Through this review , we found two key health system barriers to effective T2DM care and management : financial constraints faced by the patient and limited access to health services and medication .
This review points to the importance of reducing , or possibly eliminating , out-of-pocket costs for diabetes medication and self-monitoring supplies .
BACKGROUND Type 2 Diabetes Mellitus ( T2DM ) is reported to affect one in 11 adults worldwide , with over 80 % of T2DM patients residing in low-to-middle-income countries .
Health systems play an integral role in responding to this increasing global prevalence , and are key to ensuring effective diabetes management .
We conducted a systematic review to examine the health system-level factors influencing T2DM awareness , treatment , adherence , and control .
Structured diabetes therapy and education improves the outcome of patients with insulin treated diabetes mellitus. The 10 year follow-up of a prospective, population-based survey on the quality of diabetes care (the JEVIN Trial).
AIMS /HYPOTHESIS JEVIN ( Jena 's St. Vincent Trial ) is a prospect i ve , 10 year follow-up , population -based survey of all insulin treated patients with type 1 and type 2 diabetes mellitus aged 16 to 60 years and living in the city of Jena ( 100,000 inhabitants ) , Thuringia , Germany . It aims to show the effects of implementation of the St. Vincent Declaration and to evaluate the effect of recent changes in the health care system and new treatment strategies . PATIENTS AND METHODS 190 patients ( 83 % of the target population ) , 244 patients ( 90 % ) and 261 patients ( 90 % ) were studied in 1989/90 , 1994/95 and 1999/2000 , respectively . RESULTS Up to 1994/95 , the HbA1c of patients with type 1 diabetes mellitus increased ( 1994/95 : 8.50+/-1.80 % versus 1989/90 : 7.83+/-1.60 % , p=0.002 ) . For patients with type 2 diabetes mellitus , it remained constant ( 9.01+/-2.06 % versus 9.17+/-1.60 % , n. s. ) . During the period from 1994/95 to 1999/2000 , there was a substantial improvement in the relative HbA1c of both , patients with type 1 ( 7.62+/-1.55 % , p<0.0001 ) , and with type 2 diabetes ( 7.57+/-1.29 % , p<0.0001 ) . Up to 1999/2000 , 87.7 % of the patients with type 1 ( 1989/90 : 0 % , 1994/95 : 73.2 % ) and 96.6 % of the patients with type 2 diabetes ( 1989/90 : 0 % , 1994/95 : 89.7 % ) participated in TTP 's . The incidence of acute and the prevalence of long-term complications remained constant . CONCLUSIONS Results of the population -based , prospect i ve trial to optimise patients ' quality of diabetic control suggest : For patients with insulin treated type 2 diabetes mellitus , excellent treatment can be available by primary care physicians interested , educated and highly engaged in diabetes therapy . Moreover , structured diabetes therapy consisting of treatment and teaching programmes , regular self-monitoring , patients ' insulin dose adjustment and patients ' empowerment , should be offered to all patients with diabetes mellitus
Through this review , we found two key health system barriers to effective T2DM care and management : financial constraints faced by the patient and limited access to health services and medication .
This review points to the importance of reducing , or possibly eliminating , out-of-pocket costs for diabetes medication and self-monitoring supplies .
BACKGROUND Type 2 Diabetes Mellitus ( T2DM ) is reported to affect one in 11 adults worldwide , with over 80 % of T2DM patients residing in low-to-middle-income countries .
Health systems play an integral role in responding to this increasing global prevalence , and are key to ensuring effective diabetes management .
We conducted a systematic review to examine the health system-level factors influencing T2DM awareness , treatment , adherence , and control .