Diabetes—a global challenge

Diabetes develops when the pancreas produces insufficient insulin or when the body cannot effectively use it, leading to high blood glucose levels. Over time, high glucose levels can damage various tissues and organs, particularly the heart, blood vessels, brain, eyes, kidneys, and nerves. 

Recent estimates on the prevalence of diabetes were published in The Lancet in 2023 by the Global Burden of Disease, Injuries, and Risk Factors Study (GBD). The study estimated that 529 million (prevalence 6.1%) people globally are living with diabetes. The highest prevalence rates were observed in the Middle East and North Africa (9.3%), with Qatar having one of the highest prevalence rates. By 2050, more than 1.31 billion people are projected to have diabetes, with a prevalence exceeding 10%, particularly affecting the Middle East and North Africa (16.8%).

Recent studies by Weill Cornell Medicine-Qatar (WCM-Q) have focused on understanding the epidemiology and public health impact of diabetes within the Qatari population. These studies employed advanced mathematical modeling and population-level data to assess the burden of diabetes, its risk factors, and its relationship with obesity, while also contributing to the identification of effective interventions to reduce diabetes incidence and prevalence, including lifestyle changes, system-level interventions, and weight loss strategies. The research forecasted an increase in diabetes prevalence among Qataris from 17.8% in 2023 to 29.5% by 2050, with diabetes-related healthcare expenditures predicted to account for nearly one-third of the national health budget. This body of work was led by Dr. Laith Abu-Raddad, professor of population health sciences, associate dean for extramural research funding, and director of the Biostatistics, Epidemiology, and Biomathematics Research Core at WCM-Q.

In the GBD analyses, 96% of cases had Type 2 diabetes (T2D), of whom 52.2% were attributable to a high body mass index (BMI). Therefore, lifestyle changes such as adopting a healthy diet, engaging in regular physical activity, and increasingly using medication to lose weight can prevent, delay, and even lead to remission of T2D.

World Diabetes Day, established in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO) and recognized by the United Nations (UN) in 2006, is observed annually on November 14. It aims to raise awareness about diabetes, highlight the importance of early diagnosis and effective management, and support those living with the condition. The theme for 2024, “Diabetes and Well-being,” emphasizes the need to place physical and mental wellbeing at the heart of diabetes care, acknowledging the daily challenges faced by millions.

A 2024 research productivity analysis on diabetic neuropathy, which leads to pain, foot ulceration, and amputation, revealed that Denmark was the most active country with a Relative Publication Output per capita (R_POP) of 20.27, followed closely by Qatar with a (R_POP) of 18.01 and the United Kingdom with a (R_POP) of 9.54. Dr. Rayaz Malik, professor of medicine at WCM-Q and consultant physician in endocrinology and diabetes at Hamad Medical Corporation (HMC), was involved in most of the publications that led to Qatar’s elevated ranking. He has pioneered the technique of Corneal Confocal Microscopy (CCM), a rapid, non-invasive eye scan that identifies early nerve damage and predicts the progression of neurodegenerative diseases like diabetic neuropathy and dementia. Dr. Malik, who was named Qatar’s top medical researcher in 2023 and 2024 by Research.com, said: “It’s a privilege to be working in a country which values and supports our cutting-edge research that is making a huge difference in earlier diagnosis and the approval of new treatments for neurodegenerative diseases.”

Research by Dr. Chris Triggle, a professor of pharmacology at WCM-Q, focuses on the cellular basis of diabetes-related vascular disease and the optimization of therapeutic and regenerative interventions that can protect the endothelium, repair and restore normal endothelial function, and prevent disease progression. His laboratory has extensively studied the widely used anti-diabetic drug metformin, supporting its extensive and continued use as an insulin-sensitizing and anti-hyperglycemic drug for over 150 million people with T2D. According to Dr. Triggle: “Despite the proven benefits of newer drugs for T2D, notably the glucagon-like peptide receptor agonists such as semaglutide, and the gliflozins, such as empagliflozin, metformin remains an important, safe, and inexpensive drug for T2D and its multiple therapeutic benefits have also stimulated research to determine whether it could be re-purposed for a multitude of ailments, including use as an anti-aging drug.”

Dr. Nayef Mazloum, an associate professor of microbiology and immunology at WCM-Q and the associate dean of student research, investigates molecular and cellular pathways in metabolic disorders like obesity and diabetes. His research is centered on studying the possible causes of obesity and related complications, such as inflammation and T2D, and has helped explain why some obese individuals are at higher risk of developing T2D at much younger ages than lean individuals. “Obesity is believed to drive premature aging of the adipose tissue, leading to sterile “low-grade” chronic inflammation, which in turn leads to insulin resistance and T2D. Understanding the altered molecular and cellular pathways in obesity driven T2D will allow us to identify therapeutic targets which will open new pharmacological approaches for therapies of dibestes and obesity complications,” Dr. Mazloum said.

Researchers at WCM-Q have made remarkable progress in understanding and combating diabetes and its complications. They published a landmark study that sheds light on the role of proteins in various diseases while also making new discoveries about the complex metabolic and genetic processes that drive the formation of new fat cells, thereby enhancing understanding of obesity and its associated complications. Another study at WCM-Q revealed critical insights into the dysregulation of long non-coding RNA (lncRNA) gene expression pathways in monocytes from patients with T2D who also suffer from cardiovascular disease. Scientists have also introduced advanced analytical tools that explore links between genetic variations, proteins, and various diseases, and created a Diabetes Risk Score to predict an individual’s risk of developing diabetes. Additionally, researchers have developed an intricate molecular map of the human body and its complex physiological processes.

Commenting on WCM-Q’s remarkable contributions to the study of diabetes, Dr. Khaled Machaca, professor of physiology and biophysics/senior associate dean for research, innovations, and commercialization, said: “It is remarkable how quickly Qatar’s and Qatar Foundation’s research investments have led to actionable deliverables in the context of diabetes epidemiology, diagnosis, prevention, and treatment nationally. I am very pleased to see that our WCM-Q faculty’s contributions have been significant over the years and have supported the national effort. We look forward to further strong collaborative efforts with our national partners in Qatar to further advance diabetes treatment in a more personalized fashion.”

As diabetes continues to present significant health and economic challenges all over the world, scientists at WCM-Q remain committed to advancing understanding of the condition. The college’s expertise and cutting-edge research capabilities are paving the way for innovative diagnostic tools and treatments for diabetes and its complications.