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Diabetes

How well do health systems manage diabetes in lower-income countries?

Manne-Goehler J, Geldsetzer P, Agoudavi K, et al. · PLoS medicine · 2019

Open access · cc by · source: Europe PMC

Across >800,000 adults in 28 LMICs, diabetes prevalence was 8.8% and total unmet need along the care cascade reached 77%, with only ~23% achieving control.

Study at a glance

Design
Cross-sectional — Pooled nationally representative surveys; diabetes care-cascade analysis
N
N=800000 · Over 800,000 adults across 28 LMICs
Population
Adults in 28 low- and middle-income countries (2008–2016 surveys)
Outcome
Diabetes prevalence and cascade stages (tested/diagnosed/treated/controlled)

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Key findings

Undiagnosed diabetes 4.8%; large losses at detection (63.4%); control only 22.8% overall and 16–25% across World Bank income groups; unmet need 77%.

Methodology

They pooled nationally representative surveys (2008–2016), defined diabetes by glucose/HbA1c/medication, and constructed a cascade from testing through control (HbA1c <8.0% or equivalent).

Limitations

Cross-sectional cascades cannot track individual longitudinal care quality or prove which health-system reforms work.

How this study connects

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