RESEARCH PAPER
GLYCEMIC CONTROL AND COMORBIDITIES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A GENDER-BASED STUDY IN HEALTH FACILITIES OF DUHOK, IRAQ
1
Department of Medical Laboratory, Cihan University – Duhok, Duhok, Kurdistan Region, Iraq
Submission date: 2025-08-01
Final revision date: 2025-09-26
Acceptance date: 2025-10-22
Publication date: 2025-11-03
KEYWORDS
TOPICS
ABSTRACT
Background:
This study aimed to investigate gender-related differences in glycemic control and the prevalence of comorbidities among diabetic patients attending healthcare facilities in Duhok, Iraq. It also examined associations between treatment regimens, lifestyle factors, and glycemic outcomes.
Material and methods:
A cross-sectional study was conducted from October 2024 to April 2025, enrolling 200 diabetic patients from the Duhok Diabetes Center and Azadi Teaching Hospital. Data collected included patient demographics, HbA1c values, diabetes treatment modalities, comorbid conditions, and lifestyle factors. Glycemic control was categorized as poor (HbA1c ≥ 7%) or good (HbA1c < 7%) based on the American Diabetes Association criteria.
Results:
Overall, 52% of patients achieved good glycemic control (HbA1c < 7%), with no statistically significant difference between males (49.52%) and females (54.74%) (p=0.4612). In contrast, patients on combined insulin and oral hypoglycemic therapy showed significantly poorer glycemic control, with 95.65% of males and 93.75% of females in this group having HbA1c ≥ 7% (p<0.0001).
Conclusions:
The study found no significant gender differences in glycemic control or the prevalence of comorbidities. The poorer glycemic outcomes observed in patients receiving combination therapy likely reflect more advanced or difficult-to-control disease.
This study aimed to investigate gender-related differences in glycemic control and the prevalence of comorbidities among diabetic patients attending healthcare facilities in Duhok, Iraq. It also examined associations between treatment regimens, lifestyle factors, and glycemic outcomes.
Material and methods:
A cross-sectional study was conducted from October 2024 to April 2025, enrolling 200 diabetic patients from the Duhok Diabetes Center and Azadi Teaching Hospital. Data collected included patient demographics, HbA1c values, diabetes treatment modalities, comorbid conditions, and lifestyle factors. Glycemic control was categorized as poor (HbA1c ≥ 7%) or good (HbA1c < 7%) based on the American Diabetes Association criteria.
Results:
Overall, 52% of patients achieved good glycemic control (HbA1c < 7%), with no statistically significant difference between males (49.52%) and females (54.74%) (p=0.4612). In contrast, patients on combined insulin and oral hypoglycemic therapy showed significantly poorer glycemic control, with 95.65% of males and 93.75% of females in this group having HbA1c ≥ 7% (p<0.0001).
Conclusions:
The study found no significant gender differences in glycemic control or the prevalence of comorbidities. The poorer glycemic outcomes observed in patients receiving combination therapy likely reflect more advanced or difficult-to-control disease.
REFERENCES (33)
1.
Chandrasekaran P. The role of obesity in type 2 diabetes mellitus – an overview. Mol Sci. 2024; 25: 1-21. https://doi.org/10.3390/ijms25....
2.
Murtaza G, Riaz S, Zafar M, Raza MA, Kaleem I, Imran H, et al. Examining the growing challenge: prevalence of diabetes in young adults (Review). Med Int. 2025; 5(1): 1-8. https://doi.org/10.3892/mi.202....
3.
Kropp M, Golubnitschaja O, Mazurakova A, Koklesova L, Sargheini N. Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications – risks and mitigation. EPMA J. 2023; 14: 21-42. https://doi.org/10.1007/s13167....
4.
Amsalu H, Hailu M, Asefa A, Ayenew M. The effect of lifestyle factors on chronic complications of diabetes at public health hospitals in Southwest Ethiopia. Sci Rep. 2024; 14: 1-9. https://doi.org/10.1038/s41598....
5.
Zhu XY, Shi MQ, Jiang ZM, Li X, Tian JW, Su FF. Global, regional, and national burden of cardiovascular diseases attributable to metabolic risks across all age groups from 1990 to 2021: an analysis of the 2021 global burden of disease study data. BMC Public Health. 2025; 25: 1-21. https://doi.org/10.1186/s12889....
6.
Marassi M, Cignarella A, Russo GT, Nollino L, Strazzabosco M, Marzullo P, et al. Sex differences in the weight response to GLP-1RA in people with type 2 diabetes. A long-term longitudinal real-world study. Int J Mol Sci. 2025; 219(April): 1-9. https://doi.org/10.1016/j.phrs....
7.
Ciarambino T, Crispino P, Leto G, Mastrolorenzo E, Para O, Giordano M. Influence of gender in diabetes mellitus and its complication. Int J Mol Sci Rev. 2022; 23(16): 1-13. https://doi.org/10.3390/ijms23....
8.
Jaza H, Salh H, Aziz TA, Ahmed ZA. Association between albuminuria, glycated hemoglobin with comorbidities in type 2 diabetes patients: experience in Sulaimani City, Iraq. Al-Rafidain J Med Sci. 2024; 6(1): 1-8. https://doi.org/10.54133/ajms.....
9.
Alrubaiee GG. Prevalence of chronic diabetic complications and associated risk factors among follow-up diabetic patients: estimates from a referral national diabetes center in Yemen. BMC Endocr Disord. 2025 ;25(68): 1-11. https://doi.org/10.1186/s12902....
10.
Zakir M, Ahuja N, Surksha MA, Sachdev R, Kalariya Y, Nasir M, et al. Cardiovascular complications of diabetes : from microvascular to macrovascular pathways. Cureus. 2023; 15(9): 1-14. https://doi.org/10.7759/cureus....
11.
Caycho-Rodríguez T, Vilca LV, Corrales-Reyes IE, Hernández-García F, Pupo Pérez A, González Quintana P, et al. COVID-19 contagion concern scale (PRE-COVID-19 ): Validation in Cuban patients with type 2 diabetes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2021; 15(5): 102245. https://doi.org/10.1016/j.dsx.....
12.
Yedjou CG, Sims JN, Njiki S, Chitoh AM, Cherkos AS, Tchounwou PB. Health and racial disparities in diabetes mellitus prevalence, management, policies, and outcomes in the United States. PMC. 2024; 8(3): 1-27. https://doi.org/10.29011/2577-....
13.
Care D, Suppl SS, Brown FM, Bruemmer D, Collins BS, Cusi K, et al. Introduction and methodology: standards of care in diabetes – 2023. Diabetes Care. 2023; 46(1): 1-4.
14.
Rob A, Hoque A, Asaduzzaman M, Ali M, Khatoon A, Thomas D, et al. The global challenges of type 2 diabetes. Bangladesh J Med. 2025; 36(2): 92-98. https://doi.org/10.3329/bjm.v3....
15.
Abusaib M, Ahmed M, Nwayyir HA, Alidrisi HA, Al-Abbood M, Al-Bayati A, et al. Iraqi experts consensus on the management of type 2 diabetes/prediabetes in adults. Clin Med Insights Endocrinol Diabetes. 2020; 13: 1-11. https://doi.org/10.1177/117955....
16.
Shafiee G, Gharibzadeh S, Panahi N, Razi F, Arzaghi SM, Haghpanah V, et al. Management goal achievements of diabetes care in Iran: study profile and main findings of DiaCare survey. J Diabetes Metab Disord. 2023; 22(1): 355-366. https://doi.org/10.1007/s40200....
17.
Ali J, Muhammad S, Haider S, Ali SM, Haider T, Anwar A, et al. Overall clinical features of type 2 diabetes mellitus with respect to gender. J Diabetes Metab Disord. 2023; 15(3). https://doi.org/10.7759/cureus....
18.
Alidrisi HA, Al-ibadi AA, Al-saidi JS, Alsawad MA, Jameel AA, Al-shati AW. Comparative analysis of glycemic and lipid profiles in newly diagnosed males and females with type 2 diabetes mellitus. Cureus. 2023; 15(12): 6-13. https://doi.org/10.7759/cureus....
19.
Wondm SA, Zeleke TK, Dagnew SB, Moges A, Tarekegn GY, Belachew EA. Association between self-care activities and glycemic control among patients with type 2 diabetes mellitus in Northwest Ethiopia general hospitals: a multicenter cross-sectional study. Sci Rep. 2024; 14(1): 1-15. https://doi.org/10.1038/s41598....
20.
Kautzky-Willer A, Leutner M, Harreiter J. Sex differences in type 2 diabetes. Diabetologia. 2023; 66: 986-1002. https://doi.org/10.1007/s00125....
21.
Al-Rubaye AAH. Risk factors of hypertension in Basra governorate. Intern ional J Biosci Biochem. 2024; 6(1): 102-107. https://doi.org/10.33545/26646....
22.
Ülgü MM, Gülkesen KH, Akünal A, Ayvalı MO, Zayim N, Birinci Ş, et al. Characteristics of diabetes mellitus patients in Turkey: an analysis of national electronic health records. Turkish J Med Sci. 2023; 53(1): 316-322. https://doi.org/10.55730/1300-....
23.
Ruze R, Liu T, Zou X, Song J, Chen Y, Xu R, Yin X, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis. Front Endocrinol (Lausanne). 2023; 14: 1-23. https://doi.org/10.3389/fendo.....
24.
Xie X, Wu C, Hao Y, Wang T. Benefits and risks of drug combination therapy for diabetes mellitus and its complications: a comprehensive review. Front Endocrinol (Lausanne). 2023; 14: 1-17. https://doi.org/10.3389/fendo.....
25.
Kim JY, Kim NH. Initial combination therapy in type 2 diabetes. Endocrinol Metab. 2024; 39(1): 23-32. https://doi.org/10.3803/EnM.20....
26.
Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, et al. Consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) management of hyperglycemia in type 2 diabetes, 2022. Diabetes Care. 2022; 45(11): 2753-2786. https://doi.org/10.2337/dci22-....
27.
Che M, Zhou Q, Lin W, Yang Y, Sun M, Liu X, et al. Healthy lifestyle score and glycemic control in type 2 diabetes mellitus patients: a city-wide survey in China. Healthcare. 2023; 11(14): 1-12. https://doi.org/10.3390/health....
28.
Al-Chawishli S, Dizaye K, Azeez S. Measuring diabetic medication adherence and factors that lead to non-adherence among patients in Erbil. Cureus. 2024; 16(9): 1-20. https://doi.org/10.7759/cureus....
29.
Reed J, Bain S, Kanamarlapudi V, Bain S. A review of current trends with type 2 diabetes epidemiology, aetiology, pathogenesis, treatments and future perspectives. Diabetes Metab Syndr Obes. 2021; 14: 3567-3602. https://doi.org/10.2147/DMSO.S....
30.
Andersson E, Brådvik G, Nilsson FOL, Arpegård J, Strambi A. Prevalence of diabetes and hospitalization due to poor glycemic control in people with bladder cancer or renal cell carcinoma in Sweden. BMC Urol. 2024; 24: 1-12. https://doi.org/10.1186/s12894....
31.
Szablewski L. Insulin resistance: the increased risk of cancers. Curr Oncol. 2024; 31(2): 998-1027. https://doi.org/10.3390/curron....
32.
Yahaya JJ, Doya IF, Morgan ED, Ngaiza AI, Bintabara D. Poor glycemic control and associated factors among patients with type 2 diabetes mellitus: a cross‑sectional study. Sci Rep. 2023; 13(1): 1-10. https://doi.org/10.1038/s41598....
33.
Rosenfeld RM, Grega ML, Karlsen MC, Moain A, Dabrh A, Aurora RN, et al. Lifestyle interventions for treatment and remission of type 2 diabetes and prediabetes in adults: a clinical practice guideline from the American College of Lifestyle Medicine. American Journal of Lifestyle Medicine. 2025; 19(2 suppl): 10S-131S. https://doi.org/10.1177/155982....
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