One out of every four citizens of the United Arab Emirates has diabetes — a federation that includes the city-states of Dubai and Abu Dhabi. With the second-highest diabetes rate in the world, treatment gobbles up an estimated 40 percent of the national health care budget.
"We know that the UAE is one of the highest," says Dr. Abdulrazzaq Ali Al Madani, head of the Emirates Diabetes Society. "But we won't just stand and wait while the prevalence goes from 20 percent, to 40 percent, to 50 percent and so on."
The UAE's diabetes rate of roughly 20 percent for residents -- 25 percent for Emirati nationals -- eclipses the global average of 5 percent. Other Gulf Arab states, such as Kuwait and Bahrain, and much larger Saudi Arabia, follow closely behind. The only country with a higher rate by percentage is the Pacific island nation of Nauru, with a population of 14,000.
After decades of oil-fueled economic development, Dubai and Abu Dhabi are considered two success stories of the modern Middle East. But one downside of that modernization has been the spread of the post-industrial lifestyle — more driving, less exercise, and more fast food. The vast majority of cases here — by some estimates, up to 90 percent — involved Type 2 diabetes, triggered by lifestyle factors, like diet and exercise.
"We are, in this area, more genetically prone [to diabetes]," Al Madani told ABC News. "But there has also been a change in lifestyle over the past 35 years, with the economic boom and the change from a primitive lifestyle to a highly modernized lifestyle."
On the flip side, exercise has become a more regular part of daily life, as local culture adapted to modern lifestyles.
"When I first arrived in 1995, the only health clubs were in hotels," said Julie Amer, a U.K. native, working in the UAE with Mountain High, an organization that promotes health through adventure outings. " [Now] there are sports programs, health clubs ... [and] there's yoga for diabetes."
Amer, Al Madani and others are leading a nationwide charge to raise diabetes awareness, with the primary goal of convincing local residents to get screened and adjust their lifestyles to more healthy standards.
Even Dubai's famed shopping centers are addressing the national health crisis. Last month, Ibn Battuta Mall and Mall of the Emirates — home to the country's eye-popping indoor ski slope — hosted free screening programs.
With a high incidence of adult and child obesity in Gulf Arab countries, stomach reduction or gastric bypass surgery has become the preferred option for many looking to curb their diabetes risk.
"I got the surgery done eight months ago, and today, my weight has come down from 180 kg (396 pounds) to 110 kg (242 pounds)," 30-year-old Ahmed Al Dhaheri told the Emirates Today newspaper. "[My doctor] told me I needed to get the surgery done in order to save my life."
"In the Gulf area, in the past 30 years, there has been an annual increase in the rate of obesity. Bahrain has the highest rate, at around 35 percent, followed by the UAE, at 30 percent," said Dr. Gabi Wazz, who is based in Dubai, and specializes in gastric surgery.
"We don't operate on slim patients. We operate on patients who are obese or morbidly obese," Wazz told ABC News. "Around 80 percent will get substantial control of their diabetes, and some will even stop their medication."