Healthy lifestyle behaviours and risk of mortality among adults with and without diabetes in the U.s.

Abstract

| 191 began at ISSSTE, a social security provider with an affiliation of almost 11 million people with national coverage in Mexico. Multidisciplinary teams were established at each clinic, including general practitioners, nurses, dietitians, psychologists and social workers. Healthcare delivery was improved to reduce waiting times, rotation of staff, and to increase the time for baseline and follow-up visits. Resources were devoted to provide all the clinics with A1c measurements and medications, online continuing education is delivered every month, and an electronic file was created to receive information in real time. results: At the first quarter of 2009, 89 diabetes clinics have been established in every state of the country, in which 7,902 patients are currently treated. Acceptance of the program has been universal, and has led to introduction of additional programs for chronic disease care. Improvements in glycemic control have been documented, with 59.2 percent of the patients achieving A1c levels below 7%. conclusions: Less than two years after its creation, the National Diabetes Program at ISSSTE is the largest in Mexico. Milestones include: 1) real, effective national coverage; 2) multidisciplinary approach; 3) a patient centered approach, active participation of patients and their families; 4) the first national program in Mexico to use A1c measurement as marker of glycemic control; 5) the first electronic chart of diabetes in the country; 6) introduction of self-care diabetes education as an essential component of the program. According to UKPDS estimations, the levels of glycemic control achieved in patients treated at ISSSTE are in concordance with the main objective of the program, i.e. a 20 percent reduction in mortality by 2011. National and local plans and initiatives No conflict of interest