Self-Management Comparison of Adults With Type 1 Diabetes in Latin America and the Middle East: Data From the International Diabetes Management Practices Survey (IDMPS).

GAGLIARDINO JJ ET AL

Philadelpia

Congreso; American Diabetes Association’s 72nd Scientific Sessions; 2012

American Diabetes Association

IDMPS is an ongoing 5-year multinational observational study documenting the current quality of care provided to people with type 1 or type 2 diabetes. Feasibility analyses were previously performed to validate the chances of pooling the data collected during 4 years in Latin America (2693 patientsl and 3 years in Middle East (1316 patients). The aim was to identify type 1 diabetes mellitus (T1DM) patient profiles for self-management in both regions. Self-management (SM) was defined as both self-monitoring blood glucose (SMBG) and insulin self-adjustment (ISA) performance. Patient profiles were determined by using logistic regression analysis. SM performance was greater in Latin America than in the Middle East (58.1 vs 51.3%). The frequency of SMBG (27.4 vs 21.0%1 and ISA (25.9% vs 18.9%) was also higher in Latin America. ln Latin America, SM was significantly associated with age ( 65; OR = 2.4, P= 0.002), level of education (university) (OR =2.3, P < 0.001), health insurance coverage (OR = 1.7. P = 0.004), diabetes education (OR = 1.7. p= 0.001), time since diagnosis (for 5-year changes: OR =1.1. P = 0.004), insulin pen use (vs vials-syringes use: OR = 1.7, P = 0.001), basal-prandial regimen (vs basal regimen: OR = 3.6, P< 0.001; vs other regimens: OR = 2.6, P< 0.001) and patient recruited by specialists (OR = 1.6. P=0.005). In the Middle East, SM was significantly associated with age (< 40 years vs 40 to 65 years; OR = 2.1, P= 0.003; vs > 65 years; OR = 7.1. P= 0.001), level of education (university) (OR = 2.3, P< 0.001), diabetes education (OR =2.5, P< 0.001), time since diagnosis (for 5-year changes: OR = 1.3, P< 0.001), insulin pen use (vs vials-syringes use; OR = 1.9, P= 0.0021 and basal-prandial regimen (vs other regimens: OR = 2.0, P = 0.001). In both regions, SM was associated with better glycemic control. A specific effort should be made to empower adults with T1DM to improve their care quality and outcomes.