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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2022; 05(01): 029-033
DOI: 10.1055/s-0042-1748667
Original Article

Challenges in Type-1 Diabetes Management during the Conflict in Syria

Ibrahim Alali 
1   Department of Endocrinology, Al-Assad University Hospital, Damascus University, Damascus, Syria
2   Endocrinlogist, Private Practice, Raqqa, Syria
,
Bachar Afandi 
3   Department of Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
4   The Endocrine Division, Tawam Hospital, Al Ain, United Arab Emirates
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Abstract

Background In Syria, a country at war for one decade, medical care has been severely affected by shortages in medications, resources, food, and physicians.

Objectives This study reviews the quality of care for patients with type-1 diabetes (T1D) receiving treatment in a private endocrinology service in Raqqa City, Syria.

Patients and Method A cross-sectional medical record review for patients with T1D followed-up at a private clinic run by a certified endocrinologist in Raqqa, Syria. All medical records were evaluated for patients' characteristics and multiple diabetes care indicators.

Results One hundred and ninety-seven patients with T1D were evaluated; 109 (55.3%) patients were females. The median age of participants was 16 (1.7–42) years, median duration of diabetes was 4 (0–27) years, and mean hemoglobin was A1C, 9.1% (8.7–9.5%). One hundred and twenty-five (63.5%) patients used premixed insulin. Eighty-one (42.4%) patients performed regular self-monitoring of blood glucose (SMBG) at least twice daily. Episodes of hypoglycemia and diabetic ketoacidosis (DKA) were reported in 62.4 and 54.4% of patients, respectively. There were significant correlations between the incidence of DKA and female gender and premixed insulin regimens.

Conclusion In this private endocrine practice in Raqqa City, Syria, the majority of patients are treated with premixed insulin. Only a minority have their glycosylated A1c monitored regularly. Our unprivileged population is poorly controlled with increased risk of hypoglycemia and admissions with diabetic ketoacidosis.

Keywords

Syria - type-1 diabetes - diabetes care indicators - A1C - hypoglycemia - insulin treatment - diabetic ketoacidosis - self-monitoring of blood glucose

Author's Contributions

I.A. has full access to all the data presented and takes responsibility for the integrity and accuracy of the content. All patient's data are available upon request as SPSS sheet. Both authors contributed to the conception and writing of the manuscript, literature search, revision, and approval of the final version.


Compliance with Ethical Principles

The study was undertaken as a quality assurance exercise, and it was approved by health local authorities.


Financial Support and Sponsorship

None.




Publication History

Article published online:
19 July 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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