Type 1 Diabetes Mellitus in Northern Palestinian Community

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Majd Asa'd M. Abu-Ali
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In Palestine, studies on diabetes and diabetic patient were limited. With respect to type 1 diabetes no available data of any nature is available. The current study aimed at evaluating the effect of health services provided by governmental clinics on type 1 diabetic patients in the northern parts of the West Bank area. All cases enrolled at the diabetic centers of the cities of Nablus, Jenin and Tulkarm were interviewed and the data was collected using a specially designed questionnaire. A total of 100 cases, representing all admitted cases over a period of 1 year (September 2000-September 2001), were enrolled. Data was analyzed using the Statistical Package for Social Sciences (SPSS). The findings of the current study showed that the study population was distributed as follows: 51 from Nablus diabetic center, 31 from Jenin center and 18 from Tulkarm center. Equal representation for both males and females was observed with a mean age of disease onset of 4.95 years. It was also found that 20% of the study population reported to have first degree relative with diabetes. Among the study population 84% were reported to have episodes of hypoglycemia, while 96% were reported to have episodes of hyperglycemia as complications associated with the disease. The findings on the association between recommended daily practices (changes in diet and physical activities, home monitoring of sugar level in blood and urine and blood sugar level adjustment through insulin and diet) and presence of complications (hypo-hyperglycemia) showed that no statistical significant association between such practices and improvement of health status of the patients. With respect to clinical (consultations with ideologist and dietitians) and educational services about diabetes, offered in these centers, and its effect on the control of patients’ blood sugar level, our findings showed that such services did not show any improvement on the health status of these patients. Our data shows that 46.0% of those who attended consultation sessions with dietitian were with controlled random blood sugar and 20.0% for those who attended consultation sessions with dialectologist were with controlled random blood sugar. Association with recommended health practices and control of blood sugar also showed no significant improvement on the health status of these patients with the exception of home monitoring of blood sugar level as 90% of those who practiced this activity were with controlled acceptable blood sugar levels. The effect of diabetic complication on the quality of life showed that less than 50% of the study population who had either hypo or hyperglycemia were able to cope with their normal life activities and around 18% of this group were able to cope with recommended diet regimes. With respect to patients satisfaction with the offered services, 87% of them seems to be satisfied with what is offered by their centers, although no any noticeable improvement on their health status.