Ahmadieh H, Sawaya MT, Azar ST. Management and control of type 2 diabetes mellitus in Lebanon: Results from the International Diabetes Management Practices Study Wave 6. World J Diabetes 2019; 10(4): 249-259 [PMID: 31040901 DOI: 10.4239/wjd.v10.i4.249]
Corresponding Author of This Article
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
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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World J Diabetes. Apr 15, 2019; 10(4): 249-259 Published online Apr 15, 2019. doi: 10.4239/wjd.v10.i4.249
Table 1 Demographic characteristics of patients with diabetes mellitus
Characteristics of type 2 diabetes patients
Age, mean ± SD
59.37 ± 10.85
Female, n (%)
307 (51.6)
Body mass index in kg/m2, mean ± SD
30.13 ± 5.47
Waist circumference in cm, mean ± SD
100.25 ± 13.14
Residence, n (%)
Urban
375 (63.0)
Rural
126 (21.2)
Sub-urban
94 (15.8)
Health insurance
Yes
417 (70.1)
No
178 (29.9)
Time since diabetes diagnosis in yr, mean ± SD
8.88 ± 7.19
Family history of diabetes, n (%)
Yes
436 (76)
No
138 (24)
Time since diabetes diagnosis in yr, n (%)
≤ 1
85 (14.3)
1-5
162 (27.3)
5-10
137 (23.1)
10-20
171 (28.8)
> 20
38 (6.4)
Treatment of diabetes
Diet and exercise alone
10 (1.7)
OGLD
421 (70.7)
Insulin treatment
22 (3.7)
OGLD treatment + insulin treatment
124 (20.8)
Other (No OGLD - no insulin - no diet)
18 (3)
Level of education, n (%)
Illiterate
54 (9.1)
Primary
207 (34.9)
Secondary
228 (38.4)
University/higher education
104 (17.5)
Health insurance coverage, n (%)
None
178 (29.9)
Public
288 (69.1)
Private
80 (19.2)
Public and private
49 (11.8)
Smoking habit, n (%)
Never
150 (25.2)
Former
131 (22.0)
Current
314 (52.8)
Hypertension, n (%) [95%CI]
356 (60.2) [56.2%; 64.2%]
Patient receiving anti-platelet therapy, n (%)
236 (42.4)
Dyslipidemia, n (%) [95%CI]
401 (68.3) [64.4%; 72.1%]
Table 2 Baseline characteristics of patients with diabetes mellitus in 2011 and 2013
IDMPS 2013
IDMPS 2011
Total patients recruited
596
1157
Age in yr
59.37
56.42
Male/female, n/n
289/307
588/569
BMI, kg/m2
30.13
28.92
BP control
Mean BP
130.03/77.89
130.8/79.7
SBP < 130, %
40.2
43.7
DBP < 80, %
39.8
33
HTN treatment
ACEI, %
33.3
36.2
ARB, %
50
50.1
Antiplatelet therapy, %
42.4
45.7
Dyslipidemia and management
Diagnosed with dyslipidemia, %
68.3
68
LDL < 100 mg/dL, %
39.2
39.3
HDL ≥ 40 mg/dL, %
68.5
62.7
TG < 150 mg/dL, %
44.4
39
Statin therapy, %
86.5
82.7
Glycemic control
Mean HbA1c
7.98
7.79
HbA1c < 7%, %
31.4
36.1
Table 3 Screening of diabetes-related complications in patients with diabetes mellitus
Screening for any diabetes-related complication, n (%)
Yes
553 (97.9)
No
12 (2.1)
Screening for cardiovascular disease
At least one time during the past year
376 (76.9)
Never
113 (23.1)
Eye screening
At least one time during the past year
295 (65.7)
Never
154 (34.3)
Number of eye screening, mean (SD)
1.20 (0.57)
Screening for nerve damage
At least one time during the past year
232 (53.8)
Never
199 (46.2)
Number of screening for nerve damage, mean ± SD
1.75 ± 1.01
Screening for kidney damage
At least one time during the past year
425 (82.5)
Never
90 (17.5)
Number of screening for kidney damage, mean ± SD
1.87 ± 1.02
Screening for foot examination
At least one time during the past year
297 (63.9)
Never
168 (36.1)
Number of screening for foot examination, mean ± SD
1.90 ± 1.08
Screening for blood lipid control
At least one time during the past year
496 (94.8)
Never
27 (5.2)
Number of screening for blood lipid control, mean ± SD
2.06 ± 1.04
Screening for blood pressure control n (%)
At least one time during the past year
286 (86.1)
Never
46 (13.9)
Number of screening for blood pressure control, mean ± SD
2.57 ± 1.17
Table 4 Reported diabetes-related complications for patients with type 2 diabetes mellitus
Reported diabetes-related complications
n (%)
Any diabetes-related complication
264 (45.7)
Microvascular complications
At least one microvascular complication
223 (38.6)
Retinopathy
77 (13.3)
Sensory neuropathy: abnormal sensation in distal limbs
125 (21.6)
Microalbuminuria: lab test
130 (22.5)
Proteinuria: dip stick
20 (3.5)
Dialysis
1 (0.2)
Amputation: below knee or above knee
2 (0.3)
Foot ulcer: active or past history
13 (2.2)
Macrovascular complications
At least one macrovascular complication
122 (21.1)
Angina
31 (5.4)
Myocardial infarction/acute coronary syndrome
38 (6.6)
Heart failure
11 (1.9)
Stroke with partial recovery
4 (0.7)
Stroke with full recovery
8 (1.4)
Peripheral vascular disease
59 (10.2)
History of revascularization: e.g., PTCA, CABG
41 (7.1)
Other complications
20 (3.5)
Table 5 Dyslipidemia among patients with diabetes mellitus, n (%)
Dyslipidemia among patients with type 2 diabetes mellitus
Patient diagnosed with dyslipidemia
402 (68.4)
Patient treated for lipids
380 (94.8)
Current treatment
Statins
329 (86.6)
Fibrates
92 (24.2)
Nicotinic acid
0
Other treatment for dyslipidemia
3 (0.8)
Citation: Ahmadieh H, Sawaya MT, Azar ST. Management and control of type 2 diabetes mellitus in Lebanon: Results from the International Diabetes Management Practices Study Wave 6. World J Diabetes 2019; 10(4): 249-259