Prevalence of obesity among diabetic patients in Sabahia area in Kuwait

There is well known strong association between type 2 diabetes and obesity. Also obesity represent a major health problem worldwide and specially in Kuwait and gained a great interest in recent years from the different health authorities. The aim of this study was to find out the prevalence of obesity among patients with Diabetes Mellitus attending the primary health care center in El-Sabahia area. Five hundred adult patient known to be diabetic either on oral hypoglycemic drugs or on Insulin therapy or both were included in the study. They were subjected to the following: Full history taking, full general and local examination of the heart, chest and abdomen, anthropometric Height, weight and waist and hip circumferences and Laboratory investigations including: Fasting and 2 hours post-prandial blood glucose [FBS] measurement, an oral glucose tolerance test [OGTT], blood pressure measurement, blood lipids tests and completing a questionnaire on socio-demographic and smoking information. Patients were calssified according to the BMI as [underweight when BMI <18.5kg/m[2], normal weight when BMI >/= 18.5 to 24.9kg/m[2], overweight when BMI >/= 25.0 to 29.9kg/m[2], class I obesity when BMI = 30.0 to 34.9kg/m[2], class II obesity when BMI =35.0 to 39.9 kg/m[2], class III or morbid obesity when BMI >/= 40kg/m[2]. Waist circumference and Waist hip ratio were calculated. Results of the current study regarding the degree of obesity as determined by the body mass index was; 18 patients [3.6%] have normal weight, 54 patients [10.8%] were overweight, 137 patients [27.4%] had class I obesity, 169 patients [33.8%] had class II obesity and 122 patients [24.4%] had morbid obesity. The overall prevalence of obesity in our study population was 85.6%. The mean WHR was significantly higher among males than females [p<0.05] and the prevalence of central obesity among males was more than that in females. Also the mean WHR increased with advanced age but it showed non-significant decrease in the age group >65 years. The prevalence of obesity among patients with Diabetes Mellitus in Sabahia Kuwait is very high and even higher than most studies. The Waist Hip ratio was found to be also significantly high among diabetic patients. Both sexes had a very high prevalence of obesity and males tended to be more obese than females. These alarming results necessitate rapid intervention for control of obesity especially among Kuwaiti diabetic patients in order to decrease the risk of cardiovascular disease and toward better control of diabetes

Awareness and implementation of hypertension guidelines in primary health care in Kuwait

World Health Organization / International Society of Hypertension [WHO/ISH] guideline makes recommendations on primary care management of hypertension. Hypertension control is based on physician awareness and familiarity with these guidelines and their attitudes in clinical practice. This study aimed to evaluate primary health care [PHC] physicians' awareness and attitude towards WHO / ISH guidelines for management of hypertensive patients, and their opinions regarding barriers for implementation of these guidelines. The study is a cross-sectional survey that was conducted from September to October 2008. Self-administered questionnaires were distributed to all physicians currently working in all PHC centers in the five health regions in Kuwait. The questionnaire included data about personal characteristics, level of knowledge and agreement with [WHO / ISH] guidelines as well as implementation of the guidelines and questions related to barriers to improve their hypertensive patient management. Although most physicians [90.7%] were familiar with the new WHO / ISH guidelines. 83.4% of them were in agreement with. Also, it was found that only 26.7% always follow these guidelines, 56.7% sometimes follow them. The median value of the correct answers was 5 from 10 statement with a range from zero to 9. About one fifth of the physicians [20.5%] could not attain 5/10 score, and none chose correctly the 10 correct statements. Results suggest that participants, in their clinical practice, accept higher BP levels than recommnended in clinical practice. Also, they tend to give more attention for hypertensive patients with co-morbidity. The most important barriers for improvement of hypertension control, that physicians stated, were lack of time, non availability of the drugs in the clinic, lake of patient knowledge, poor patient compliance to life style modifications, non adherence of patients to their medications, and follow up by different physicians. The results of this survey indicate that there is an urge tit need to establish nationwide educational and quality monitoring programs to facilitate the implementation of new hypertension guidelines vi PHC clinical practices in Kuwait