Synthesis: Deriving a Core Set of Recommendations to Optimize Diabetes Care on a Global Scale

• Main Authors: Jeffrey I. Mechanick, Derek Leroith
• Format: Article
• Language: English
• Published: Levy Library Press 2016-04-01
• Series: Annals of Global Health
• Subjects: diabetes; recommendations; global; diabetes care; type 2 diabetes; type 1 diabetes; public policy
• Online Access: https://annalsofglobalhealth.org/articles/1455

Background: <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">Diabetes</a> afflicts 382 million people worldwide, with increasing prevalence rates and adverse effects on health, well-being, and society in general. There are many drivers for the complex presentation of diabetes, including environmental and genetic/epigenetic factors. Objective: The aim was to synthesize a core set of recommendations from information from 14 countries that can be used to optimize diabetes care on a global scale. Methods: Information from 14 papers in this special issue of Annals of '<a title="Learn more about Global Health" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/global-health">Global Health</a>' was reviewed, analyzed, and sorted to synthesize recommendations. PubMed was searched for relevant studies on diabetes and global health. Findings: Key findings are as follows: (1) Population-based transitions distinguish region-specific diabetes care; (2) biological drivers for diabetes differ among various populations and need to be clarified scientifically; (3) principal resource availability determines quality-of-care metrics; and (4) governmental involvement, independent of economic barriers, improves the contextualization of diabetes care. Core recommendations are as follows: (1) Each nation should assess region-specific epidemiology, the scientific evidence base, and population-based transitions to establish risk-stratified guidelines for diagnosis and therapeutic interventions; (2) each nation should establish a public health imperative to provide tools and funding to successfully implement these guidelines; and (3) each nation should commit to education and research to optimize recommendations for a durable effect. Conclusions: Systematic acquisition of information about diabetes care can be analyzed, extrapolated, and then used to provide a core set of actionable recommendations that may be further studied and implemented to improve diabetes care on a global scale.