The objective of this study was to investigate the impact of almost 3 years of war on glycaemic control and blood pressure in Sarajevans with non-insulln-dependent diabetes mellitus (NIDDM). Fifty-five patients with NIDDM were randomly selected from a register of 279. Data from pre-war records were retrieved and the same measurements were repeated using a similar methodology. These included blood glucose levels, ghycosylated haemoglobin Ale (HbAlc), serum cholesterol and triglycerides. Other measurements included weight, height and systolic and diastolic blood pressure. Information was collected on the prescribed therapy, the availability of drugs and access to medical facilities. Weight was significantly reduced by 11.7 ± 8.2 kg. Sixty per cent of the sample were obese (body mass index (BMI) >30) before the war compared with only 18% afterwards. The percentage of patients with NIDDM with acceptable blood glucose values Increased from 15 to 35%. The values of HbA1c improved significantly but no differences in the total serum cholesterol or in the trigiyceride levels were found. Twenty-five of the participants were hypertensive (BP > 140/90 mmHg) before the war compared with only 14 in 1994–1995. The number of patients controlled without any anti-diabetic medication increased from 3 to 13. The reduction in anti-diabetic drugs and blood pressure probably occurred as a result of the significant weight loss. It can be concluded that glycaemic control and the level of hypertension improved in patients with NIDDM in Sarajevo during the war. These findings have major implications for future policies related to public health.
COLIN SANDERSON, BO J. A. HAGLUND, PER TILLGREN, LEIF SVANSTROM, CLAES-GORAN OSTENSON, LARS-ERIK HOLM, HENRIK ULLEN and ARIF SMAJKIC Health Services Research Unit, Department of Public Health &Policy, London School of Hygiene & Tropical Medicine, London, UK, Department of International Health &Social Medicine, Karolinska Institute, Stockholm, Sweden, Department of Endocrinology, Karolinska Institute, Stockholm, Sweden,Swedish National Public Health Institute, Stockholm, Sweden, Department of Oncology, Karolinska Institute, Stockholm, Sweden and Institute for Social Medicine, University of Sarajevo, Sarajevo, Former Yugoslavia
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