COVID-19 and Type 2 diabetes: Regional experts shed light on the latest scientific updates and clinical practices in disease management for patient education

Boehringer Ingelheim - one of the world’s leading pharmaceutical companies - held a regional media webinar titled ‘Managing Type 2 Diabetes during COVID-19’ with the participation of leading healthcare professionals who provided the latest updates on type 2 diabetes (T2D) management during the pandemic. The regional media event formed part of the ‘Regional Interchange on Diabetes’ (e-RID) internationally-accredited digital program, organized by Boehringer Ingelheim, targeting more than 5,000 international and regional healthcare professionals in the Middle East, Turkey and Africa region. By hosting prominent international experts from the USA, Canada and UK, the scientific program aims at exchanging experiences and practices in managing type 2 diabetes and its complications during COVID-19. 

Thirty-nine million people are currently living with diabetes in the Middle East and North Africa, and it is estimated that by 2045, around 82 million people will have the condition, according to the International Diabetes Federation [2]. With diabetes being reported as a risk factor for the severity of COVID-19[3], patients are being encouraged to take precautions to avoid contracting the virus, such as washing hands thoroughly and regularly, cleaning and disinfecting objects and surfaces that are touched frequently, and avoiding contact with anyone showing symptoms of respiratory illness, such as coughing [4]. Patients living with T2D need to pay extra attention to their glucose levels and monitor them regularly to avoid complications caused by high or low blood glucose levels. Should they display flu-like symptoms, it is vital they consult with a physician immediately for medical support [5].

“At a time where the world is focused on COVID-19, it is crucial to highlight the diseases affecting the lives of so many patients in our region such as Type 2 Diabetes. We felt committed to providing patients living with T2D, their caregivers and the wider healthcare community credible sources of information related to diabetes management and necessary precautions during the pandemic,” said Mohammed Al-Tawil, Regional Managing Director and Head of Human Pharma at Boehringer Ingelheim.
“People with diabetes and related comorbidities are at a higher risk of complications from COVID-19. In fact, 40 percent of COVID-19 mortality cases in the UAE and Kuwait as announced had diabetes[10]. It is therefore imperative that we educate patients on diabetes self-management and comorbidities at this time,” explained Dr. Mohammed Hassanein, Senior Consultant in Endocrinology and Diabetes at Dubai Hospital. “Patients living with uncontrolled T2D face a higher risk of contracting the virus than patients living with controlled T2D. Our priority is therefore to ensure effective type 2 diabetes control at this critical time.”

Cardiovascular disease (CVD) remains the number one killer of people with type 2 diabetes, accounting for around 52% of type 2 diabetes patients worldwide [6] . Diabetes is a known risk factor for CVD, so are conditions such as high blood pressure and obesity, all commonly seen in people with diabetes. Collectively, this means that the risk of death due to CVD is up to four times higher in people diagnosed with T2D [7] .
Reducing cardiovascular risk is an essential component of diabetes management, therefore patients are encouraged to educate themselves on how to modify cardiovascular risk factors in order to benefit from the best chance at improving their CVD outcomes [8]. A patient-centric and holistic approach are needed to guide the choice of pharmacologic agents used in patients diagnosed with T2D due to the chronic nature of the disease. Considerations include efficacy, hypoglycemia risk, history of CVD, impact on weight, potential side effects, renal effects, delivery method, cost, and patient preferences [9] .

The “Managing type 2 diabetes during COVID-19” webinar session was delivered by leading endocrinologists from the Middle East; Professor Dr Yehia Ghanem, Professor of Diabetes, Lipid and Metabolism, and member of the Egyptian Diabetes National Committee in Egypt touched on the cardiovascular and renal complications related to T2D. Microvascular complications include damage to eyes (retinopathy) leading to blindness, to kidneys (nephropathy) leading to renal failure and to nerves (neuropathy) leading to impotence and diabetic foot disorders (which include severe infections leading to amputation). Macrovascular complications include stroke, heart failure, myocardial infarction, coronary artery disease and atherosclerosis. Dr. Ghanem also mentioned the EMPA-REG OUTCOME^® trial, which  changed the paradigm of T2D management, particularly in the reduction of cardiovascular events in general such as delayed progression of the disease, reduction of the risk of hospitalization for heart failure and reduction of cardiovascular and total mortality for those high risk T2D patients. 

Dr. Eman Sheshah, Director of Endocrine and Diabetes Center in King Salman Hospital Riyadh in KSA, explained during the event the burden of diabetes: “The prevalence of type 2 diabetes has increased dramatically during the last two decades, with obesity identified as a primary risk factor. Having this condition not only increases the burden for patients and their caregivers, but for governments who have to carry the cost of treatment, hospitalization, management of complications, disability, and loss of productivity related to uncontrolled diabetes. As a region, we must work together to invest more efforts into research to produce further statistics on patients with uncontrolled T2D, to help reduce this governmental burden and the number of patients in the long-term.”  

Dr. Thamer Alessa, Consultant Endocrinologist and Head of the Endocrinology, Diabetes and Metabolism Division at Jaber Al-Ahmad Hospital, Kuwait highlighted the availability of numerous new treatments and medical solutions in the Middle East to support patients living with T2D. “It is important that we bring awareness to the latest updates available. SGLT2 inhibitors and GLP-1 agonists have shown beneficial effects for patients with type 2 diabetes and high cardiovascular and renal impairment risk. These options have proven to help in terms of reducing cardiovascular diseases risk and also chronic kidney disease risk.”

During the event, Dr Paola Atallah, Specialist Endocrinologist at Saint George Hospital University Medical Center in Lebanon, focused on medical tips and guidance for patients planning to return to work during COVID-19. “Stress levels and disruptions to diet and physical activity throughout COVID-19 could contribute to worsening outcomes for patients with T2D. It is therefore essential that patients regularly follow up with their doctors virtually, maintain a healthy diet and fitness routine, stock up on medical supplies, and have an emergency contact on speed dial in case of dire situations”, she explained.  

Dr. Atallah also advised people living with diabetes across the region to continue working remotely and to try to minimize contact with those outside their households: “If patients absolutely have to go back to work, I encourage them to make sure they follow strict social distancing measures, wash their hands frequently, and avoid touching their faces.” 
In April 2020, Boehringer Ingelheim launched its Global Support Programme to step up its efforts in support of the fight against COVID-19 in the region. The programme focuses on four areas: financial and in-kind donations for local emergency aid worth 7 million euros, research for COVID-19 therapies through a team of over 100 highly engaged scientists from all areas of research and development, volunteering to bring COVID-19 relief and supporting social entrepreneurs through the “Making More Health” relief fund.

“Our offices in the Middle East, Turkey and Africa have joined hands to bring financial relief, protective materials and donations of medicine to healthcare institutions and communities in need. So far, we have allocated funds and provided in-kind donations for local emergency aid in Jordan, Turkey, Morocco and Tunisia. We are currently gearing up to provide similar support in other countries, including Lebanon, Egypt and Algeria, where it is also much needed,” Tawil added.
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Notes to the editor:
About Boehringer Ingelheim

Improving the health of humans and animals is the goal of the research-driven pharmaceutical company Boehringer Ingelheim. The focus in doing so is on diseases for which no satisfactory treatment option exists to date. The company therefore concentrates on developing innovative therapies that can extend patients’ lives. In animal health, Boehringer Ingelheim stands for advanced prevention. 
Family-owned since it was established in 1885, Boehringer Ingelheim is one of the pharmaceutical industry’s top 20 companies. Some 50,000 employees create value through innovation daily for the three business areas human pharmaceuticals, animal health and biopharmaceuticals. In 2018, Boehringer Ingelheim achieved net sales of around 17.5 billion euros. R&D expenditure of almost 3.2 billion euros corresponded to 18.1 per cent of net sales. 
As a family-owned company, Boehringer Ingelheim plans in generations and focuses on long-term success. The company therefore aims at organic growth from its own resources with simultaneous openness to partnerships and strategic alliances in research. In everything it does, Boehringer Ingelheim naturally adopts responsibility towards humankind and the environment. 
For more information please visit www.boehringer-ingelheim.com

For more information, please contact:
Stephanie Tasrini
Account Director | Healthcare
Asda’a BCW
T: + 971 529632868 
stephanie.tasrini@bcw-global.com 

OR
Sara Shamel
Head of External Communications – META
Boehringer Ingelheim
T: +971 553258101
sara.shamel@boehringer-ingelheim.com 

References

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[2] Idf.org. 2020. Members. [online] Available at: <https://www.idf.org/our-network/regions-members/middle-east-and-north-africa/members/49-united-arab-emirates.html>

[3] touchENDOCRINOLOGY. 2020. COVID-19 Infection In People With Diabetes. [online] Available at: <https://www.touchendocrinology.com/insight/covid-19-infection-in-people-with-diabetes/>

[4] Idf.org. 2020. COVID-19 And Diabetes. [online] Available at: <https://www.idf.org/aboutdiabetes/what-is-diabetes/covid-19-and-diabetes/1-covid-19-and-diabetes.html>

[5] Idf.org. 2020. COVID-19 And Diabetes. [online] Available at: https://www.idf.org/aboutdiabetes/what-is-diabetes/covid-19-and-diabetes/1-covid-19-and-diabetes.html

[6] Research Gate. 2001. Mortality And Causes Of Death In The WHO Multinational Study Of Vascular Disease In Diabetes. [online] Available at: <https://www.researchgate.net/publication/11762754_Mortality_and_causes_of_death_in_the_WHO_Multinational_Study_of_Vascular_Disease_in_Diabetes>

[7] World Heart Federation. 2017. Risk Factors - World Heart Federation. [online] Available at: <https://www.world-heart-federation.org/resources/risk-factors/>

[8] Research Gate. 2001. Mortality And Causes Of Death In The WHO Multinational Study Of Vascular Disease In Diabetes. [online] Available at: <https://www.researchgate.net/publication/11762754_Mortality_and_causes_of_death_in_the_WHO_Multinational_Study_of_Vascular_Disease_in_Diabetes>

[9] www.heart.org. 2015. What Is Cardiovascular Disease?. [online] Available at: <https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease>

[10] https://www.thenational.ae/uae/health/coronavirus-about-40-of-uae-deaths-linked-to-diabetes-1.1034114