Columbia and Partners Address Growing Diabetes Problem in the Middle East

Jan 29 2019 | By Allison Elliott | Photo Credit: Columbia Global Center | Amman; Building Photo Credit: Andreas Hielscher

High incidences of chronic conditions like diabetes have long been considered an artifact of higher-income, industrialized nations. But for a complex set of reasons, that may no longer be the case. For instance, in a growing trend that stretches across the Middle East, close to ten percent of the adult population in the Kingdom of Jordan now suffers from the disease.

Parsing out exactly why isn’t always a straightforward proposition, but searching for solutions to unmet medical needs is a priority at Columbia Engineering. In that spirit, last month, Columbia University and Jordan University of Science and Technology (JUST), in collaboration with the King Abdullah University Hospital (KAUH) and Columbia Global Centers | Amman, held a symposium to investigate the scope of diabetes in the Middle East and new research into prevention, diagnosis, treatment, and the social impact of the disease.

Participants and attendees, including Professor Hielscher (m), at the Columbia Global Center | Amman.

The well-attended event represented the first phase of collaboration between a team of Columbia Engineers led by Andreas H. Hielscher, a professor in biomedical and electrical engineering and radiology, and researchers and medical professionals in the Middle East—all focusing on peripheral arterial disease (PAD) and diabetic foot syndrome (DFS), two very serious diabetes-related ailments that can result in gangrene and the need for amputation. Everything from lifestyle, and diet, and even footwear, can be factors. 

“It’s a particularly a big problem in Jordan and neighboring countries, and it’s not always clear why,” said Hielscher.

In his talk, Hielscher, who directs Columbia’s Biophotonics and Optical Radiology Lab, focused on the development of state-of-the-art systems for optical tomography—a medical imaging method using near infrared light—to diagnose and monitor vascular diseases, arthritis, and breast cancer. Hielscher has used this imaging technique to design technology capable of diagnosing and monitoring PAD in diabetic patients.             

“About a quarter to half of all diabetic patients will have DFS or PAD, but people with PAD don’t all have diabetes,” said Hielscher.

Professor Andreas Hielscher presents at the Symposium.

Hielscher was joined by several longtime collaborators in the field. Danielle R. Bajakian, MD, a vascular surgeon and director of the Critical Limb Ischemia Program at Columbia University Irving Medical Center, spoke on endovascular techniques for treating PAD and DFS. Professor John Kymissis, an electrical engineer and head of the Columbia Laboratory for Unconventional Electronics, moderated a panel discussion on management and diagnosis methods. Kymissis, an expert in flexible electronics, sees potential for wearable electronics that monitor glucose levels and levels of blood perfusion in the limbs to particularly benefit the refugee population in the region.

Also in attendance was Adler Perotte, assistant professor in biomedical informatics. Perotte spearheads Columbia’s Health Tech Assembly, a group bringing together medical, engineering, and business faculty and students to translate biomedical innovations to the market through entrepreneurship. He is also involved in the Observation Health Data Sciences and Informatics (OHDSI) collaborative housed and coordinated at Columbia. OHDSI is a worldwide interdisciplinary program aiming to bring out the value of health data through large-scale analytics. With Perotte’s help, health science researchers at JUST and KAUH seek to become part of this international network of scientist and observational health databases to better understand population trends in diabetes.

Many at the symposium said they had never gotten a call from an engineer. They thought it was a great idea to combine forces—engineering and medicine—to address the problem and see what would be possible solutions.

Ioannis Kymissis

Other speakers spanned faculty and doctors from several institutions in the Middle East, all eager to put the spotlight on a growing global issue by incorporating perspectives from public health, internal medicine, and pharmacy to biomedical engineering, vascular surgery, podiatric medicine, nursing, and policy.      

“Managing this has a lot to do with prevention and awareness,” said Bajakian.

The idea for a symposium came about when a former colleague of Hielscher’s reached out from his new post at JUST. Rabah Al Abdi, an assistant professor in biomedical engineering, had previously worked with Hielscher on an optical breast imaging system before Al Abdi returned to his native Jordan. 

Nestled in the fertile crescent, the Kingdom has been an example of economic development and relative political stability in the region, making it a haven for refugees from nearby Palestine, Iraq, and Syria—a population facing unique challenges in addressing chronic illness. The collaborators received a grant from the Presidential Global Innovation Fund (PGIF) which included a focus on how to better serve the country’s sizeable refugee population.

While in Jordan, the team also visited JUST and KAUH. After meeting with the deans of engineering and medicine, as well as the vice-president of JUST, the Columbia team and its Jordanian collaborators have started on a proposal for a joint research project that looks at emerging technologies and processes that could be utilized in low-resource environments. Furthermore, they have plans to establish a Middle East Limb Salvage Consortium that would involve engineering and medical groups from countries such as Egypt, Qatar, Unite Arab Emirates, and Jordan, dedicated to advancing care of the diabetic foot and preventing amputations.

“Many at the symposium said they had never gotten a call from an engineer,” said Kymissis. “They thought it was a great idea to combine forces—engineering and medicine—to address the problem and see what would be possible solutions.”

The University project is supported by the President’s Global Innovation Fund for projects and research collaborations within and across the University’s nine Columbia Global Centers that increase opportunities for research, teaching, and service around the world.

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