Diabetes Care in Venezuela

Background: The incidence of type 2 <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">diabetes</a> (T2D) and its economic burden have increased in Venezuela, posing difficult challenges in a country alread...

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Autores principales:	Ramfis Nieto-Martínez, Juan P. González-Rivas, Marcos Lima-Martínez, Victoria Stepenka, Alejandro Rísquez, Jeffrey I. Mechanick
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2016
Materias:	diabetes diabetes care management prediabetes Venezuela Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/eabde7ee8e1c4ff6b73d24e403fb5956
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id	oai:doaj.org-article:eabde7ee8e1c4ff6b73d24e403fb5956
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes diabetes care management prediabetes Venezuela Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	diabetes diabetes care management prediabetes Venezuela Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Ramfis Nieto-Martínez Juan P. González-Rivas Marcos Lima-Martínez Victoria Stepenka Alejandro Rísquez Jeffrey I. Mechanick Diabetes Care in Venezuela
description	Background: The incidence of type 2 <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">diabetes</a> (T2D) and its economic burden have increased in Venezuela, posing difficult challenges in a country already in great turmoil. Objectives: The aim of this study was to review the prevalence, causes, prevention, <a title="Learn more about Health Care Management" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/health-care-management">management, health</a> policies, and challenges for successful management of diabetes and its complications in Venezuela. Methods: A comprehensive literature review spanning 1960 to 2015 was performed. Literature not indexed also was reviewed. The weighted prevalence of diabetes and <a title="Learn more about Prediabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/prediabetes">prediabetes</a> was estimated from published regional and subnational population-based studies. Diabetes care strategies were analyzed. Findings: In Venezuela, the weighted prevalence of diabetes was 7.7% and prediabetes was 11.2%. Diabetes was the fifth leading cause of death (7.1%) in 2012 with the mortality rate increasing 7% per year from 1990 to 2012. In 2012, <a title="Learn more about Cardiovascular disease" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cardiovascular-disease">cardiovascular disease</a> and diabetes together were the leading cause of disability-adjusted life years.T2D drivers are genetic, epigenetic, and lifestyle, including unhealthy dietary patterns and physical inactivity. Obesity, <a title="Learn more about Metabolic syndrome" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/metabolic-syndrome">insulin resistance, and metabolic syndrome</a> are present at lower cutoffs for <a title="Learn more about Body mass index" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/body-mass-index">body mass index</a>, <a title="Learn more about Homeostatic model assessment" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/homeostatic-model-assessment">homeostatic model assessment</a>, and visceral or ectopic fat, respectively. Institutional programs for early detection and/or prevention of T2D have not been established. Most <a title="Learn more about Patients with Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/patients-with-diabetes">patients with diabetes</a> (∼87%) are cared for in public facilities in a fragmented health system. Local clinical practice guidelines are available, but implementation is suboptimal and supporting information is limited. Conclusions: Strategies to improve diabetes care in Venezuela include enhancing resources, reducing costs, improving education, implementing screening (using Latin America Finnish Diabetes Risk Score), promoting diabetes care units, avoiding <a title="Learn more about Insulin (medication)" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/insulin-medication">insulin</a> levels as diagnostic tool, correct use of oral <a title="Learn more about Impaired glucose tolerance" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/impaired-glucose-tolerance">glucose tolerance</a> testing and <a title="Learn more about Metformin" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/metformin">metformin</a> as first-line T2D treatment, and reducing health system fragmentation. Use of the Venezuelan adaptation of the transcultural Diabetes Nutrition Algorithm for lifestyle recommendations and the Latin American Diabetes Association guidelines for pharmacologic interventions can assist primary care physicians in diabetes management.
format	article
author	Ramfis Nieto-Martínez Juan P. González-Rivas Marcos Lima-Martínez Victoria Stepenka Alejandro Rísquez Jeffrey I. Mechanick
author_facet	Ramfis Nieto-Martínez Juan P. González-Rivas Marcos Lima-Martínez Victoria Stepenka Alejandro Rísquez Jeffrey I. Mechanick
author_sort	Ramfis Nieto-Martínez
title	Diabetes Care in Venezuela
title_short	Diabetes Care in Venezuela
title_full	Diabetes Care in Venezuela
title_fullStr	Diabetes Care in Venezuela
title_full_unstemmed	Diabetes Care in Venezuela
title_sort	diabetes care in venezuela
publisher	Ubiquity Press
publishDate	2016
url	https://doaj.org/article/eabde7ee8e1c4ff6b73d24e403fb5956
work_keys_str_mv	AT ramfisnietomartinez diabetescareinvenezuela AT juanpgonzalezrivas diabetescareinvenezuela AT marcoslimamartinez diabetescareinvenezuela AT victoriastepenka diabetescareinvenezuela AT alejandrorisquez diabetescareinvenezuela AT jeffreyimechanick diabetescareinvenezuela
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spelling	oai:doaj.org-article:eabde7ee8e1c4ff6b73d24e403fb59562021-12-02T11:13:40ZDiabetes Care in Venezuela2214-999610.1016/j.aogh.2015.11.002https://doaj.org/article/eabde7ee8e1c4ff6b73d24e403fb59562016-04-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/1445https://doaj.org/toc/2214-9996Background: The incidence of type 2 <a title="Learn more about Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes">diabetes</a> (T2D) and its economic burden have increased in Venezuela, posing difficult challenges in a country already in great turmoil. Objectives: The aim of this study was to review the prevalence, causes, prevention, <a title="Learn more about Health Care Management" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/health-care-management">management, health</a> policies, and challenges for successful management of diabetes and its complications in Venezuela. Methods: A comprehensive literature review spanning 1960 to 2015 was performed. Literature not indexed also was reviewed. The weighted prevalence of diabetes and <a title="Learn more about Prediabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/prediabetes">prediabetes</a> was estimated from published regional and subnational population-based studies. Diabetes care strategies were analyzed. Findings: In Venezuela, the weighted prevalence of diabetes was 7.7% and prediabetes was 11.2%. Diabetes was the fifth leading cause of death (7.1%) in 2012 with the mortality rate increasing 7% per year from 1990 to 2012. In 2012, <a title="Learn more about Cardiovascular disease" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cardiovascular-disease">cardiovascular disease</a> and diabetes together were the leading cause of disability-adjusted life years.T2D drivers are genetic, epigenetic, and lifestyle, including unhealthy dietary patterns and physical inactivity. Obesity, <a title="Learn more about Metabolic syndrome" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/metabolic-syndrome">insulin resistance, and metabolic syndrome</a> are present at lower cutoffs for <a title="Learn more about Body mass index" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/body-mass-index">body mass index</a>, <a title="Learn more about Homeostatic model assessment" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/homeostatic-model-assessment">homeostatic model assessment</a>, and visceral or ectopic fat, respectively. Institutional programs for early detection and/or prevention of T2D have not been established. Most <a title="Learn more about Patients with Diabetes" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/patients-with-diabetes">patients with diabetes</a> (∼87%) are cared for in public facilities in a fragmented health system. Local clinical practice guidelines are available, but implementation is suboptimal and supporting information is limited. Conclusions: Strategies to improve diabetes care in Venezuela include enhancing resources, reducing costs, improving education, implementing screening (using Latin America Finnish Diabetes Risk Score), promoting diabetes care units, avoiding <a title="Learn more about Insulin (medication)" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/insulin-medication">insulin</a> levels as diagnostic tool, correct use of oral <a title="Learn more about Impaired glucose tolerance" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/impaired-glucose-tolerance">glucose tolerance</a> testing and <a title="Learn more about Metformin" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/metformin">metformin</a> as first-line T2D treatment, and reducing health system fragmentation. Use of the Venezuelan adaptation of the transcultural Diabetes Nutrition Algorithm for lifestyle recommendations and the Latin American Diabetes Association guidelines for pharmacologic interventions can assist primary care physicians in diabetes management.Ramfis Nieto-MartínezJuan P. González-RivasMarcos Lima-MartínezVictoria StepenkaAlejandro RísquezJeffrey I. MechanickUbiquity Pressarticlediabetesdiabetes caremanagementprediabetesVenezuelaInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 81, Iss 6, Pp 776-791 (2016)

Diabetes Care in Venezuela

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