Only 1 in 10 diabetics in low- and middle-income countries receive comprehensive evidence-based, low-cost care-ScienceDaily

Many people don’t even know they are in that state.

Only 1 in 10 diabetics in 55 low- and middle-income countries surveyed have a type of comprehensive care that has been shown to alleviate diabetes-related problems, according to a new study published in I have received it. Lancet’s healthy longevity..

Its Comprehensive Care Package-A low-cost drug for lowering blood sugar, blood pressure and cholesterol levels. Diet, exercise, and weight counseling can help reduce the health risk of under-treated diabetes. These risks include future heart attacks, strokes, nerve damage, blindness, amputation, and other disorders or fatal conditions.

A new study, led by doctors at the University of Michigan and Brigham and Women’s Hospital, along with a global team of partners, will use data from standardized home studies to enable comparisons between apples across countries and regions.

The authors analyzed data from surveys, tests, and tests of more than 680,000 people between the ages of 25 and 64 conducted worldwide in recent years. Over 37,000 of them had diabetes. More than half of them had not yet been formally diagnosed, but had important biomarkers for elevated blood sugar levels.

As part of an initiative known as the Global Diabetes Compact, the researchers provided the findings to the World Health Organization, which is working to expand the provision of evidence-based diabetes care globally. All forms of diabetes-related care used in this study are included in WHO’s 2020 Essential Non-Infectious Disease Intervention Package.

“Diabetes continues to explode everywhere and in every country, and 80% of diabetics live in these low- and middle-income countries,” said lead author, UM Institute for Healthcare Policy and Innovation. “There is an increased risk of complications such as heart attack, blindness and stroke. Comprehensive diabetes treatment needs to prevent these complications and make them available to people around the world. “

Flood is Jennifer Manne-Goehler, MD, Sc.D., Senior Author of Brigham and Women’s Hospital. And in collaboration with the Massachusetts General Hospital Medical Practice Evaluation Center, he led the analysis of detailed global data.

Main survey results

In addition to the main finding that 90% of the diabetic patients studied did not have access to all six elements of effective diabetes care, the study also found that there was a large gap in specific care.

For example, about half of diabetic patients are taking drugs that lower blood glucose levels, 41% are taking drugs that lower blood pressure, but only 6.3% are taking cholesterol-lowering drugs.

These findings indicate that proven treatments need to be scaled up to address risk factors for cardiovascular disease, such as hypertension and high cholesterol, as well as lower glucose in diabetics.

Less than one-third had access to diet and exercise counseling. This helps diabetics develop habits that allow them to further control their health risks.

Even when the author focused on people who had already been formally diagnosed with diabetes, they were 85% taking medication to lower blood sugar and 57% taking blood pressure medication. , Found that only 9% were taking something to control their cholesterol. Nearly 74% received diet-related counseling and just under 66% received exercise and weight counseling.

In summary, less than one in five people previously diagnosed with diabetes had a complete package of evidence-based care.

Relationship between national income and personal characteristics

In general, this study found that it was unlikely to receive evidence-based diabetes treatment. The lower the average income of the country and region in which you live. It is based on a model created by the author using national economic and demographic data. It was included in the study.

Countries in the Oceania region of the Pacific had the highest prevalence of diabetes, both diagnosed and undiagnosed, but with the lowest proportion of diabetes-related care.

However, citing the Costa Rica example, there were exceptions in which low-income countries showed higher-than-expected diabetes treatment rates, says Flood. And in general, Latin America and the Caribbean were second only to Oceania in prevalence of diabetes, but with a much higher level of care.

The authors state that focusing on what is doing well in countries that have achieved great results in diabetes treatment can provide valuable insights for improving treatment elsewhere. .. This includes notifications of care in high-income countries such as the United States, which do not consistently provide evidence-based care to diabetics.

The study also sheds light on differences between countries and regions in the proportion of cases of diabetes diagnosed. Improving reliable access to diabetes diagnostic techniques is important in guiding more people to receive preventive care and counseling.

Women, well-educated and wealthy individuals, and older people and those with a high obesity index were more likely to receive evidence-based diabetes treatment. Diabetes in people with “normal” BMI is not uncommon in low- and middle-income countries, suggesting an increasing need to focus on these individuals, the authors say.

The fact that diabetes-related drugs are available at very low cost and that individuals can reduce their risk through lifestyle changes means that cost should not be a major barrier, Flood said. Says. In fact, studies have shown that drugs are cost-effective. That is, the cost of early and consistent use is more important than saving other types of care later.