Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2019; 10(4): 249-259
Published online Apr 15, 2019. doi: 10.4239/wjd.v10.i4.249
Management and control of type 2 diabetes mellitus in Lebanon: Results from the International Diabetes Management Practices Study Wave 6
Hala Ahmadieh, Marie-Therese Sawaya, Sami T Azar
Hala Ahmadieh, Department of Medicine, Beirut Arab University, Beirut 1100, Lebanon
Marie-Therese Sawaya, Medical Affairs Department, Sanofi-aventis Lebanon, Beirut 1100, Lebanon
Sami T Azar, Department of Internal Medicine, Division of Endocrinology, American University of Beirut-Medical Center, New York, NY 10017, United States
Author contributions: Ahmadieh H, Sawaya MT and Azar ST contributed to study conception and design; Ahmadieh H contributed to data acquisition, data analysis and interpretation, and writing of article; Ahmadieh H, Sawaya MT and Azar ST contributed to editing, reviewing and final approval of article.
Institutional review board statement: Ethics committee’s approval was obtained from participating centers where such committees are in place.
Informed consent statement: A signed written informed consent was obtained from all the participating patients before the application of any study-related procedures. This was available in Arabic and English.
Conflict-of-interest statement: All authors declared that there are no personal conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sami T Azar, FACP, MD, Professor, Department of Internal Medicine, Division of Endocrinology, American University of Beirut-Medical Center, 3 Dag Hammarskjold Plaza, 8th Floor, New York, NY 10017, United States. sazar@aub.edu.lb
Telephone: +961-32-34250 Fax: +961-17-44703
Received: January 23, 2019
Peer-review started: January 23, 2019
First decision: February 19, 2019
Revised: March 13, 2019
Accepted: March 26, 2019
Article in press: March 26, 2019
Published online: April 15, 2019
Processing time: 83 Days and 0.4 Hours
Abstract
BACKGROUND

Diabetes mellitus is a worldwide public health problem associated with significant complications. There is lack of data on the quality of care of patients with diabetes, specifically among the non-Western countries. Efforts have been made in Lebanon to better study the characteristics of patients with diabetes mellitus in order to improve glycemic control and prevent late-term complications.

AIM

To investigate control and therapeutic management of patients with diabetes mellitus in the current medical practice in Lebanon.

METHODS

Wave 6 of the International Diabetes Management Practice Study in Lebanon is an international and multicenter study involving selected countries.

RESULTS

Only 1 patient with type 1 diabetes and 595 patients with type 2 diabetes were included in Wave 6. Average age was around 60 years, with a mean body mass index of 30. The mean fasting serum glucose was 159.42 mg/dL, and the mean glycosylated hemoglobin (HbA1c) level was 7.98 with around 30% achieving an HbA1c target of < 7%. More patients were on oral anti-diabetic medications. Screening of diabetic complications has improved over the years. A large percentage is diagnosed with hypertension and dyslipidemia, the majority of whom were treated but only a small percentage were controlled.

CONCLUSION

Diabetes, with its associated dyslipidemia and hypertension, is still not very well controlled. Screening for diabetes complications has improved over the years. Patients need to have more proper care, and physicians need to follow diabetes guidelines, and to have a larger number of patients who have appropriate treatment of diabetes, hypertension and lipids.

Keywords: Diabetes complications; Dyslipidemia; Hypertension; Blood pressure control; Glycemic control

Core tip: This paper assessed the therapeutic management and control of patients with diabetes mellitus in the current medical practice in Lebanon. It also identified the proportion of subjects with target glycosylated hemoglobin, good blood pressure and lipid control, showing that it was suboptimal. Screening of diabetes-related complications is improving. Treating physicians and caregivers are becoming more aware of the importance of screening, but despite all their efforts, glycemic and metabolic control of the Lebanese type 2 diabetes mellitus population is still suboptimal.