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Gaps in Guidelines for the Management of Diabetes in Low- and Middle-Income Versus High-Income Countries-A Systematic Review

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dc.contributor.author Owolabi, Mayowa O.
dc.contributor.author Yaria, Joseph O.
dc.contributor.author Daivadanam, Meena
dc.contributor.author Makanjuola, Akintomiwa I.
dc.contributor.author Parker, Gary
dc.contributor.author Oldenburg, Brian
dc.contributor.author Vedanthan, Rajesh
dc.contributor.author Norris, Shane
dc.contributor.author Oguntoye, Ayodele R.
dc.contributor.author Osundina, Morenike A.
dc.contributor.author Herasme, Omarys
dc.contributor.author Lakoh, Sulaiman
dc.contributor.author Ogunjimi, Luqman O.
dc.contributor.author Abraham, Sarah E.
dc.contributor.author Olowoyo, Paul
dc.contributor.author Jenkins, Carolyn
dc.contributor.author Feng, Wuwei
dc.contributor.author Bayona, Hernán
dc.contributor.author Mohan, Sailesh
dc.contributor.author Joshi, Rohina
dc.contributor.author Webster, Ruth
dc.contributor.author Kengne, Andre P.
dc.contributor.author Trofor, Antigona
dc.contributor.author Lotrean, Lucia Maria
dc.contributor.author Praveen, Devarsetty
dc.contributor.author Zafra-Tanaka, Jessica H.
dc.contributor.author Lazo-Porras, Maria
dc.contributor.author Bobrow, Kirsten
dc.contributor.author Riddell, Michaela A.
dc.contributor.author Makrilakis, Konstantinos
dc.contributor.author Manios, Yannis
dc.contributor.author Ovbiagele, Bruce
dc.contributor.author COUNCIL Initiative
dc.date.accessioned 2018-11-30T03:10:47Z
dc.date.available 2018-11-30T03:10:47Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4076
dc.description.abstract OBJECTIVE: The extent to which diabetes (DM) practice guidelines, often based on evidence from high-income countries (HIC), can be implemented to improve outcomes in low- and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation. RESEARCH DESIGN AND METHODS: Eligible guidelines were sought from online databases and websites of diabetes associations and ministries of health. Type 2 DM guidelines published between 2006 and 2016 with accessible full publications were included. Each of the 54 eligible guidelines was assessed for compliance with the Institute of Medicine (IOM) standards, coverage of the cardiovascular quadrangle (epidemiologic surveillance, prevention, acute care, and rehabilitation), translatability, and its target audiences. RESULTS: Most LMIC guidelines were inadequate in terms of applicability, clarity, and dissemination plan as well as socioeconomic and ethical-legal contextualization. LMIC guidelines targeted mainly health care providers, with only a few including patients (7%), payers (11%), and policy makers (18%) as their target audiences. Compared with HIC guidelines, the spectrum of DM clinical care addressed by LMIC guidelines was narrow. Most guidelines from the LMIC complied with less than half of the IOM standards, with 12% of the LMIC guidelines satisfying at least four IOM criteria as opposed to 60% of the HIC guidelines (P < 0.001). CONCLUSIONS: A new approach to the contextualization, content development, and delivery of LMIC guidelines is needed to improve outcomes. en_US
dc.language.iso eng
dc.publisher American Diabetes Association
dc.relation.ispartof urn:issn:1935-5548
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Developed Countries en_US
dc.subject Developing Countries en_US
dc.subject Poverty en_US
dc.subject Diabetes Mellitus en_US
dc.subject Guideline Adherence en_US
dc.subject Health Personnel en_US
dc.subject Income en_US
dc.subject Practice Guidelines as Topic en_US
dc.title Gaps in Guidelines for the Management of Diabetes in Low- and Middle-Income Versus High-Income Countries-A Systematic Review en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.2337/dc17-1795
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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