ABU DHABI // More than 400,000 diabetics may be suffering from diabetic nerve pain, a study has found.
Doctors say the condition, which occurs when the nerves are damaged by too much glucose in the blood, may be twice as common among diabetics in the Middle East compared to in the West.
If could affect as many as two-thirds of diabetics in the region, compared with barely a quarter in Western countries.
The condition, said Dr Mohammed Saadah, consultant neurologist at Zayed Military Hospital, can be excruciating.
It begins as a numbness or tingling in the limbs, he said, and develops into a burning pain "so severe that some patients are not even able to tolerate the weight of their bed sheets on their thighs".
While the pain can be localised to just one foot, it can spread to the legs, knees or whole body. It can even be felt as a searing pain in the face. "It's horrific," said Dr Saadah.
Yet only 10 per cent of patients seek medical help, perhaps because of a culture that frowns on voicing concern over pain.
Dr Ammar Salti, the consultant anaesthetist at Zayed Military Hospital who compiled the data on the condition, said the main reasons it was more common in Arab countries were later diagnosis and treatment combined with the high levels of diabetes.
The UAE has the second highest prevalence of diabetes in the world - behind the Pacific island nation of Nauru - with almost a fifth of the population affected. Also in the top 10 are Oman, Bahrain, Kuwait and Saudi Arabia.
"Other reasons include genetic and social factors, such as higher rates of consanguine marriages and obesity as a result of unhealthy lifestyles - both of which are real problems in the region, particularly the Gulf," he said.
Marriage between cousins, he said, increases the chance of an offspring getting diabetes if there is family history of the condition.
Once the damage has set in, it cannot be reversed. And, according to Dr Saadah, it is a costly problem. "Chronic pain causes sleep and mood disturbances, which causes anxiety and depressions and affects people's quality of life," he said.
The issue of diabetic nerve damage was raised in Dubai last week by the former US president Bill Clinton. "It affects the stability of the family in the worst way, having people of younger and younger ages in pain and with constant medical problems that erode the fabric of ordinary life," he said at the MENA Diabetes Leadership Forum.
hkhalaf@thenational.ae
Vikram%20Vedha
%3Cp%3E%3Cstrong%3EDirectors%3A%3C%2Fstrong%3E%20Gayatri%2C%20Pushkar%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EStars%3A%3C%2Fstrong%3E%20Hrithik%20Roshan%2C%20Saif%20Ali%20Khan%2C%20Radhika%20Apte%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ERating%3A%C2%A0%3C%2Fstrong%3E3.5%2F5%3C%2Fp%3E%0A
Ireland v Denmark: The last two years
Denmark 1-1 Ireland
7/06/19, Euro 2020 qualifier
Denmark 0-0 Ireland
19/11/2018, Nations League
Ireland 0-0 Denmark
13/10/2018, Nations League
Ireland 1 Denmark 5
14/11/2017, World Cup qualifier
Denmark 0-0 Ireland
11/11/2017, World Cup qualifier
JAPAN SQUAD
Goalkeepers: Masaaki Higashiguchi, Shuichi Gonda, Daniel Schmidt
Defenders: Yuto Nagatomo, Tomoaki Makino, Maya Yoshida, Sho Sasaki, Hiroki Sakai, Sei Muroya, Genta Miura, Takehiro Tomiyasu
Midfielders: Toshihiro Aoyama, Genki Haraguchi, Gaku Shibasaki, Wataru Endo, Junya Ito, Shoya Nakajima, Takumi Minamino, Hidemasa Morita, Ritsu Doan
Forwards: Yuya Osako, Takuma Asano, Koya Kitagawa
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”