Transculturalizing Diabetes Prevention in Latin America

• Main Authors: Ramfis Nieto-Martínez, Juan P. González-Rivas, Pablo Aschner, Noël C. Barengo, Jeffrey I. Mechanick
• Format: Article
• Language: English
• Published: Levy Library Press 2017-08-01
• Series: Annals of Global Health
• Subjects: FINDRISC; Latin America; prevention; type 2 diabetes; validation
• Online Access: https://annalsofglobalhealth.org/articles/156

Background: <a title="Learn more about Diabetes mellitus type 2" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes-mellitus-type-2">Type 2 diabetes</a> (T2D) imposes a heavy burden in developing countries, requiring effective <a title="Learn more about Primary Prevention" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/primary-prevention">primary prevention</a> policies. <a title="Learn more about Randomized Clinical Trial" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/randomized-clinical-trial">Randomized clinical trials</a> have identified successful strategies in T2D prevention. However, translating these results to real-life scenarios and adapting to ethnocultural differences is a major challenge. Transculturalization allows incorporating <a title="Learn more about Cultural Factor" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cultural-factor">cultural factors</a> to <a title="Learn more about Diabetes Prevention" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes-prevention">diabetes prevention</a> strategies to optimize implementation of <a title="Learn more about Clinical Trial Results" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/clinical-trial-results">clinical trials results</a>. The purpose of this paper is to review the transcultural adaptations developed for T2D prevention in Latin America (LA). Methods: A comprehensive literature review spanning 1960-2016 was performed, using “Diabetes,” “Latin America,” “Prevention,” “Screening,” and “Tools” as key words. Results: Two major tasks are underway in LA: adaptation of screening tools for high-risk individuals, and implementation of diabetes prevention programs. The Finnish <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">Diabetes</a> Risk Score (FINDRISC) is the most widely used screening tool to detect new cases of T2D and people with <a title="Learn more about Prediabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/prediabetes">prediabetes</a>, and it has been adapted (LA-FINDRISC) to include the waist circumference cutoff values appropriate for LA population (≥94 cm for men and ≥90 cm for women). The validation of the LA-FINDRISC performance depends on the local characteristics. A LA-FINDRISC score >10 may be the best cutoff to identify individuals with impaired <a title="Learn more about Glucose" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/glucose">glucose</a> regulation in population-based studies, but a higher score (>12-14) might be more appropriate in a clinical setting. A shorter version of the FINDRISC using only the 4 variables with highest impact has been developed and validated in Colombia (ColDRISC). The translation of the Diabetes Prevention Program study in a Latino population in Venezuela found a significant improvement in cardiometabolic risk factors. An adaptation of the Diabetes Prevention Study in the DEMOJUAN study in Barranquilla, Colombia, reduced 2-hour postload glucose. Conclusion</h3>Successful transculturalization strategies have been implemented in screening tools and prevention programs in LA.