Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality

IntroductionFrench Guiana is a multicultural overseas territory in the Amazon, where precariousness and difficulties in access to care are widespread. The prevalence of diabetes is double that of other French departments, and cardiovascular morbidity and mortality is high. The objective of the study...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Christine Sudre, Hélène Duplan, John Bukasakakamba, Mathieu Nacher, Pascale Peyre-Costa, Nadia Sabbah
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	diabetes guidelines & recommendations health inequalities diabetes complication French Guiana Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/0991f416832e476cbc1088e772134f8b
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:0991f416832e476cbc1088e772134f8b
record_format	dspace
spelling	oai:doaj.org-article:0991f416832e476cbc1088e772134f8b2021-12-01T20:29:18ZDiabetes Care in French Guiana: The Gap Between National Guidelines and Reality1664-239210.3389/fendo.2021.789391https://doaj.org/article/0991f416832e476cbc1088e772134f8b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.789391/fullhttps://doaj.org/toc/1664-2392IntroductionFrench Guiana is a multicultural overseas territory in the Amazon, where precariousness and difficulties in access to care are widespread. The prevalence of diabetes is double that of other French departments, and cardiovascular morbidity and mortality is high. The objective of the study was to analyze the biological, clinical and therapeutic follow-up of patients with diabetes mellitus using exhaustive data and to correlate it with national and European recommendations.Material and MethodsUsing the national health insurance data, 9079 and 10075 patients with diabetes mellitus were analyzed in 2018 and 2019, respectively. We analyzed antidiabetic treatments, medical, dental, and podiatric consultations, examinations prescribed as part of the annual follow-up, and home nursing care.ResultsThere was a significant increase over one year in the number of patients (+10%) with diabetes, mainly women (60%), and 31% were under 54 years of age, with a disparity depending on the area of the territory, the most isolated having less access to screening. Less than 56% of patients had HbA1c measurements twice a year, less than 43% had an annual renal check-up, only 19% had an ophthalmic check-up at least every two years, less than 25% had an annual dental check-up, and less than 4% had an annual follow-up with the podiatrist.ConclusionsSubstandard diabetes monitoring is a major problem likely to increase morbidity and mortality. Adapting health care to the specificities of the territory is crucial, notably by formalizing the delegation of care to advanced practice nurse and non-healthcare professionals in precarious or geographically isolated areas.Christine SudreHélène DuplanJohn BukasakakambaMathieu NacherPascale Peyre-CostaNadia SabbahNadia SabbahFrontiers Media S.A.articlediabetesguidelines & recommendationshealth inequalitiesdiabetes complicationFrench GuianaDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes guidelines & recommendations health inequalities diabetes complication French Guiana Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	diabetes guidelines & recommendations health inequalities diabetes complication French Guiana Diseases of the endocrine glands. Clinical endocrinology RC648-665 Christine Sudre Hélène Duplan John Bukasakakamba Mathieu Nacher Pascale Peyre-Costa Nadia Sabbah Nadia Sabbah Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality
description	IntroductionFrench Guiana is a multicultural overseas territory in the Amazon, where precariousness and difficulties in access to care are widespread. The prevalence of diabetes is double that of other French departments, and cardiovascular morbidity and mortality is high. The objective of the study was to analyze the biological, clinical and therapeutic follow-up of patients with diabetes mellitus using exhaustive data and to correlate it with national and European recommendations.Material and MethodsUsing the national health insurance data, 9079 and 10075 patients with diabetes mellitus were analyzed in 2018 and 2019, respectively. We analyzed antidiabetic treatments, medical, dental, and podiatric consultations, examinations prescribed as part of the annual follow-up, and home nursing care.ResultsThere was a significant increase over one year in the number of patients (+10%) with diabetes, mainly women (60%), and 31% were under 54 years of age, with a disparity depending on the area of the territory, the most isolated having less access to screening. Less than 56% of patients had HbA1c measurements twice a year, less than 43% had an annual renal check-up, only 19% had an ophthalmic check-up at least every two years, less than 25% had an annual dental check-up, and less than 4% had an annual follow-up with the podiatrist.ConclusionsSubstandard diabetes monitoring is a major problem likely to increase morbidity and mortality. Adapting health care to the specificities of the territory is crucial, notably by formalizing the delegation of care to advanced practice nurse and non-healthcare professionals in precarious or geographically isolated areas.
format	article
author	Christine Sudre Hélène Duplan John Bukasakakamba Mathieu Nacher Pascale Peyre-Costa Nadia Sabbah Nadia Sabbah
author_facet	Christine Sudre Hélène Duplan John Bukasakakamba Mathieu Nacher Pascale Peyre-Costa Nadia Sabbah Nadia Sabbah
author_sort	Christine Sudre
title	Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality
title_short	Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality
title_full	Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality
title_fullStr	Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality
title_full_unstemmed	Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality
title_sort	diabetes care in french guiana: the gap between national guidelines and reality
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/0991f416832e476cbc1088e772134f8b
work_keys_str_mv	AT christinesudre diabetescareinfrenchguianathegapbetweennationalguidelinesandreality AT heleneduplan diabetescareinfrenchguianathegapbetweennationalguidelinesandreality AT johnbukasakakamba diabetescareinfrenchguianathegapbetweennationalguidelinesandreality AT mathieunacher diabetescareinfrenchguianathegapbetweennationalguidelinesandreality AT pascalepeyrecosta diabetescareinfrenchguianathegapbetweennationalguidelinesandreality AT nadiasabbah diabetescareinfrenchguianathegapbetweennationalguidelinesandreality AT nadiasabbah diabetescareinfrenchguianathegapbetweennationalguidelinesandreality
_version_	1718404554726309888

Diabetes Care in French Guiana: The Gap Between National Guidelines and Reality

Ejemplares similares