A new study on diabetes treatment has found that many individuals from at least 55 low and middle income countries were actually unaware of the fact that they had diabetes. Moreover, less than 5% of these people were getting proper treatment or health advice on their daily lifestyle choices.
The research group that handled the study took data from a number of nationally represented surveys that asked them about treatments for blood pressure, cholesterol levels, on how to reduce blood sugar and cholesterol levels, as well as what advice they received regarding weight, diet and exercise.
While some lack the proper treatment, diabetes medications are known to be cheap, while proving to lessen their risk of diabetes-associated complications while having long-term costs of care as well.
According to the International Diabetes Federation, there are around 463 million adults globally that are suffering from diabetes. In addition, at least 89% of that number live within low and middle income countries.
When someone has diabetes, it increases their risk of getting a number of disabling and even possibly fatal complications that can occur as a result of this disease, such as stroke, blindness, heart attack, and even nerve and kidney damage.
Meanwhile, drug treatments for diabetes are normally quite cheap and are proven to lessen the possibility of major sickness and death.
The problem is that in a number of these low and middle income countries, there is a huge lack in the availability of health services where patients can be diagnosed. Likewise, the facilities where they can receive treatment are quite limited too. Because of this, there are a large number of unnecessary deaths that occur, all of which also lead to avoidable heartache.
The study, which was led by doctors from the University of Michigan in Ann Arbor and Brigham and Women’s Hospitalin Boston, MA, was able to determine just how large the issue of the lack of proper diagnosis and treatment can truly be.
The study group took data from standardized household surveys collected in low and middle income countries that had information from participants on their blood test results for diabetes, as well as self-reported treatments they used.
What the researchers found was that ‘only 4.6% of people with diabetes were receiving the whole package of care that the World Health Organization (WHO) recommends’ when it comes to treating diabetes in primary care.
The authors also discovered that of the study respondents, at least 50.5% were taking medications to lower their blood sugar while 41.3% were using medications to lower their blood pressure. Yet, only 6.3% were using medication to lower their cholesterol.
Furthermore, 32.2% of the participants shared that they were given diet advice, while only 31.5% were given weight loss advice. Meanwhile, only 28.2% were told about the benefits of exercise for diabetes.
National clinician scholar that University of Michigan Institute for Healthcare Policy & Innovation and lead author of the study, David Flood, M.D., M.Sc. shared, “Diabetes continues to explode everywhere, in every country, and 80% of people with it live in these low and middle income countries.”
He added, “It confers a high risk of complications, including heart attacks, blindness, and strokes. We can prevent these complications with comprehensive diabetes treatment, and we need to make sure people around the world can access treatment.”
The research can be seen in the journal The Lancet Health.
High Cholesterol Treatment is Lacking
The household surveys reconciled data from 680,102 adults that belong to 55 low and middle income countries. What they uncovered from the group was that 37,094 of these adults all had diabetes. Yet from that number, only 43.9% of them said that they had gotten an actual diagnosis.
Even for those that did receive a formal diagnosis, there were still a number of areas where improvements could be made, especially when it came to their drug treatments. 85% of the participants that knew they had diabetes were taking medications to lessen their blood sugar levels while another 57% were taking meds to lower their blood pressure. However, only 9% of them were taking a statin medication to lessen their cholesterol.
The researchers iterate, “Our findings suggest that delivering treatment not only to lower glucose but also to manage [cardiovascular disease] risk factors, such as hypertension and elevated cholesterol, among people with diabetes are urgent global priorities.”
When it comes to countries that have higher income brackets, they also tend to have better treatment and coverage for all types or forms of diabetes treatments, it seems. The study found that while the coverage was highest in the Latin America and the Caribbean areas, it was relatively lower in the Oceania (Pacific Islands) and sub-Saharan Africa regions.
The research group went as far as submitting their findings to the World Health Organization (WHO), who in turn, on April 14, 2021, decided to launch the Global Diabetes Compact in order to both help prevent and treat diabetes all around the world.
The Link Between Diabetes and COVID-19
As COVID-19 continues to ravish countries across the globe, it’s important to note that those struggling with diabetes and obesity are much likelier to develop severe Covid-19 infections. Furthermore, researchers also believe that COVID-19 could even trigger the diabetes in someone that is already at risk.
One of the co-authors of the paper, Jennifer Manne-Goehler, M.D., Sc.D., explained to publication MNT that because of the pandemic, there is a pressing need to improve diabetes services, especially in those areas that are highly lacking in both treatment and diagnosis abilities.
Dr. Manne-Goehler is a clinical fellow at Harvard Medical School who also happens to work as an infectious diseases physician at the Brigham and Women’s Hospital, both of which are located in Boston, Massachusetts.
What the research group found was that diabetes has been associated with “poor early outcomes” when it comes to patients that end up hospitalized from COVID-19.
She goes on to explain, “The COVID-19 pandemic has really highlighted how important the intersection between diabetes and infectious conditions is and the far-reaching implications of ensuring everyone with diabetes has access to much needed services.”
The Limitations of the Research
The study authors note that there are quite a number of limitation to their paper though, such as ‘inconsistencies across the different surveys’ like the year the studies took place, the age profile of the participants, as well as which diagnostic tests were used on the participants.
Because of these vast differences, the study observations also noted that there were varied results for what the treatment coverage was in the different countries.
They also share that they didn’t have enough information on whether participants were given counseling to quit smoking or if such treatments were even available to them. The research authors explain that this is an important factor and acts largely as a limitation since smoking is such a big factor when it comes to raising one’s risk of developing cardiovascular disease for those diagnosed with diabetes.
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