Type 2 diabetes mellitus (T2DM) management differs dramatically between Iraqi public and private sectors; this variability is due to treatment access discrepancy. The aim of this consensus is to put for the first-time uniform recommendation on how to manage patients with T2DM taking in consideration the local obstacles in Iraq. These consensuses were approved by a group of Iraqi Internist and diabetologist from all over the country. Up-to-date and latest level of evidence was used throughout the recommendation.

Background: Subclinical hypothyroidism (SCH) is estimated to affect around 7.5-8.5% of females and 2.8-4.4% of males. One of the features of clinical hypothyroidism is dyslipidemia. There is a great debate about the presence of abnormal lipid profiles in patients with subclinical hypothyroidism (SCH) and weather it is clinically significant or not. Some evidences show reduction in the level of the serum lipid profile after replacement with thyroid hormones. The purpose of this study is to estimate the prevalence of dyslipidemia in patients with subclinical hypothyroidism in Duhok and Erbil cities, Iraq. Patients and Methods: This is a case-control study that was done on 200 individuals. One hundred patients confirmed with subclinical hypothyroidism were compared with a group of 100 apparently healthy individuals. These two groups were matched for age and sex. The study done in 2 centres; Azadi Teaching Hospital in Duhok and Rizgari Teaching Hospital in Erbil, Kurdistan Region, Iraq from from 1st December 2017 to 1st December 2018. Results: Dyslipidemia was commoner in patients with subclinical hypothyroidism compared to control group (p value 0.001) compared to the control group (p value 0.766). The total cholesterol and the triglyceride levels were steadily increased in relation to the level of the thyroid stimulating hormone (TSH). Conclusions: Subclinical hypothyroidism (SCH) is regarded as an atherogenic condition because it increases the cholesterol and the triglyceride levels. Management of subclinical hypothyroidism with thyroid hormones may have a positive impact on the cardiovascular health. It is reasonable to measure the levels of the serum lipids and cardiovascular risk in these patients and to manage them when it is clinically applicable.

Background and objectives: The curfew implemented during the COVID-19 pandemic can affect several factors that contribute to energy balance, but the impact of the curfew on weight changes is unknown. We aimed to determine the impact of the COVID-19 curfew on body weight among doctors. Methods: A survey of 380 doctors was conducted between the 15th of March 2020 and the 20th of April 2020. The survey participants were recruited from the staff of general teaching hospitals in the Kurdistan Region irrespective of the clinical origin. Three hundred and eighty doctors completed the questionnaire. The weight and height of all participants were determined at the beginning of the COVID-19 curfew and at the end of the curfew, and BMI was calculated. Results: A total of 380 doctors from many regions of Kurdistan were included in this survey. Out of 380 doctors, 177 (47%) reported weight gain (75.2 ± 16.9 to 77.7 ± 17.1 Kg, (p:0.020), 116 (30%) reported weight loss (77.0 ± 14.1 to 74.4± 13.4 Kg, p:0.021) and 87 (23%) had no change in body weight. The study showed that the majority of subjects with weight loss 80 (69%), were those that had fewer hours of sleep (less than 6 hours sleep, p:0.010), compared to those with unchanged weight and weight gain groups (p:0.010, 18.1%, and 12.1% respectively). Conclusion: The impact of the COVID-19 curfew on body weight among doctors was diverse, with almost half having weight gain and a third having weight loss. Identifying factors that contribute to weight changes during curfew could inform the planning of future similar situations.

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Background: Ramadhan is the fasting month among the Muslim population, and fasting is one of the five pillars of the Islamic religion. During Ramadhan, there is a major change in the meal times, which significantly affects the body's metabolism and hydration status, increasing the risk of hyper and hypoglycemia in diabetic patients. Probably Pre-Ramadan counseling will improve the rate of these complications. Patients and methods: This is a prospective cross-sectional study, which included 307 Muslim patients with type 2 diabetes mellitus who decided to fast Ramadan during 2019 in two cities in the Kurdistan region of Iraq. Participants were categorized based on whether they had pre-Ramadan counseling or not. Results: The mean age of our patients was 55.24, and 71% of patients were females; the mean duration of diabetes mellitus was 80.76 months. Most patients enrolled in this study fasted the whole month (the mean was 26.86 days). Less than 20% had pre-Ramadhan counseling. The majority of patients were not ready to break the fasting (61.6%). Hypoglycemic attacks were less common in patients who had undergone pre-Ramadan counseling (p-value 0.006). There was also no significant correlation of pre-Ramadan counseling with the level of HbA1c (p-value 0.401); however, there was a significant correlation of pre-Ramadan counseling with both serum cholesterol, serum LDL, and hypoglycemic attacks (p values 0.13, 0.002, and 0.006), respectively, with no any significant correlation with triglycerides and HDL levels (p values 0.687 and 0.698) respectively. Conclusion: Pre-Ramadan counseling is very vital for diabetic patients who decided to fast Ramadan. Pre-Ramadan counseling is a good tool to inform patients about if they are fit to fast or not, the likelihood of complications during Ramadan, and how to manage them (principles of self-management). We recommend a structured diabetes education to decrease the attacks of hypoglycemia. A patient will know when to monitor his/her blood sugar and when to breakfasting. Will know when to exercise, when to monitor his/her blood sugar and when to breakfasting.