The Effect of War on the Control of Diabetes in Patients with Type 2 Diabetes Mellitus in Yemen: A Cross-Sectional Study

Background: The War in Yemen, which started in March 2015, has had many effects on patients with type 2 diabetes mellitus (DM). We conducted this study to analyze the effect of war on type 2 diabetics at our clinic. Patients and methods: We studied 430 patients attending an endocrinology clinic in Sana’a, Yemen from September 2015 to January 2016. Of the total, 229 were female and 201 were male. Additionally, 111 patients had been coming to our clinic before the war, and 319 were new patients. The glycated hemoglobin (HbA1c), blood sugar, body mass index (BMI) and blood pressure of the patients were measured. The patients who came during the war answered a questionnaire regarding their diabetes and the war. The data were presented as the mean with the standard deviation (SD) and 95% confidence interval (95% CI) of the mean. Frequencies and percentages were used to describe qualitative data. The mean, SD, and 95% CI were used to describe quantitative data. Results: The mean HbA1c before the war was 7.7 (61 mmol/mol) (SD 1.9), whereas the mean HbA1c during the war was 9.4 (80 mmol/mol) (SD 2.4) (p value: <0.001). The mean BMI before the war was 28.1 (SD 4.7) and during the war was 27.6 (SD 4.8) (p-value: 0.015). The results showed that 22% of the patients were displaced, 16.4% had relatives at their home, 8.9% had damage to their homes and 10% had lost a relative. In total, 8.4% of the patients had discontinued some or all of their diabetes medications during the war. Conclusion: Patients with type 2 DM in Yemen attending our clinic during the war had a higher HbA1c and a lower BMI compared to before the war. Many patients were displaced, had their homes damaged or lost a relative during the war.