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. 2016 Jun;7(3):101-9.
doi: 10.1177/2042018816643227. Epub 2016 Apr 13.

Management of diabetes in Morocco: results of the International Diabetes Management Practices Study (IDMPS) - wave 5

Asmae Chadli  1 , Siham El Aziz  1 , Nawal El Ansari  2 , Farida Ajdi  3 , Mehdi Seqat  4 , Hanane Latrech  5 , Ghizlaine Belmejdoub  6
Affiliations

Management of diabetes in Morocco: results of the International Diabetes Management Practices Study (IDMPS) - wave 5

Asmae Chadli et al. Ther Adv Endocrinol Metab. 2016 Jun.

Abstract

Objectives: The International Diabetes Mellitus Practice Study (IDMPS) is a 5-year survey documenting changes in diabetes treatment practices in developing countries. The primary objective of this survey was to assess the therapeutic management of type 2 diabetes mellitus (T2DM) in real-life medical practice. The secondary objectives were to evaluate the clinical management of type 1 diabetes mellitus (T1DM) and to assess the proportion of all diabetic patients failing to reach the glycated haemoglobin (HbA1c) <7% target.

Methods: Data were analysed for 738 patients (240 with T1DM and 498 with T2DM) included in wave 5 of the IDMPS in Morocco in 2011.

Results: Nearly two-thirds (61%) of T2DM patients were treated with oral glucose-lowering drugs (OGLDs) alone, 13.1% were treated with insulin alone and 23.3% were treated with OGLDs plus insulin. Insulin use was less frequent, was initiated later and involved a greater use of premixes versus basal/prandial schedules compared to other populations evaluated in the IDMPS. The majority (92.5%) of T1DM patients were treated with insulin alone and the remainder received insulin plus an OGLD. Insulin protocols included basal + prandial dosing (37.5%) and premix preparations (41.3%). The recommended target of HbA1c <7% was achieved by only 22.2% of T1DM patients and 26.8% of T2DM patients. More macrovascular but fewer microvascular complications were reported in T2DM compared to T1DM patients. Late complications increased with disease duration so that 20 years after diagnosis, 75.7% of T2DM patients were found to have at least one late complication.

Conclusions: The clinical burden of diabetes is high in Morocco and the majority of patients do not achieve the recommended glycaemia target, suggesting that there is a huge gap between evidence-based diabetic management and real-life practice. Better education of patients and improved compliance with international recommendations are necessary to deliver a better quality of diabetic care.

Keywords: basal–prandial; complications; diabetes; glycaemic control; insulin; management.

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Conflict of interest statement

Conflict of interest statement: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: A. Chadli, S. El Aziz, N. El Ansari, F. Ajdi, H. Latrech and G. Belmejdoub declare that there is no conflict of interest. M. Seqat is an employee of Sanofi-Aventis, Morocco.

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