Viral diet worries Yemen doctors as diabetes patients quit medicine

Doctors at Republican Hospital in Taiz say they are treating more diabetes patients who became seriously ill after stopping prescribed medication. The cases have raised concern in Yemen because the patients had followed el-tayebat, a restrictive diet promoted online by former Egyptian doctor Diaa el-Awadi, according to Al Jazeera.

Dr Hamza al-Qusais, who heads the hospital’s emergency department, told Al Jazeera that staff first stabilise the patients, then refer them to specialists for further care. Hospital doctors linked the recent admissions to patients abandoning insulin or other diabetes drugs after seeing diet claims spread on social media.

Online following grows after promoter’s death

Al Jazeera identified el-tayebat as an Arabic term meaning “those that are good.” El-Awadi popularised the approach through social media videos and a website, according to Al Jazeera, and urged people to avoid foods including salad greens, citrus fruits, eggs and legumes.

Egyptian medical authorities struck el-Awadi off, and two of his clinics were closed in March, Al Jazeera reported. Egypt’s health ministry described him as a health risk after his views on diet and medicine drew a wide online audience.

Egypt later barred his media appearances, according to Al Jazeera. The Egyptian foreign ministry said he died of a heart attack in the United Arab Emirates two months later, and Egyptian authorities said there were no suspicious circumstances, but Al Jazeera reported that conspiracy claims about the death helped fuel his popularity.

Cost pressures make the claims tempting

One Republican Hospital patient, 67-year-old construction labourer Murad al-Adimi, told Al Jazeera he had lived with diabetes for more than 15 years and had taken medication daily before a friend pointed him toward el-Awadi’s advice. He stopped treatment for 10 days, felt well at first, then fainted and was taken to the hospital, Al Jazeera reported.

Al-Adimi told Al Jazeera the diet appealed to him because medicine was costly, but he now believes stopping treatment nearly cost him his life. Yemen was already the poorest country in the Middle East before its civil war began more than a decade ago, Al Jazeera noted, making cheaper alternatives attractive to some patients.

Dr Sadeq Aqlan, a cardiologist at the Republican Hospital, told Al Jazeera that many patients who stop their medication are either poor or lack the health knowledge to judge online medical claims. He said patients may choose any diet they want, but should not stop prescribed drugs unless a doctor approves.

Medical professionals cited by Al Jazeera warned that el-Awadi’s claim that insulin is harmful contradicts standard diabetes care. Al Jazeera reported that untreated diabetes can lead to diabetic ketoacidosis, a dangerous buildup of acids in the body that can be fatal.

Food sellers and nutritionists see effects

The diet’s list of restricted foods has also affected food sales in Taiz, according to Al Jazeera. A tray of eggs that had sold for $3.50 now sells for $1.60, and shopkeeper Nashwan al-Hufa told Al Jazeera he sells about a quarter of the eggs he sold two months earlier and five or fewer chickens a day, down from about 20.

Some followers still report feeling better. Rafat Abdu Yassin, 39, told Al Jazeera that he tried el-tayebat after years of heartburn and said his symptoms eased within two days, though he was not taking medication at the time.

Yemeni nutritionist Maram Fuad told Al Jazeera that fasting may help some people, but dividing foods into broad “good” and “bad” categories has no scientific basis. She said cutting whole food groups can deprive people of fibre, vitamins, minerals and protein, and that patients with chronic disease need individual plans supervised by a clinician or nutritionist.

Fuad said some heartburn patients may improve because they stop eating specific triggers, such as white flour or hydrogenated oils, rather than because the wider restrictions are healthy. Yassin told Al Jazeera a doctor had suggested that cutting flour alone might address his heartburn while allowing him to keep eating fruits and vegetables.

This story draws on original reporting from Al Jazeera.