Insulin crisis in Iraq

Mansour, Abbas Ali; Wanoose, Hameed Laftah

doi:10.1016/s0140-6736(07)60849-6

Cited by 7 publications

(7 citation statements)

References 2 publications

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“…In Iraq, diabetic patients received their medications including insulin from the PHC that distributed all over, but after the war in 2003, there was catastrophic shortage of drug supply [ 1 ]. That's why most patients blame the PHC as a cause of uncontrolled of diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…The health system in Iraq underwent progressive decline since the embargo that followed the second gulf war in 1991. The war in 2003, exacerbated that by causing further damage to the infrastructure, with lack of security that making even drug distribution unsafe, with further deterioration due to electricity problems [ 1 - 3 ]. This makes drug storage even more difficult.…”

Section: Introductionmentioning

confidence: 99%

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Patients' opinion on the barriers to diabetes control in areas of conflicts: The Iraqi example

Mansour

2008

Confl Health

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BackgroundThe health system in Iraq has undergone progressive decline since the embargo that followed the second gulf war in 1991. The aim of this study is to see barriers to glycemic control form the patient perspective, in a diabetic clinic in the south of Iraq.MethodsA cross sectional study from the diabetes out-patient clinic in Al-Faiha general hospital in Basrah, South Iraq for the period from January to December 2007. The study includes diabetic patients whether type 1 or 2 if they have at least one year of follow up in the same clinic. Those with A1C ≥ 7% were interviewed by special questionnaire, that was filled in by the medical staff of the clinic. The subjects analyzed in this study were adults (≥ 18 years old) with previously diagnosed diabetes (n = 3522). The duration of diabetes range from 1 to 30 years.ResultsMean A1C was 8.4 ± 2 percent, with 835(23.7%) patients with A1C less than 7% and 2688(76.3%) equal to or more than 7%. Of 3522 studied patients, 46.6% were men and 51.5% were women, with mean age of 53.78 ± 12.81 year and age range 18–97 years. Patient opinion for not achieving good glycemic control among 2688 patients with HbA1C ≥ 7% included the following. No drug supply from primary health care center (PHC) or drug shortage is a cause in 50.8% of cases, while drugs and or laboratory expense were the cause in 50.2%. Thirty point seven percent of patients said that they were unaware of diabetics complications and 20.9% think that diabetes is an untreatable disease. Thirty percent think that non-control of their diabetes is due to migration after the war. No electricity or erratic electricity, self-monitoring of blood glucose (SMBG) is not available, or strips were not available or could not be used, and illiteracy as a cause was seen in 15%, 10.8% and 9.9% respectively.ConclusionOur patients with diabetes mellitus declared that of the causes for poor glycemic control most of them related to the current health situation in Iraq.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients' opinion on the barriers to diabetes control in areas of conflicts: The Iraqi example

Mansour

2008

Confl Health

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“…The Iraqi health system has a lot of problems [1] probably made worse by the United Nations economic sanctions against Iraq in 1990 [2][3][4][5][6] . Self-medication and the use of nonprescription drugs are common in developing countries [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Corticosteroid Nonprescription Use: A Cross-Sectional Hospital-Based Study in Basrah

Mansour

Odaa²,

Wanoose³

2010

Med Princ Pract

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Objective: To study the prevalence and attitude of using nonprescription corticosteroids (oral or parenteral formulation of glucocorticosteroids) in Basrah, Iraq. Methods: A face-to-face model structured interview was used to collect information from 682 patients between January 2006 and December 2008. The following information was obtained: age, gender, marital status, smoking, drinking of alcohol, occupation, educational level, social class and place of residence. Results: Of the 682 (2.6%) subjects using nonprescription corticosteroids most were females: 471 (69%); married: 567 (83%); of low social class: 430 (63.1%); lived in the city center: 475 (69.6%). The majority (569, 83.5%) thought that corticosteroid use was safe and 463 (68.0%) did not feel guilty for using such medications. About half of them (377, 55.3%) were still using drugs at the time of presentation. Three hundred and fifty-seven (52.4%) reported that physicians advised them for the first time to use corticosteroids and the remaining 325 (42.2%) used it to become beautiful or marry. Three hundred and sixty-four (53.4%) patients obtained the drug from the pharmacy and 252 (36.9%) from street vendors. Weight gain was the main indication for use in 342 (50.1%) patients. Almost all had some features of corticosteroid side effects. Conclusion: This study showed high use of nonprescription corticosteroid in Basrah, Iraqi. We therefore recommend educational programs to alert the population of the untoward side effects of corticosteroids.

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Section: Introductionmentioning

confidence: 99%

“…In addition, and since the 1991 embargo following the Gulf War, the healthcare system in Iraq has started declining, which was only exacerbated during the 2003 war [ 10 , 11 ]. This situation created barriers to self-care among patients in general and patients with T2DM in particular, given the complicated nature of the disease and the dependence on medical supplies and insulin [ 10 , 12 ]. Although insulin is not required by all patients with T2DM, it might be indispensable to achieve good glycemic control [ 13 ], due to a progressive decline in beta-cell function or to the failure of oral anti-diabetes drugs (OADs) [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Type 2 Diabetes With Insulin Glargine-100 in Iraq in a Real-Life Observation

Mansour¹,

Rahmah²,

Khudhair³

2022

Cureus

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Introduction: Type 2 diabetes mellitus (T2DM) management is challenging in conflict zones, such as Iraq, and insulin might not be readily prescribed or available to patients who need it. This study describes the profile of Iraqi T2DM patients treated with insulin glargine-100 (Glar-100) and their response to the treatment.Research design and methods: This observational, multicenter registry collected data over six months on demographic and medical history, insulin regimen, changes in glycemic parameters, and vital signs in patients with T2DM in Iraq.Results: Patients (N = 245) were 55.2 ± 10.2 years old, with 58.4% females. They had had diabetes for 10 years, with baseline glycated hemoglobin (HbA1c) levels of 10.3% ± 1.6% (89 mmol/mol), diabetes complications, and co-morbidities. Almost all were on oral anti-diabetics before treatment intensification with Glar-100. Over 50% of patients with prior insulin exposure were receiving basal plus or bolus regimens at baseline, versus 6% of insulin-naïve patients, though some required treatment intensification. Most were asked to self-titrate according to fasting plasma glucose (FPG), but self-titration proved challenging. Upon Glar-100 treatment, HbA1c and FPG levels significantly decreased (P < 0.001), and 20% of patients (mostly insulin-naïve) achieved HbA1c < 7% (53 mmol/mol). Vital signs improved, while weight changes were modest. Most safety events were mild, and only two patients discontinued Glar-100. Conclusion.Glar-100 safely and effectively decreased FPG and HbA1c levels, achieving HbA1c control in some patients. Glar-100 is a promising T2DM therapeutic option in Iraq.

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Insulin crisis in Iraq

Cited by 7 publications

References 2 publications

Patients' opinion on the barriers to diabetes control in areas of conflicts: The Iraqi example

Patients' opinion on the barriers to diabetes control in areas of conflicts: The Iraqi example

Corticosteroid Nonprescription Use: A Cross-Sectional Hospital-Based Study in Basrah

Management of Type 2 Diabetes With Insulin Glargine-100 in Iraq in a Real-Life Observation

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