Abbas Ali Mansour, Hameed Laftah Wanoose and Akream Hussain Odaa
Background: In Iraq, diabetes affects 10.4 % of people according to the 2006 WHO survey. The aim of this study is to see how a diabetic center in a developing country can control type 2 diabetes mellitus over 3 years period.
Methods : This is 3-year open-label, non-randomized, treat-to-target, single center study in the Al-Faiha Diabetes and Endocrine Center in Basrah. Patients with type 2 diabetes, regardless of the duration or treatment were enrolled in January 2007.
Results: We had 998 patients complete the study. The mean HbA1c levels at the start of the study was 9.8 ± 1.9 % and after 3 years it was 8.1 ± 1.6 %. The target of HbA1c levels < 7 % were achieved only in 25.6 %. Those on insulin achieved HbA1c levels < 7 less than those on oral anti-diabetic drugs (16.9 % versus 67.9 % with p value of <0.0001). On univeriate analysis for variables associated with poor outcome and non achieving target HbA1c were only insulin use (OR =2.318, 95 % CI = 1.705-3.152;p < 0.0001) and duration of diabetes >5 years (OR =1.688 , 95 % CI = 1.261- 2.259;p < 0.0001). On logistic regression analysis (table-4),only the insulin use remain significantly associated with poor outcome (OR =0.475 , 95 % CI =0.344 -0.656, p < 0.0001).
Conclusion: This study confirms that we are still lagging in diabetic control from guidelines, but no worse than neighboring countries in the Middle East. Implementing local guidelines will probably solve some of the obstacles in diabetic care locally.