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Building Blocks for Diabetes CareDiabetes management is complex and requires training and resources. This document was prepared with input from a group of experts and people with diabetes from 25 countries of the Americas with the aim of providing a simple framework for diabetes care. This framework can be applied at different levels of care, according to technical capabilities and available resources.


Diabetes and other chronic diseases have become the primary causes of morbidity and mortality in all countries. An estimated 171 million people around the world are living with diabetes and this number will climb to 300 million in 2030. In the Americas, the estimated number of people with diabetes was 13.3 million in 2000, with a projection of 32.9 million in 20301.

Diabetes is an expensive disease. In Latin America and the Caribbean, the cost of diabetes was estimated at $65 billion in 20002. In that study, most of the estimated costs of diabetes was attributed to premature mortality and disability.

The few studies that have been conducted in Latin America and the Caribbean have demonstrated that the quality of care for diabetes is suboptimal.3, 4, 5, 6, 7 High-quality diabetes care can improve glycemic control, and this has been associated with a lower frequency of certain complications and hence a reduction in premature mortality8, 9

In September 2008 the Directing Council of the Pan American Health Organization adopted Resolution CD48.R9, Population and Individual Approaches to the Prevention and Management of Diabetes and Obesity, which calls on Member States to strengthen their efforts in the prevention and control of diabetes and obesity.

Building Blocks in Diabetes Careicon Building Blocks in Diabetes Education and Control: A Framework for Comprehensive Diabetes Care (BBDEC)  

Diabetes management is complex and requires training and resources. This document was prepared with input from a group of experts and people with diabetes from 25 countries of the Americas with the aim of providing a simple framework for diabetes care. This framework can be applied at different levels of care, according to technical capabilities and available resources.

 

The preparation of this document was based on several international workshops coordinated by the Declaration of the Americas on Diabetes (DOTA), with representation from 25 countries. 

 

The final review of the manuscript was carried out by Juan José Gagliardino (Argentina), Elena Carrasco (Chile), Elizabeth Duarte and Sandra Verduguez (Bolivia), Rosario García (Cuba), Felicia Cañete (Paraguay), Linda Siminerio (United States), Godfrey Xuereb (CFNI , /WHO, Geneva), and Anne Belton (Canada).

 

From 2004 to 2009, the Building Blocks program was implemented as a pilot in the municipality of Misiones in Paraguay, with excellent results. Based on the results obtained in Misiones, the document was reviewed and updated in 2009 by Alberto Barceló (PAHO), Elena Carrasco (Chile), Elizabeth Duarte (Bolivia), Felicia Cañete (Paraguay), and Juan José Gagliardino (Argentina), who together prepared the final version in Spanish which was then translated to English. The final English version was reviewed by Alberto Barceló from PAHO, Godfrey Xuereb from WHO, and Dalip Ragoobirsingh from the University of West Indies, Mona Campus, Jamaica.

 

The result is this guide, Building Blocks in Diabetes Education and Control (BBDEC), which organizes diabetes care according to different scenarios and levels of treatment. It identifies the characteristics of each scenario and proposes measures and standards to facilitate the establishment of a comprehensive care network for people living with diabetes.

1. Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of Diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27(5):1047-1053.

2. Barceló A, Aedo C, Swapnil R, Robles S. The cost of diabetes in Latin America and the Caribbean. Bulletin World Health Organization 2003;81(1):19-27.

3. Guilliford MC, Alert CV, Mahabir D et al. Diabetes Care in Middle-income Countries: A Caribbean Case Study. Diab Medicine 1996; 13: 574-81.

4. Wilks RJ, Sargeant LA, Gulliford MC, Reid ME, Forrester TE. Management of diabetes mellitus in three settings in Jamaica. Revista Panamericana de Salud Pública 2001;9(2):65-72.

5. Gagliardino JJ, de la Hera M et al. Evaluation of the Quality of Care for Diabetic Patients in Latin America [Evaluación de la calidad de la asistencia al paciente diabético en América Latina]. Pan Am J Pub Health 2001; 10 (5): 309-317.

6. Escobar MC, Delgado I. Diabetes y Calidad de la Atención en el Sistema Nacional de Servicios de Salud. República de Chile. Ministerio de Salud, 1999.

7. Barceló A, et al. Final Report: Institutional Response to Diabetes and Its Complications (IRDC )— An Evaluation of the Quality of Diabetes Care. Pan American Health Organization, (DPC/NC /DIA /66/1.3/273-04 ), Washington, DC, 2004.

8. Diabetes Control and Complication Trial Research Group. The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-term Complications in Insulin-Dependent Diabetes Mellitus. New Engl J Med 1993; 329 (14): 77-86.

9. United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive Blood Glucose Control with Sulphonylureas or Insulin Compared with Conventional Treatment and Risk of Complications in Patients with Type 2 Diabetes ( UK PDS 33). Lancet 1998; 352: 837-53.

Last Updated on Monday, 04 January 2010 07:08

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