Diabetes in Mexico: cost and management of diabetes and its complications and challenges for health policy

Abstract

BackgroundMexico has been experiencing some of the most rapid shifts ever recorded in dietary and physical activity patterns leading to obesity. Diabetes mellitus has played a crucial role causing nearly 14% of all deaths. We wanted to make a comprehensive study of the role of diabetes in terms of burden of disease, prevalence, cost of diabetes, cost of complications and health policy.MethodWe review the quantitative data that provides evidence of the extent to which the Mexican health economy is affected by the disease and its complications. We then discuss the current situation of diabetes in Mexico with experts in the field.ResultsThere was a significant increase in the prevalence of diabetes from 1994 to 2006 with rising direct costs (2006: outpatient USD$ 717,764,787, inpatient USD$ 223,581,099) and indirect costs (2005: USD$ 177,220,390), and rising costs of complications (2010: Retinopathy USD$ 10,323,421; Cardiovascular disease USD$ 12,843,134; Nephropathy USD$ 81,814,501; Neuropathy USD$ 2,760,271; Peripheral vascular disease USD$ 2,042,601). The health policy focused on screening and the creation of self-support groups across the country.ConclusionsThe increasing diabetes mortality and lack of control among diagnosed patients make quality of treatment a major concern in Mexico. The growing prevalence of childhood and adult obesity and the metabolic syndrome suggest that the situation could be even worse in the coming years. The government has reacted strongly with national actions to address the growing burden posed by diabetes. However our research suggests that the prevalence and mortality of diabetes will continue to rise in the future.

The impact of diabetes on employment in Mexico

“…In Mexico type 2 diabetes is increasingly affecting people in their productive age, raising the possibility that a larger share of people with diabetes will have to cope with debilitating complications already relatively early in life (Barquera et al, 2013;Villalpando et al, 2010). Further, only a minority of Mexicans appears to successfully manage their diabetes condition, with as much as 70 percent of the people with diabetes having poor control over their disease (Villalpando et al, 2010).…”

“…Only in recent years the awareness has been growing of the sheer size of the problem in health terms (Yach et al, 2006;Hu, 2011). Mexico is one example of a middle-income country that has seen diabetes rates increase sharply over the last years, from about 7.5 percent in 2000 (Barquera et al, 2013) to 12.6 percent in 2013 (International Diabetes Federation, 2013). The high prevalence of diabetes in Mexico reflects an epidemiological transition from a disease pattern previously characterized by high mortality and infectious diseases to low-mortality rates and non-communicable diseases (NCDs) affecting predominantly adults (Stevens et al, 2008).…”

The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico

“…[10][11][12] In the most recent report, Barraza-Lloréns and colleagues (2015) estimated that in 2013 this burden, including direct and indirect costs, was MXN$362 859.8 million accounting for 2.25% of GDP. Direct costs were estimated as MXN$179 495.3 million of which medical care for the main diabetic complications represented 87%.…”

Glycemic Control and Rate of Sputum Conversion in Diabetic Patients with Pulmonary Tuberculosis

“…Adequate control of glycaemia in Mexican patients is very rare; in a national survey, only 6.6% of those diagnosed with DM had HbA1c < 7%. [3,10].…”