In a recent study published in scalpelIn this study, researchers describe the goals of the World Health Organization’s Global Diabetes Compact (GDC) to improve health outcomes for all individuals affected by this fatal, non-communicable disease. They reviewed the main measures and treatment goals developed by the GDC, their scientific basis, priority setting, variations, and coverage at the global level.
background
Inspired by past successes in HIV and the premise that measurement drives action, GDC united diverse stakeholders to achieve the goal of reducing diabetes risk on a global scale. In addition, they have ensured that people diagnosed with diabetes receive quality, affordable care. An assessment of the achievement of these GDC targets at the global and national levels by 2030 is planned.
According to recent global estimates, more than 530 million adults suffer from diabetes, about 80% of whom live in low- and middle-income countries (LMICs). With the high prevalence and financial burden of diabetes, it will disproportionately affect low- and middle-income countries. Population studies have shown that even in developed countries with well-funded healthcare systems, delivery of evidence-based care to the diabetic patient remains suboptimal.
20% of high-income countries meet recommended targets for diabetes, and the situation is even worse in low- and middle-income countries. Therefore, while in the former settings, HbA1c or blood pressure control ranges between 50% and 70%, in the latter only 50% of people with established diabetes have adequate glycemic control, and one of All four control their blood sugar. blood pressure.
Proposed core and supplemental GDC metrics
The GDC has developed and prioritized core and supplement measures to serve as triggers for action against further increase in diabetes. This framework also monitors progress in improving diabetes diagnosis, HbA1c and blood pressure control, and statin use in People with type 1 diabetesand ensuring adequate insulin supply.
Interestingly, the percentage of people diagnosed with diabetes was, on average, 61% across all countries. Of these, the average number of people with an HbA1c less than 8% and blood pressure less than 140/90 mm Hg was 68% and 56%, respectively, and those using statins were 12%. In the United States, the proportion of people with confirmed diabetes who met the goals increased by 12 to 13 percentage points between 1999 and 2009, but has stagnated relatively thereafter.
GDC metrics covered four areas:
i) Influencing factors at system, structural or policy level,
b) care operations,
c) Biomarkers, eg, HbA1c and
4) Health outcomes
Similarly, these scales had three risk levels, for example, confirmed diagnosis of diabetes or high risk exposure, which they revised based on data availability, adjustability, and global inequality. In addition, the researchers reviewed the global distribution of each major measure to set future goals.
Finally, they proposed complementary measures, for example, incidence of end-stage renal disease and lower limb amputations, which should be covered by global observation systems at the population level.
The researchers also discussed three types of evidence for assessing the global status of metrics. The first is an assessment of the latest population-based estimates of realistic baselines at the national level. Second estimated trends in metric rates from different settings to find a realistic magnitude of change over time. Finally, they estimated the expected health benefits and costs incurred with meeting in the face of not meeting these goals.
They also compiled data from the published literature from various sources, eg, country-based and sub-national population-based studies, to name a few.
conclusions
In fact, the GDC has set ambitious targets for diabetes management globally. When they do, they will benefit the millions who live with this debilitating disease.
However, the GDC’s metrics and targets should lead to multidimensional actions at both the individual level and the policy level across countries. Primary prevention of diabetes and integrated diabetes care help prevent long-term repercussions and guide the development of new measures and goals. Achieving goals may also significantly reduce acute heart-related complications Diabetics at the population level.
In addition, the authors highlight the importance of developing improved data systems for measuring complementary metrics in low- and middle-income countries. Most importantly, they highlight the need to promote improvements in health outcomes for people with diabetes in the context of innovation in health financing, access to care and healthcare systems.
