Print ISSN: 2790-0207

Online ISSN: 2790-0215

Keywords : HbA1c

Factors associated with poor glycemic control in diabetic patients in Kirkuk

waleed mohammed Ali

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 87-97
DOI: 10.32894/kjms.2022.174187

Iraq's health-care system has faced tremendous obstacles in its recovery from the Islamic State's conflict. There is no public insurance system in place. Iraq has set targets to prevent and control noncommunicable diseases (NCDs) such as diabetes, but safety confrontation  and governmental insecurity have made these objectives difficult to achieve. Better glycemic control is critical in allowing patients to perform at their best in terms of diabetes management and preventing long-term complications.
The goal is to identify the roadblocks to better glycemic management.
The participants in this cross-sectional study were recruited from a diabetes out-patient clinic at Baba Gurgur diabetic facility. From April to December 2019, K1 hospital – North oil company in Kirkuk city. A validated questionnaire was used to interview those with an uncontrolled glycemic index (AIC7%). Patients were asked to name the primary causes of inadequate  glucose  control and to select more than one response based on their opinion.
The mean A1C was 8.3 2.1 percent, with 256 (22.5 percent) patients having an A1C less than 7% and 880 (77.5 percent) having an A1C equal to or greater than 7. Poor glycemic control is caused by a lack of medication and/or a lack of drug supply from PHC in 51.1 percent of cases. Diet and medication non-compliance, as well as illiteracy, account for 35.1 percent and 19.8 percent of the population, respectively. Glycemic regulation is greatly influenced by one's financial situation. However, security issues and political instability play a significant impact.
Conclusion: Diabetic patients confirmed poor glycemic control, with the majority of cases being linked to Iraq's current health situation.

Utility of HbA1c in the Screening of Diabetes Mellitus in Pregnancy

Sinan Butrus Garabet

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 1, Pages 45-52
DOI: 10.32894/kjms.2013.169490

Background and objectives: Diabetes mellitus is a major public health concern with adverse pregnancy outcome. The objective of this study was to assess the validity of HbA1c as a screening tool in pregnant ladies not known to have diabetes before pregnancy. Patients and methods: Three hundred pregnant women with gestational age between 24 - 28(25.3±2.1) weeks were evaluated for diabetes mellitus using HbA1c, fasting and postprandial plasma glucose for the period of October 2010 - October 2012, using McNamara's test which is expressed as percentages and 95% confidence intervals of the percentages. Results: Of pregnant ladies with non-diabetic fasting plasma glucose values: 79% had HbA1c level of <6.1%, 17% had an HbA1c level of > 6.1% and 5% showed diabetic 2-h plasma glucose values (17% CI 51–71 vs. 5% CI 35–55, respectively; P = 0.007). Of pregnant ladies with diabetic fasting plasma glucose:72% had an HbA1c level of ≥6.1%, 28% had HbA1c level of ≤ 6.0 % and 11% subjects in this group showed nondiabetic 2-h plasma glucose values (28% CI 66 – 86 vs. 11% CI 32–52, respectively; P = 0.003).Of pregnant ladies with postprandial blood glucose >200mg/dL; 42% had normal, 18% had impaired, 39% had high fasting plasma glucose while 71% had HbA1c ≥ 6.1% (71 % CI 51–71 vs. 39% CI 35–55, respectively; P = 0.003). Conclusion: HbA1c is an important alternative screening tool to identify pregnant ladies with undiagnosed diabetes.