Background: Iraq's healthcare system continues to face major challenges in the aftermath of conflict, with no public insurance system and significant barriers to achieving national goals for noncommunicable diseases (NCDs), including diabetes. Effective glycemic control is essential to minimize complications and improve quality of life among diabetic patients. This study aimed to identify the main barriers to achieving optimal glycemic control among diabetic patients in Kirkuk, Iraq.
Methods: A cross-sectional study was conducted from April to December 2019 at the Baba Gurgur Diabetes Clinic, K1 Hospital – North Oil Company, in Kirkuk. Adult diabetic patients with uncontrolled blood sugar levels (A1C ≥ 7%) were interviewed using a validated questionnaire. Participants were asked to report perceived causes of poor glycemic control and could select multiple responses.
Result: Among 1,136 participants, the mean A1C was 8.3 ± 2.1%. Only 256 patients (22.5%) had controlled glycemia (A1C < 7%), while 880 (77.5%) were uncontrolled. The most commonly reported cause of poor glycemic control was lack of medication or inconsistent drug supply from primary health centers (51.1%). Other major contributors included non-compliance with diet and medication (35.1%) and illiteracy (19.8%). Financial hardship, ongoing security concerns, and political instability were also frequently cited as significant influencing factors.
Conclusions: Poor glycemic control remains prevalent among diabetic patients in Kirkuk, with key barriers including inadequate drug availability, socioeconomic challenges, and the broader unstable healthcare environment in Iraq.