Compliance with Second Visit of Diabetes Mellitus Screening Program and Impact of Dietary and Exercise Modification on Glycemic Control

Abstract

Background: Diabetes is frequently not diagnosed until complications appear. Therefore, diabetes can be considered the top candidate for early detection and management. Objectives: To assess the non-compliance level of the 2nd visit of the screening program for diabetes and to evaluate the effect of diet and exercise modification on glycemic control. Methods: The first part was a cross-sectional study with analytic components, and the second was an interventional study during a period of one year, from September 2023 to September 2024. It included 400 adults aged ≥ 40 years, who were included in the program of early diabetes detection and showed an elevated blood sugar level; then they were scheduled for the 2nd visit for follow-up. HbA1c %, body mass index, and waist circumference were evaluated, and then these patients were put on a diet and exercise program to be evaluated again after three months. Results: The prevalence of non-compliance is 64.4%. Lower educational level, not enough time to explain problems by the provider, fear and worry about diagnosis, hesitation to treatment, and not giving an appointment for a 2nd visit are independent risk factors. Means of BMI, WC, and HbA1c were significantly decreased after three months of lifestyle modification. Conclusions: Non-compliance with the 2nd visit of the program of early detection of diabetes is a common problem among Iraqis. The primary care infrastructure and expertise are lacking in Iraq, and healthcare provision relies heavily on secondary and tertiary care.