Abstract
In low- and middle-income countries (LMICs), the burden of non-communicable diseases such as diabetes is rapidly rising, overpassing the existing burden of communicable diseases. Patients with diabetes living in low-income communities face unique challenges related to lack of awareness, difficulty in accessing health care systems and medications, and consequently failure in achieving optimal diabetes management and preventing complications. Effective diabetes prevention and care models could help reduce the rising burden by standardizing guidelines for prevention and management, improving access to care, engaging community and peers, improving the training of professionals and patients and using the newest technology in the management of the disease. In this article, we review the latest research and evidence on effective models of diabetes prevention and diabetes care delivery in low- income settings. We also provide existing evidence relating to the effectiveness of these models in low-resource contexts, with the aim to highlight characteristics and strengths that make their implementation successful and long-lasting.
Highlights
Diabetes is one of the most prevalent non-communicable diseases associated with increased morbidity, mortality, and economic burden [1]
By conducting a literature review, we present diabetes care models in low- and middle-income countries (LMICs) for preventing/delaying the onset of the disease in high-risk individuals and for the control of the disease when already present
This review focused on type 2 DM (T2DM), which accounts for 90 to 95% of diagnosed cases of the disease and did not include data on gestational or type one diabetes
Summary
Diabetes is one of the most prevalent non-communicable diseases associated with increased morbidity, mortality, and economic burden [1]. India has the second largest number of people with type 2 DM (T2DM) (> 69 million) after China, and the largest number of individuals (36.5 million) with impaired glucose tolerance (IGT) and prediabetes [2] Most of these individuals are at high risk of developing diabetic complications [4]. Economic difficulties challenge the affordability of medications and medical supplies by many patients [10] To minimize these obstacles, many organizations, institutions, and researchers in western countries have tried to organize global health programs and develop comprehensive models of diabetes care designed for a particular LMIC and/or low-resource health care settings, or introduce new concepts in the existing care systems [11,12,13,14,15,16,17,18,19,20,21,22,23]. We tried to identify the features and qualities that can make these programs successfully implemented, scaled up, and sustained [31] in the diabetes care in these low-resource contexts
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