New weapons to help reverse diabetes and offer patients less invasive alternatives to weight loss surgery will soon be at the disposal of doctors in the UAE.
While the trend for obese patients opting for extreme bariatric surgery continues in the Emirates, those operations can be expensive and have lengthy recovery periods; however, a new day procedure under general anaesthetic – available at King’s College Hospital from January – could help patients reverse diabetes and the first patients are currently being screened for suitability.
The EndoBarrier procedure involves doctors inserting a flexible tube through the throat and around the patient’s duodenum, the first segment of the small intestine. It helps alter the way hormones react in the body, encouraging weight loss.
The device is left inside the patient for a year, combining with lifestyle and diet changes to help reverse diabetes.
The objective is to mimic what is achieved through traditional bariatric surgery without having to undergo an extreme procedure that permanently changes the patient’s body, and is very expensive.
“We are starting to understand more about the hormones produced in the bowel, how they work and how they can control blood sugar and body weight to absorb and process nutrients from the diet,” said Dr Bu Hayee, a consultant gastroenterologist, at King’s College Hospital – UAE.
“[The procedure] has the same effect as bariatric bypass surgery. The effects are not as dramatic as what you would see through traditional operations, but the benefit is it can be done as a day case procedure and there is no need for a hospital stay or surgery.
“It involves an endoscopy via general anaesthetic that takes about half an hour to an hour to insert.
“We are trying to change the biology of the condition as the hormones that control body weight are altered by this procedure.”
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Read more:
A fifth of Emiratis in Dubai are diabetic, new survey reveals
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Reducing the amount of fat in someone’s liver can also alter the balance of hormones that keeps the patient in an obese, diabetic state.
Any changes made through diet and exercise encourage a temporary shift in the condition, rather than a permanent one.
“It is important to note that from a public health perspective, healthy eating and good food choices should always be encouraged first,” Dr Hayee said.
“This is not a magic bullet. By the time people are obese and have developed diabetes, diet and exercise alone will often not help in the long term.
“This [procedure] can help break the cycle and the biology of the disease.
“We know this is effective and even once the device has been removed, patients don’t revert to their original state.
“In the cases we’ve looked at, there is sometimes a gradual and slight increase in weight, but the beauty of this procedure is it can be repeated if there is a need to.”
Doctors at NMC Royal Hospital have treated an increasing number of patients in 2017 for obesity-related health conditions.
Between 2009 and 2015, the Bariatric and Metabolic Institute Abu Dhabi at Sheikh Khalifa Medical City received 940 bariatric surgery cases; however, they say operations on morbidly obese patients are increasing by more than 5,000 cases a year.
Surgery can cost up to Dh50,000, with further costly procedures likely to be necessary to remove excess skin left behind after rapid weight loss.
The solution is rarely a long-term one without drastic lifestyle adaptations, and some patients put any weight they’ve lost back on within six years.
Inserting an EndoBarrier is seen as a cost-effective alternative to bariatric surgery and should be offered to more patients as an option in the UAE, doctors have said.
According to the studies done so far on EndoBarrier, it appears to be helpful for patients with advanced type two diabetes, and particularly useful with patients with a body mass index of over 35 who find it hard to control their diabetes with medication.
Dr Dinesh Dhan Wal, a consultant endocrinologist and diabetes specialist at NMC Speciality Hospital in Dubai said obesity is one of the main risk factors of diabetes.
“If we can get patients to lose weight there is often at least a partial reversal of the condition,” he said.
“Those who have been recently diagnosed with type two diabetes and with high blood glucose levels, their beta cells are repressed.
______
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“With medication these cells can recover with insulin and the patient can eventually come off medication, with lifestyle and diet modifications.
“We are doing this very successfully with our patients, who must be highly motivated to lose weight and commit to a change.”
Once the patient’s beta cells start functioning again and they improve their diet and lifestyle, they can come off medication altogether in some cases.
“When patients come to me after they have had bariatric surgery, they are rarely happy. They have not always been told what they should expect,” Dr Dhan Wal said.
UAE currency: the story behind the money in your pockets
TALE OF THE TAPE
Manny Pacquiao
Record: 59-6-2 (38 KOs)
Age: 38
Weight: 146lbs
Height: 166cm
Reach: 170cm
Jeff Horn
Record: 16-0-1 (11 KOs)
Age: 29
Weight: 146.2lbs
Height: 175cm
Reach: 173cm
Dhadak 2
Director: Shazia Iqbal
Starring: Siddhant Chaturvedi, Triptii Dimri
Rating: 1/5
What the law says
Micro-retirement is not a recognised concept or employment status under Federal Decree Law No. 33 of 2021 on the Regulation of Labour Relations (as amended) (UAE Labour Law). As such, it reflects a voluntary work-life balance practice, rather than a recognised legal employment category, according to Dilini Loku, senior associate for law firm Gateley Middle East.
“Some companies may offer formal sabbatical policies or career break programmes; however, beyond such arrangements, there is no automatic right or statutory entitlement to extended breaks,” she explains.
“Any leave taken beyond statutory entitlements, such as annual leave, is typically regarded as unpaid leave in accordance with Article 33 of the UAE Labour Law. While employees may legally take unpaid leave, such requests are subject to the employer’s discretion and require approval.”
If an employee resigns to pursue micro-retirement, the employment contract is terminated, and the employer is under no legal obligation to rehire the employee in the future unless specific contractual agreements are in place (such as return-to-work arrangements), which are generally uncommon, Ms Loku adds.
Email sent to Uber team from chief executive Dara Khosrowshahi
From: Dara
To: Team@
Date: March 25, 2019 at 11:45pm PT
Subj: Accelerating in the Middle East
Five years ago, Uber launched in the Middle East. It was the start of an incredible journey, with millions of riders and drivers finding new ways to move and work in a dynamic region that’s become so important to Uber. Now Pakistan is one of our fastest-growing markets in the world, women are driving with Uber across Saudi Arabia, and we chose Cairo to launch our first Uber Bus product late last year.
Today we are taking the next step in this journey—well, it’s more like a leap, and a big one: in a few minutes, we’ll announce that we’ve agreed to acquire Careem. Importantly, we intend to operate Careem independently, under the leadership of co-founder and current CEO Mudassir Sheikha. I’ve gotten to know both co-founders, Mudassir and Magnus Olsson, and what they have built is truly extraordinary. They are first-class entrepreneurs who share our platform vision and, like us, have launched a wide range of products—from digital payments to food delivery—to serve consumers.
I expect many of you will ask how we arrived at this structure, meaning allowing Careem to maintain an independent brand and operate separately. After careful consideration, we decided that this framework has the advantage of letting us build new products and try new ideas across not one, but two, strong brands, with strong operators within each. Over time, by integrating parts of our networks, we can operate more efficiently, achieve even lower wait times, expand new products like high-capacity vehicles and payments, and quicken the already remarkable pace of innovation in the region.
This acquisition is subject to regulatory approval in various countries, which we don’t expect before Q1 2020. Until then, nothing changes. And since both companies will continue to largely operate separately after the acquisition, very little will change in either teams’ day-to-day operations post-close. Today’s news is a testament to the incredible business our team has worked so hard to build.
It’s a great day for the Middle East, for the region’s thriving tech sector, for Careem, and for Uber.
Uber on,
Dara
PROFILE OF INVYGO
Started: 2018
Founders: Eslam Hussein and Pulkit Ganjoo
Based: Dubai
Sector: Transport
Size: 9 employees
Investment: $1,275,000
Investors: Class 5 Global, Equitrust, Gulf Islamic Investments, Kairos K50 and William Zeqiri
Indika
%3Cp%3E%3Cstrong%3EDeveloper%3A%3C%2Fstrong%3E%2011%20Bit%20Studios%3Cbr%3E%3Cstrong%3EPublisher%3A%3C%2Fstrong%3E%20Odd%20Meter%3Cbr%3E%3Cstrong%3EConsole%3A%3C%2Fstrong%3E%20PlayStation%205%2C%20PC%20and%20Xbox%20series%20X%2FS%3Cbr%3E%3Cstrong%3ERating%3A%3C%2Fstrong%3E%204%2F5%3C%2Fp%3E%0A
Killing of Qassem Suleimani
Emergency
Director: Kangana Ranaut
Stars: Kangana Ranaut, Anupam Kher, Shreyas Talpade, Milind Soman, Mahima Chaudhry
Rating: 2/5
PROFILE OF HALAN
Started: November 2017
Founders: Mounir Nakhla, Ahmed Mohsen and Mohamed Aboulnaga
Based: Cairo, Egypt
Sector: transport and logistics
Size: 150 employees
Investment: approximately $8 million
Investors include: Singapore’s Battery Road Digital Holdings, Egypt’s Algebra Ventures, Uber co-founder and former CTO Oscar Salazar
GOLF’S RAHMBO
- 5 wins in 22 months as pro
- Three wins in past 10 starts
- 45 pro starts worldwide: 5 wins, 17 top 5s
- Ranked 551th in world on debut, now No 4 (was No 2 earlier this year)
- 5th player in last 30 years to win 3 European Tour and 2 PGA Tour titles before age 24 (Woods, Garcia, McIlroy, Spieth)
What can victims do?
Always use only regulated platforms
Stop all transactions and communication on suspicion
Save all evidence (screenshots, chat logs, transaction IDs)
Report to local authorities
Warn others to prevent further harm
Courtesy: Crystal Intelligence
500 People from Gaza enter France
115 Special programme for artists
25 Evacuation of injured and sick
