Special Journal Issue Delves Into Global Diabetes Solutions

Miriam E Tucker

March 10, 2016

To address the burgeoning global diabetes epidemic, a group of experts from around the world has synthesized information from 14 countries to develop a core set of recommendations for optimizing diabetes care around the world.

The recommendations, along with a set of papers from each of the contributing countries, are currently available online in the Annals of Global Health and will be published together in a special upcoming issue later in March.

"This call to action in the context of 382 million people with diabetes worldwide and the United Nations resolution…to reduce noncommunicable diseases resonates with the missions of US clinical endocrinology and diabetes professional medical organizations to figure out ways to improve diabetes care and reduce the human suffering associated with this ravaging disease," writes editor Jeffrey I Mechanick, MD, director of metabolic support and clinical professor of medicine at the division of endocrinology, diabetes, and bone disease, Icahn School of Medicine at Mount Sinai, New York. (More recently, the number of people with diabetes worldwide has now been estimated at 415 million.)

From Panama to the Philippines: Seeking Global Solutions

For the special issue, authors from different Latin American, European, African, and Asian nations were each asked to specifically address the context of diabetes care in their country, with reference to factors such as infrastructure and socioeconomics, relevant cultural factors, and information from the literature.

The countries are Brazil, Columbia, Panama, Peru, Venezuela, Italy, Republic of Macedonia, Egypt, Iran, Nigeria, India, Malaysia, the Philippines, and Vietnam.

The authors were also asked to look at areas such as nutrition and specific management strategies, including the types of medications and glucose testing technologies employed, and describe any unique challenges and solutions.

Together the research reveals some interesting findings.

Although each paper provides a different perspective, there are a number of common themes: diabetes exacts a very high economic burden; there is insufficient funding to optimize diabetes care, especially in countries considered low to middle income, and therefore a requirement for more governmental intervention; and finally, there is a need for evidence-based guidelines to be developed and implemented for each nation.

"The problems of one country are not only relevant for that country; information gleaned from a portfolio of countries may generate emergent ideas to solve the complex diabetes problem globally," observed Dr Mechanick.

Three general recommendations are made—with countries urged to work toward the following:

  • Acquiring a knowledge base. Assess the region-specific epidemiology, scientific evidence base, and population-based transitions to identify higher-risk people and establish risk-stratified guidelines for diagnosis and therapeutic interventions.

  • Developing a public-health strategy.Establish a public-health imperative to provide tools and funding to successfully implement these guidelines, as well as develop metrics to evaluate and improve the guidelines.

  • Ensuring durability of response.Commit to education and research to advance and optimize the recommendations for a durable effect.

"These three recommendations serve as a starting point to address the complex nature of global diabetes care — to treat populations and individuals, to recognize similarities and differences, and to move more quickly than ever, as the diabetes epidemic has thus far been deaf to our calls for action," Dr Mechanick said.

"One can envision enrichment of current diabetes-care models, guidelines, and algorithms with conclusions based on patients from different cultures and regions in the world. Admittedly, this is a bold and aspirational approach, but it is in this type of vehicle — a special issue — that the adventure can begin," he concludes.

Dr Mechanick received honoraria from Abbott Nutrition International for lectures and program development.

Ann Glob Health. Published online January 13, 2016. Editorial


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.