manner and sent directly to the patient's diabetes care provider who formulates treatment plans and refers to the various team members and medical specialists. Medications are prescribed and waiting in the pharmacy for the patient to pick up before he/she leaves. It was amazing!
On the following day, my colleague, Dr.Evan Nadler, a pediatric surgeon who specializes in obesity and bariatric surgery, delivered a talk on metabolic abnormalities associated with obesity and treatment to an international audience of pediatric specialists at the Arab Health Summit in Dubai. Finally, on Thursday, January 27, I delivered my presentation on "Ambulatory treatment of type 1 diabetes in children" in the pediatric session. Amazingly enough, the questions asked emphasized the difficulty in managing complex care 24 hours/day, 365 days per year in our patient population (especially the group at most risk developmentally- adolescents). Questions also were asked about the accuracy of the hb A1c in children with G6PD deficiency (common in the Middle East) and hemolytic anemias (queried by a pediatric cardiologist).