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A Real-World Consensus on Management of Type 2 Diabetes Mellitus by Experts in Iraq

Author(s): Abbass Almousawy, Atheer Alyasss, Mahmoud Shakeer, Gelal Altaiee, Abdul Munem Dabagh, Baker Alhajami, Muqdad Alkuzaie, Ammar W. Ashor, Ali Alsaidy, Raed Sabri, Anwar Tuama, Haider Aladresi, Sherwan Bahaa, Uday Almaliky, Mohammed Qasim Alwash, Hasan Mortada, Ayad Khazal, Salim Marzoki, Sabah Alhelw, Majeed Al Rufaieey, Ali Hussain, Abbas Ali Mansoor, Shirley Dsouza

Background: Diabetes has reached epidemic status in Iraq over the last decade.

Methodology: The modified Delphi method was used to develop the best practice recommendations for the management of type 2 diabetes for adults in a real-world setting in Iraq. Diabetologists, Cardiologists, Nephrologists, Dieticians, and Physicians with clinical expertise in the management of T2DM were invited to participate in this consensus program.

Results: Obesity in the T2DM population in Iraq must be addressed concomitantly with diabetes by the initiation of measures to reduce abdominal obesity by lifestyle modification. Patients with established ASCVD or indicators of high ASCVD risk must be given optimum tailored therapy. SGLT2 inhibitors were recommended by clinical experts as the first choice in diabetic kidney disease patients in accordance with the ADA guidelines. Initiate treatment with Dapagliflozin /SGLT2i with proven CV benefits to reduce recurrent CV events/ hospitalizations due to heart failure.

Conclusion: There is a discrepancy in the diagnosis and management of diabetes in Iraq, though it has a bulk of the world’s diabetic population. In light of the recent ADA and ESC guidelines, there was a need to revisit the existing Iraqi consensus.