Dataset Information

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

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.

SUBMITTER: Owolabi MO

PROVIDER: S-EPMC5911785 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Publications

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

Owolabi Mayowa O MO Owolabi Mayowa O MO Yaria Joseph O JO Daivadanam Meena M Makanjuola Akintomiwa I AI Parker Gary G Oldenburg Brian B Vedanthan Rajesh R Norris Shane S Oguntoye Ayodele R AR Osundina Morenike A MA Herasme Omarys O Lakoh Sulaiman S Ogunjimi Luqman O LO Abraham Sarah E SE Olowoyo Paul P Jenkins Carolyn C Feng Wuwei W Bayona Hernán H Mohan Sailesh S Joshi Rohina R Webster Ruth R Kengne Andre P AP Trofor Antigona A Lotrean Lucia Maria LM Praveen Devarsetty D Zafra-Tanaka Jessica H JH Lazo-Porras Maria M Bobrow Kirsten K Riddell Michaela A MA Makrilakis Konstantinos K Manios Yannis Y Ovbiagele Bruce B

Diabetes care 20180501 5

<h4>Objective</h4>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.<h4>Research design and methods</h4>Eligible guidelines were sought from ...[more]

PMID: 29678866

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Dataset Information

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

Objective

Research design and methods

Results

Conclusions

Publications

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

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