1Abbas Mehdi Rahmah, 2Hasan Murtada, 3Haider Fadel, 4Dler Kakil, 5Jalal Altaie, 6Abdulaziz Savo, 7Arjan Hikmat, 7Idrees Ahmed, 8Salim Marzoq Alebrahimi, 5Ahmed Alhadad, 9Alsafar Yasamin, 10Jabaar Jasim Atea, Mohammed Akbar Shaikh11, 11Shalini Kumar, 11Shirley D’Souza*
1Baghdad Medical City, Baghdad, Iraq
2Imam Al-Hassen Diabetic Center, Iraq
3Al-Yarmok Teaching Hospital, Baghdad, Iraq
4Erbil Teaching Hospital, Erbil City, Iraq
5Kadhimiya Teaching Hospital, Baghdad, Iraq
6Vajeen Hospital, Iraq
7Azadi Hospital, Iraq
8Almanathera Hospital, Iraq
9Marjan Medical City, Iraq
10Alsader Hospital, Iraq
11Ajanta Pharma Limited, Mumbai, India
A b s t r a c t
Type 2 diabetes mellitus (T2DM) accounts for approximately 90% of all types of diabetes, making it very common. The objective of the study was to assess the effects of demographic variables, clinical characteristics on glycaemic control amongst patients of T2DM in Iraq. We conducted an open-label, multi-centric observational study to evaluate the demographic variables and clinical characteristics of T2DM patients reporting to a healthcare facility in Iraq and on oral anti-diabetes medications, such as metformin, DPP-4 inhibitor, SGLT-2 inhibitor, insulin, and/or sulfonylurea therapy. Both newly diagnosed and previously diagnosed T2DM Iraqi patients were included. The demographic and anthropometric data, including age, weight, height, gender, and smoking habits, clinical characteristics (duration of diabetes, HbA1c, FBG, PPBG), associated comorbidities, and anti-diabetes medications, were recorded through a Case Record Form at a single time point. Statistical analysis was done by t test analysis, and a p value of ≤ 0.05 was considered statistically significant. A total of 1164 adults were included. The mean HbA1c in patients without comorbidities was lower than in those with comorbidities. There was a statistically significant difference in mean HbA1c between patients with and without hypertension (P=0.005), dyslipidaemia (P=0.005), renal disease (P<0.0001), and diabetic foot ulcer (P<0.0001). The glucose-lowering effects of medications lowered with increment in duration since diabetes onset. There was a significant difference in mean HbA1c of patients with diabetes duration of <6 months and >6 months (P=0.000). The glycaemic control in patients with smoking habits was poor. We can conclude the presence of comorbidities and smoking leads to poor glycaemic control. In addition, the duration of diabetes affects the efficacy of the treatment, and those with recent onset have better glycaemic control. Therefore, these factors need consideration while treating T2DM patients.
Keywords: Dipeptidyl peptidase-4 inhibitors, Type 2 diabetes mellitus, Sodium-glucose cotransporter-2 inhibitors, Smoking, Dyslipidaemia, Sulfonylureas.