title: Management and control of patients with type 2 diabetes mellitus in Lebanon: results from the International Diabetes Management Practices Study (IDMPS).
abstract: BACKGROUND
  The IDMPS is a study to identify changes in diabetes treatment practice in several developing countries. This paper focuses on diabetes management and compliance with guidelines in a Middle Eastern country like Lebanon.
  
  
  METHODS
  The cross-sectional data from the 2006 wave of two weeks duration on the Lebanese population along with the longitudinal data of a 9-month follow-up study were collected.
  
  
  RESULTS
  A large proportion of Lebanese patients were not adequately controlled or followed up. A slight proportion was managed by diet and exercise alone while most patients were on two or more oral anti-hyperglycemics. Metformin was the most common monotherapy followed by sulfonylureas. 22.6% of Lebanese patients were on insulin, most commonly basal insulin alone followed by premix insulin alone. Blood glucose self-monitoring was more frequently done by insulinized patients and was associated with better glycemic control. Glycemic control was reached in 29.6% of type 2 patients (HbA1c < 7%) with poorest outcome for patients on insulin and was more frequently achieved in patients who had more frequent monitoring of HbA1c levels.
  
  
  CONCLUSIONS
  For a proper assessment of diabetic control, maintaining adherence to international guidelines needs to be evaluated. Promoting patient education, improving physician knowledge with better implementation of guidelines is recommended.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon. sazar@aub.edu.lb
authors.forename: Sami T
authors.initials: ST
authors.lastname: Azar
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Line P
authors.initials: LP
authors.lastname: Malha
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Mira S
authors.initials: MS
authors.lastname: Zantout
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Naja
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Fariha
authors.initials: F
authors.lastname: Younes
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Marie-Therese
authors.initials: MT
authors.lastname: Sawaya
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003906:Developing Countries; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D003927:Diet, Diabetic; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D019983:Guideline Adherence; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007861:Lebanon; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human