Type 2 diabetes mellitus is a chronic preventable disorder. Its prevalence increasing in Iraq and worldwide. Achieving therapeutic target goals help to prevent acute diabetic-related complications and to minimize the risk of long-term diabetic complications. Many patients in Iraq depend on public hospitals for follow-up and treatment because it is free. The purpose of this study was to evaluate a sample of Iraqi patients with type 2 diabetes for achieving the therapeutic target goals of treatment.
Methods
This cross-sectional observational descriptive study involves 200 patients with type 2 diabetes in Al-Kadhumain Teaching medical city. It evaluates the target goals achievements for glucose, lipid and blood pressure as suggested by the guidelines of the American Diabetes Association. The age of the patients is between 36 and 85 years old .Only patients with history of type 2 diabetes are enrolled randomly from consultation office of the department of internal medicine and department of endocrinology who are already diagnosed with type 2 diabetes mellitus
Results
A total of 200 patients were analyzed (106 women and 94 men). The results of this study demonstrate a mean age of 61.06 ± 11.39 years, and a mean of the duration of diabetes is 10.76 ± 9.59 years, body mass index (BMI) mean is 28.54 ± 5.05 kg/m2. The mean of HbA1c in this study is 9.36% ± 2.35% and the proportion of participants who achieved glycemic target (HbA1c <7%) is only 11.5%; 46.5% of hypertensive participants achieves the therapeutic target. The percentages of those who achieved the therapeutic target for dyslipidemia are 47% for low density lipoprotein cholesterol, 41% for triglyceride, and only 46.5% for high density lipoprotein, while 64.5% of them achieved cholesterol target level.
Discussion/Conclusion
Type 2 DM in Iraq occurs with high prevalence, this is noticed by STEP survey conducted by Iraqi ministry of health in 2015, 8.1% of Iraqi adults above 24 years age had high fasting plasma glucose. This study aims to provide an idea about the achievement of goals of type 2 DM in a sample of Iraqi subjects who attend a single governmental diabetic clinic in Baghdad who offers a basic follow up and essential medications, such as metformin, glibenlamide and old human insulin. This poor achievement can be explained in that most of patients attending governmental sector are poor and cannot pay for new drugs and modern insulins which are not available only in the private sector. Also, absence of electronic data registration for those patients makes their follow up visits not so fruitful. Other factors like lack of certified health educators and dieticians and the large number of patients per diabetologists contribute for these poor achievements. There are several limitations in this study. It is performed at one hospital in Baghdad city and does not include a large variety or a large number of patients. Also, the current situation of COVID-19 crisis restricts the number of participants. This study does not include patients attending regularly to private clinic where modern drugs are available with better achievements. As a conclusion, only a minor proportion of patients with type 2 diabetes achieved the recommended goals.
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2022
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