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Optimizing Type 2 Diabetes Management in Iraq: Expert Consensus on Initiation and Intensification of Insulin-Based
Charles Saab1,2,3, Abbas Ali Mansour4, Abbas Mahdi Rahmah5
1Clinical Research Programs-Sacré-Coeur University Hospital, Beirut, Lebanon. drcsaab@hotmail.com.
Summary
Iraq
Area of Science:
- Endocrinology
- Metabolic Disorders
- Pharmacology
Background:
- Type 2 diabetes mellitus (T2DM) prevalence is rising in Iraq, necessitating optimized insulin therapy strategies.
- An expert panel convened to evaluate current insulin treatments for T2DM management in Iraq.
Purpose of the Study:
- To assess the evolving landscape of insulin therapies for T2DM in Iraq.
- To develop practical recommendations for optimizing insulin use in the Iraqi context.
Main Methods:
- Expert panel review of international guidelines and local Iraqi practice patterns.
- Pre-meeting surveys and focused discussions on insulin initiation and intensification.
- Consideration of accessibility challenges and patient characteristics in Iraq.
Main Results:
- Specific basal insulin (BI) or GLP-1 receptor agonist (GLP-1 RA)/BI combination recommendations based on HbA1c and BMI.
- Guidance on intensifying treatment with prandial insulin or premixed insulin if targets are unmet.
- Identified barriers include high cost and limited availability of GLP-1 RAs, therapeutic inertia, and infrastructure gaps.
Conclusions:
- A structured treatment algorithm for injectable insulin therapies in Iraq was developed.
- Emphasized the role of second-generation BIs and GLP-1 RA/BI fixed-ratio combinations.
- Highlighted the need for education and addressing barriers to improve T2DM management.
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