ESPE Abstracts

Background: Diabetes mellitus is the second most common chronic disease of childhood. It requires appropriate management and follow up to reduce the complications. Type 1 diabetes mellitus (T1DM) is the most common type of diabetes that affects children. Most of the developed countries launched registries. In Iraq, there is no access to statistics or national report about the provided service. Rather, there is no standardization of the practice.

Purpose: This study aims to overview the provided service for children and young people living with diabetes in Iraq.

Methods: Online survey was sent out to colleagues from different Iraqi provinces. Responses were collected between November and December 2019.

Results: 18 responses from 10 provinces. All of them are working in government led pediatric diabetes units (PDUs). Respondents were 8 pediatricians, 6 consultant pediatric endocrinologists, 2 consultant adult endocrinologists and 2 pediatric endocrine specialists. Median number of patients in each center was 1000 ranging roughly between 100 and 3000. Total number of diabetic patients under 18 years old was approximately 15.4K. Median age before transferring patients to adult services is 16 years, ranging from 14-19 years. Majority (77.7%) have no transition policy in their health care centers. Team composition was variable between the PDUs. Median number of consultants, resident and administrator/secretary for each PDU was 1. 66% of PDUs do not have pediatric diabetologists, diabetes specialist nurses or diabetes educators. 77.8% are not having dietitians and 94.4% function without psychologists. Basic facilities were limited; stadiometers were available in 78%, and different sizes of sphygmomanometers in 33% of PDUs. Similarly not all investigations were available as celiac screen was available in only 39%, urine for albumin/creatinine measurement in 22%, and HbA1c in 67% of PDUs. Only 56% of centers run an annual screening for their patients. Glucometers are provided in 50% of centers, glucometers’ strips in 44%, insulin-syringes in 67% and insulin-pens in 44%. Lente insulin was available in all centers. 61% of PDUs do not organize any sort of activities for their patients.

Conclusion: There is a strong need to improve health services for children and young people live with diabetes in Iraq. Standardization of care is a big desire. Auditing the practice regularly is advisable to identify the gaps and poor compliance in order to be highlighted for the decision makers, working on improving the quality of care.