Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

Abstract

Purpose of Review Latin America is the scenario of great inequalities where about 32 million human beings live with diabetes. Through this review, we aimed at describing the current state of the prevalence, awareness, treatment, and control of diabetes mellitus and completion of selected guidelines of care across Latin America and identify opportunities to advance research that promotes better health outcomes. Recent Findings The prevalence of diabetes mellitus has been consistently increasing across the region, with some variation: higher prevalence in Mexico, Haiti, and Puerto Rico and lower in Colombia, Ecuador, Dominican Republic, Peru, and Uruguay. Prevalence assessment methods vary, and potentially underestimating the real number of persons with diabetes. Diabetes unawareness varies widely, with up to 50% of persons with diabetes who do not know they may have the disease. Glycemic, blood pressure, and LDL-C control and completion of guidelines to prevent microvascular complications are not consistently assessed across studies, and the achievement of control goals is suboptimal. On the other hand, multiple interventions, point-of-care/rapid assessment tools, and alternative models of health care delivery have been proposed and tested throughout Latin America. Summary The prevalence of diabetes mellitus continues to rise across Latin America, and the number of those with the disease may be underestimated. However, some local governments are embedding more comprehensive diabetes assessments in their local national surveys. Clinicians and public health advocates in the region have proposed and initiated various multi-level interventions to address this enormous challenge in the region. Keywords Latin America. Diabetes prevalence. Diabetes treatment. Control. Diabetes complications. Interventions. Health care This article is part of the Topical Collection on Diabetes Epidemiology

Lifetime risk of developing diabetes and years of life lost among those with diabetes in Brazil

“…However few studies have evaluated these strategies, including that of diabetes prevention programs targeting of high-risk adults. The increased burden observed on these countries in recent years [ 51 ] highlight the importance of such evaluation to establish more effective and sustainable models of prevention.…”

Exploring Early Combination Strategy in Latin American Patients With Newly Diagnosed Type 2 Diabetes: A Sub-analysis of the VERIFY Study 

“…Earlier studies with the traditional sequential treatment intensi cation approach in clinical practice among patients from Latin America have shown that only 25-30% of patients achieved their glycemic target [11,12]. A recent review of Latin American studies showed that non-attainment of glycemic control is primarily associated with longer duration of disease, a complex regimen, and inadequate access to healthcare and insurance coverage [10]. In this sub-analysis, 53.6% of patients using early combination therapy achieved and sustained glycemic control over a long term.…”

“…Socioeconomic conditions in Latin America present several public health challenges for diabetes care, such as low disease awareness, inadequate diagnosis, treatment and preventive measures, and limited access to healthcare facilities [6,8,9]. Diagnosis is often delayed as the prevalence of undiagnosed patients ranges from 10.3-50% in this region [10]. Access to treatment is also a major challenge [11], and less than 50% of patients receiving treatment achieve their glycemic targets [12].…”

Exploring early combination strategy in Latin American patients with newly diagnosed type 2 diabetes: a sub-analysis of the VERIFY study

“…Earlier studies with the traditional sequential treatment intensification approach in clinical practice among patients from Latin America have shown that only 25–30% of patients achieved their glycemic target [ 10 , 11 ]. A recent review of Latin American studies showed that non-attainment of glycemic control is primarily associated with longer duration of disease, a complex regimen, and inadequate access to healthcare and insurance coverage [ 9 ]. In this sub-analysis, 53.6% of patients using early combination therapy achieved and sustained glycemic control over a long term.…”

“…Socioeconomic conditions in Latin America present several public health challenges for diabetes care, such as low disease awareness; inadequate diagnosis; treatment, and preventive measures; and limited access to health care facilities [ 5 , 7 , 8 ]. Diagnosis is often delayed as the prevalence of undiagnosed patients ranges from 10.3 to 50% in this region [ 9 ]. Access to treatment is also a major challenge [ 10 ], and less than 50% of patients receiving treatment achieve their glycemic targets [ 11 ].…”