Improving care provider and patient knowledge is key to better diabetes outcomes in low resource economies

GAGLIARDINO JJ

Bahia

Encuentro; Diabetes Sumnmit for Latin America; 2010

Ministerio Salud Brasil, OPS, World Diabetes Foundation

The prevalence of diabetes is increasing in Latin America because many people have a sedentary lifestyle and overweight and obesity are common. In patients who have diabetes, glycaemic control is unsatisfactory in half, and blood pressure is satisfactorily controlled in fewer than a quarter. Poor risk factor control increases the likelihood of complications and hospitalisation, both of which are associated with increased healthcare costs. It is therefore essential that we improve the quality of healthcare, said Dr Juan Jose Gagliardino, Director of Experimental and Applied Endocrinology at the National University of La Plata, Argentina. He described the educational initiatives carried out in Latin America since 2001 to improve the knowledge and skills of the healthcare team and to empower patients. These have been shown to improve clinical and metabolic indicators of diabetes control, reduce spending on medicines, reduce hospitalisation and cut the per capita cost of care. The latest initiative is PRODIACOR, an education intervention for doctors and patients with diabetes or hypertension. In a comparative trial, physician education was shown to reduce the median costs of drug treatment for diabetes and hypertension and this reduction was greater when patients were also educated. Providing no education, or educating patients only, was associated with increased costs over a three-year periodo Clinical, psychological and metabolic indicators improved in all groups with a trend to greater gains associated with education. Delivering education is not an easy task but, Dr Gagliardino said, it is important never to give up.