Gaps in Guidelines for the Management of Diabetes in Low- and Middle-Income Versus High-Income Countries—A Systematic Review

Owolabi, Mayowa; Yaria, Joseph; Daivadanam, Meena; Makanjuola, Akintomiwa; Parker, Gary; Oldenburg, Brian; Vedanthan, Rajesh; Norris, Shane A.; Oguntoye, Ayodele R.; Osundina, M. A.; Herasme, Omarys; Lakoh, Sulaiman; Ogunjimi, Luqman; Abraham, Sarah E.; Olowoyo, Paul; Jenkins, Carolyn; Feng, Wuwei; Bayona, Hernán; Mohan, Sailesh; Joshi, Rohina; Webster, Ruth; Kengne, André Pascal; Trofor, Letitia; Lotrean, Lucia Maria; Praveen, Devarsetty; Zafra-Tanaka, Jessica Hanae; Lazo-Porras, María; Bobrow, Kirsten; Riddell, Michaela A; Makrilakis, Konstantinos; Μanios, Yannis; Ovbiagele, Bruce

doi:10.2337/dc17-1795

Cited by 71 publications

(70 citation statements)

References 46 publications

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“…Poverty is a critical deterrent to good health, and the manifold impact of poverty on health and health care service lines needs to be recognized, understood, and factored into clinical decision-making by HCP. Poverty is associated with fatalism, dependency, need for governmental aid, drug and alcohol use, stresses on family life, low self-esteem, community disengagement, increased risk for disease and complications, and decreased access to quality health care, but also gaps in formal populationspecific recommendations (4,161). Moreover, there are environmental inequalities or disparities in exposure to endocrine-disrupting compounds (endocrine discrupting chemicals or EDCs; polychlorinated biphenyls, organochlorine pesticides, air pollutants, bisphenol A, and phthalates) (162).…”

Section: Behavior and Social Determinantsmentioning

confidence: 99%

Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Mechanick¹,

Adams

Davidson

et al. 2019

Endocrine Practice

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Section: Behavior and Social Determinantsmentioning

confidence: 99%

Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Mechanick¹,

Adams

Davidson

et al. 2019

Endocrine Practice

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“…The COUNCIL (Control UNique to Cardiovascular diseases In LMIC) initiative started with the aim of reviewing the relevance of current cardiovascular disease guidelines for LMIC settings and developing an implementation pipeline for pragmatic solutions to the cardiovascular disease burden in LMICs [4]. The COUNCIL initiative has now also included other chronic NCDs including diabetes [5], stroke [6], obesity, chronic obstructive pulmonary disorder, and depression. The data consensus group aimed to develop consensus measures for data collection [7] and ensured an improvement in the commonality of data points collected across the projects, as well as improved consistent definitions across projects.…”

Section: Special Interest Working Groupsmentioning

confidence: 99%

Strategic, Successful, and Sustained Synergy: The Global Alliance for Chronic Diseases Hypertension Program

Parker¹,

Héritier

Joshi

et al. 2019

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“…Furthermore, diabetes onset in Sub-Saharan Africa is reported to occur with more severe symptoms often in under-or normal weight individuals in comparison to Western populations [5]. There is limited information to support development of evidencebased guidelines for prevention, diagnosis, classi cation and management of potential atypical sub-type of diabetes mellitus in sub-Saharan Africa and other LMICs [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Socio-demographic and clinical characteristics of diabetes mellitus in rural Rwanda: Time to contextualize the interventions? A cross-sectional study

Munganyinka

Musafiri

Rutayisire

et al. 2020

Preprint

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Background: Existing prevention and treatment strategies target the classic types of diabetes yet this approach might not always be appropriate in settings such as rural Africa where atypical phenotypes exist. This study aims to assess the socio-demographic and clinical characteristics of people with diabetes in rural and urban Rwanda. Methods: Across-sectional, clinic-based study was conducted in which individuals with diabetes mellitus were consecutively recruited from April 2015 to April 2016. Demographic and clinical data were collected from patient interviews, medical files and physical examinations. Chi-square tests and T-tests were used to compare proportions and means between rural and urban residents. Results: A total of 472 participants were recruited (mean + SD age 40.2±19.1years), including 295 women and 315 rural residents. Compared to urban residents, rural residents had lower levels of education, were more likely to be employed in low-income work and to have limited access to running water and electricity. Diabetes was diagnosed at a younger age in rural residents (mean ± SD 32±18 vs 41±17 years; p < 0.001). Physical inactivity, family history of diabetes and obesity were significantly less prevalent in rural than in urban individuals (44% vs 66%, 14.9% vs 28.7% and 27.6% vs 54.1%, respectively; p < 0.001). The frequency of fruit and vegetable consumption was lower in rural than in urban participants. High waist circumference was more prevalent in urban than in rural women and men (75.3% vs 45.5% and 30% vs 6%, respectively; p< 0.001). History of childhood under-nutrition was more frequent in rural than in urban individuals (22.5% vs 6.4%; p< 0.001). Conclusions : Characteristics of people with diabetes in rural Rwanda appear to differ from those of individuals with diabetes in urban settings, suggesting that sub-types of diabetes exist in Africa. Generic guidelines for diabetes prevention and management may not be appropriate in different populations. Key words: diabetes; risk factors; malnutrition; rural; Rwanda

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Gaps in Guidelines for the Management of Diabetes in Low- and Middle-Income Versus High-Income Countries—A Systematic Review

Abstract: A new approach to the contextualization, content development, and delivery of LMIC guidelines is needed to improve outcomes.

Cited by 71 publications

References 46 publications

Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Transcultural Diabetes Care in The United States – A Position Statement by the American Association of Clinical Endocrinologists

Strategic, Successful, and Sustained Synergy: The Global Alliance for Chronic Diseases Hypertension Program

Socio-demographic and clinical characteristics of diabetes mellitus in rural Rwanda: Time to contextualize the interventions? A cross-sectional study

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