Ghaida Kaddaha

Diabetes education and health insurance: how they affect the quality of care provided to people with type 1 diabetes in Latin America. Data from the International Diabetes Mellitus Practices Study (IDMPS)

AIMSnThis study aimed to evaluate the impact of diabetes education and access to healthcare coverage on disease management and outcomes in Latin America.nnnMETHODSnData were obtained from a sub-analysis of 2693 patients with type 1 diabetes mellitus recruited from 9 Latin American countries as part of the International Diabetes Mellitus Practices Study (IDMPS), a multinational, observational survey of diabetes treatment in developing regions.nnnRESULTSnResults from the Latin American cohort show that only 25% of participants met HbA1c target value (<u202f7% [53u202fmmol/mol]). Attainment of this target was significantly higher among participants who had received diabetes education than those who hadnt (28% vs. 19%, pu202f<u202f0.001), and among those who practiced self-management (27% vs. 21% no self-management, pu202f=u202f0.001). Multivariate analysis showed that participants who had received diabetes education were more likely to manage their diabetes (OR:1.65 [95% CI: 1.24, 2.19]; pu202f=u202f0.001), and to attain HbA1c target values (OR:1.48 [95% CI: 1.14, 1.93]; pu202f=u202f0.003).nnnCONCLUSIONSnGiven the association between uncontrolled diabetes and long-term complications, health authorities and care providers should increase efforts to ensure widespread healthcare coverage and access to self-management education to reduce the socioeconomic and humanistic burden of type 1 diabetes.

Impact of diabetes education and self-management on the quality of care for people with type 1 diabetes mellitus in the Middle East (The International Diabetes Mellitus Practices Study, IDMPS)

AIMSnSelf-management (self-monitoring of blood glucose, plus self-adjustment of insulin dose) is important in diabetes care, but its complexity presents a barrier to wider implementation, which hinders attainment and maintenance of glycemic targets. More evidence on self-management is needed to increase its implementation and improve metabolic outcomes.nnnMETHODSnData from 1316 participants with type 1 diabetes mellitus who were enrolled from Middle East countries into the International Diabetes Management Practices Study (IDMPS), a multinational observational survey, were analyzed to assess the impact of education on disease management and outcomes.nnnRESULTSnA majority (78%) of participants failed to achieve glycemic target (HbA1cu202f<u202f7.0% [<53u202fmmol/mol]). Participants who had received diabetes education (59%) were more likely to practice self-management than those who had not (odds ratio [OR]: 2.51; 95% confidence interval [CI]: 1.7-3.69; pu202f<u202f0.001), and those who practiced self-management were more likely to attain target HbA1c than those who did not (OR: 1.49; 95% CI: 1.06-2.09; pu202f=u202f0.023).nnnCONCLUSIONSnThese relationships between diabetes education, self-management and glycemic control suggest that diabetes education provides knowledge and skills to optimize self-management, favoring HbA1c target attainment. Middle East health authorities should search for ways to facilitate access to diabetes education to optimize treatment outcomes.