AJMAN // For the country's many diabetics, losing a toe - or an entire foot - is a real danger, but experts say it does not have to be every diabetic's destiny.
Although a quarter of diabetics will develop a foot ulcer and one in five of those will require an amputation, that number can be brought down with a little education and some changes of habit.
"Everyone with diabetes thinks they're going to get an amputation," said Dr Timothy Fisher, a consultant podiatric surgeon at Sheikh Khalifa Hospital's Rashid Centre for Diabetes and Research in Ajman. "But I don't see nearly as many wounds or foot ulcers here as I did in the US."
Dr Fisher joined the hospital's diabetes centre in August to address a complication of diabetes that often goes overlooked in the region. "The disease is new here and the country's younger population have not yet lived with diabetes for the 10, 20 and 30 years that precede complications such as kidney disease, blindness and of course, neuropathy [nerve damage]," he said.
About two-thirds of diabetics suffer this irreversible nerve damage. It usually begins with a numbness in the feet, as the nerves furthest away from the central part of the body are attacked and killed. The patient loses "the gift of pain", so they can step on glass and not feel it. This leads to wounds that go unnoticed, which can become dangerously infected.
While the number of people in the UAE with diabetes is worryingly high - it has the second-highest prevalence of the disease in the world - the relatively young population means that "this is the time for us to go in and teach people what to look for in order to prevent amputations later in life", according to Dr Fisher.
Teaching patients to be alert for numbness and tingling, to avoid walking barefoot and to see a foot specialist at least once a year should prevent foot complications, he said.
Gulnaz Tariq, a charge nurse at Sheikh Khalifa Medical City in the capital, said sandals were at least partly to blame. She tells her patients to invest in medical shoes with a special sole to offset pressure. "We have 100 per cent improper footwear in this part of the region, especially for diabetics."
Patients are also taught to cut their toenails straight to avoid ingrown nails, and to dry feet properly after ablutions to avoid fungal infection.
Ms Tariq makes sure every diabetic in the hospital gets his or her feet checked - 518 were screened between April and August this year. Of those, 473 suffered ulcers on their feet, 354 had calluses - which can develop into ulcers - and 267 suffered nerve damage, while 41 had already had an amputation. Of the 518, none owned medical footwear.
Dr Fisher welcomed the move towards specialised centres, saying they were "crucial for a country with such a high incidence of diabetes".
The number of diabetes-related amputations in the UAE is not known, but Dr Fisher said he had seen too many since he had arrived. Half of those amputees will die within five years. That, he said, "is more than the mortality rate of breast cancer or colorectal cancer".
hkhalaf@thenational.ae
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The specs
Engine: Four electric motors, one at each wheel
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Transmission: Single-speed automatic
Price: From Dh825,900
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BULKWHIZ PROFILE
Date started: February 2017
Founders: Amira Rashad (CEO), Yusuf Saber (CTO), Mahmoud Sayedahmed (adviser), Reda Bouraoui (adviser)
Based: Dubai, UAE
Sector: E-commerce
Size: 50 employees
Funding: approximately $6m
Investors: Beco Capital, Enabling Future and Wain in the UAE; China's MSA Capital; 500 Startups; Faith Capital and Savour Ventures in Kuwait
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At a glance
Global events: Much of the UK’s economic woes were blamed on “increased global uncertainty”, which can be interpreted as the economic impact of the Ukraine war and the uncertainty over Donald Trump’s tariffs.
Growth forecasts: Cut for 2025 from 2 per cent to 1 per cent. The OBR watchdog also estimated inflation will average 3.2 per cent this year
Welfare: Universal credit health element cut by 50 per cent and frozen for new claimants, building on cuts to the disability and incapacity bill set out earlier this month
Spending cuts: Overall day-to day-spending across government cut by £6.1bn in 2029-30
Tax evasion: Steps to crack down on tax evasion to raise “£6.5bn per year” for the public purse
Defence: New high-tech weaponry, upgrading HM Naval Base in Portsmouth
Housing: Housebuilding to reach its highest in 40 years, with planning reforms helping generate an extra £3.4bn for public finances
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Starring: Jack Black, Jennifer Coolidge, Jason Momoa
Rating: 3/5
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Results
4pm: Al Bastakiya – Listed (TB) $150,000 (Dirt) 1,900m; Winner: Panadol, Mickael Barzalona (jockey), Salem bin Ghadayer (trainer)
4.35pm: Dubai City Of Gold – Group 2 (TB) $228,000 (Turf) 2,410m; Winner: Walton Street, William Buick, Charlie Appleby
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5.45pm: Burj Nahaar – Group 3 (TB) $228,000 (D) 1,600m; Winner: Midnight Sands, Pat Dobbs, Doug Watson
6.20pm: Jebel Hatta – Group 1 (TB) $260,000 (T) 1,800m; Winner: Lord Glitters, Daniel Tudhope, David O’Meara
6.55pm: Al Maktoum Challenge Round-1 – Group 1 (TB) $390,000 (D) 2,000m; Winner: Salute The Soldier, Adrie de Vries, Fawzi Nass
7.30pm: Nad Al Sheba – Group 3 (TB) $228,000 (T) 1,200m; Winner: Final Song, Frankie Dettori, Saeed bin Suroor
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How to report a beggar
Abu Dhabi – Call 999 or 8002626 (Aman Service)
Dubai – Call 800243
Sharjah – Call 065632222
Ras Al Khaimah - Call 072053372
Ajman – Call 067401616
Umm Al Quwain – Call 999
Fujairah - Call 092051100 or 092224411
Test
Director: S Sashikanth
Cast: Nayanthara, Siddharth, Meera Jasmine, R Madhavan
Star rating: 2/5
Specs
Engine: Dual-motor all-wheel-drive electric
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Power: 905hp
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Skewed figures
In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458.
The smuggler
Eldarir had arrived at JFK in January 2020 with three suitcases, containing goods he valued at $300, when he was directed to a search area.
Officers found 41 gold artefacts among the bags, including amulets from a funerary set which prepared the deceased for the afterlife.
Also found was a cartouche of a Ptolemaic king on a relief that was originally part of a royal building or temple.
The largest single group of items found in Eldarir’s cases were 400 shabtis, or figurines.
Khouli conviction
Khouli smuggled items into the US by making false declarations to customs about the country of origin and value of the items.
According to Immigration and Customs Enforcement, he provided “false provenances which stated that [two] Egyptian antiquities were part of a collection assembled by Khouli's father in Israel in the 1960s” when in fact “Khouli acquired the Egyptian antiquities from other dealers”.
He was sentenced to one year of probation, six months of home confinement and 200 hours of community service in 2012 after admitting buying and smuggling Egyptian antiquities, including coffins, funerary boats and limestone figures.
For sale
A number of other items said to come from the collection of Ezeldeen Taha Eldarir are currently or recently for sale.
Their provenance is described in near identical terms as the British Museum shabti: bought from Salahaddin Sirmali, "authenticated and appraised" by Hossen Rashed, then imported to the US in 1948.
- An Egyptian Mummy mask dating from 700BC-30BC, is on offer for £11,807 ($15,275) online by a seller in Mexico
- A coffin lid dating back to 664BC-332BC was offered for sale by a Colorado-based art dealer, with a starting price of $65,000
- A shabti that was on sale through a Chicago-based coin dealer, dating from 1567BC-1085BC, is up for $1,950
Why your domicile status is important
Your UK residence status is assessed using the statutory residence test. While your residence status – ie where you live - is assessed every year, your domicile status is assessed over your lifetime.
Your domicile of origin generally comes from your parents and if your parents were not married, then it is decided by your father. Your domicile is generally the country your father considered his permanent home when you were born.
UK residents who have their permanent home ("domicile") outside the UK may not have to pay UK tax on foreign income. For example, they do not pay tax on foreign income or gains if they are less than £2,000 in the tax year and do not transfer that gain to a UK bank account.
A UK-domiciled person, however, is liable for UK tax on their worldwide income and gains when they are resident in the UK.
