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 .
Diabetes specialist nurse as main care provider for patients with type 2 diabetes.
BACKGROUND The objective of this study was to determine whether the management of type 2 diabetes ( DM2 ) can be transferred from an internist to a nurse specialised in diabetes ( NSD ) . METHODS Ninety-three patients with DM2 referred by their general practitioner were r and omised ; 84 patients completed the study . The intervention group received care from an NSD who treated glycaemia , blood pressure and lipid profile by protocol . The control group received care from an internist . The primary endpoint was the main decrease in HbA1c . Secondary endpoints included blood pressure , lipid profile , healthcare costs , QOL , and patient satisfaction . RESULTS HbA1c , total cholesterol , LDL cholesterol and cholesterol/HDL ratio decreased significantly in both study population s after a follow-up time of 12 months . Cholesterol/HDL ratio decreased by 0.4 and 0.9 in the NSD and control group respectively ( p=0.034 for the difference between groups ) . The decreases ( 95 % confidence interval ) in systolic blood pressure were 8.6 mmHg ( 2.6 , 14.7 ) in the NSD group and 4.0 mmHg ( -0.9 , 8.9 ) in the control group , without a significant difference between groups . After one year , 33.3 % of the patients in the NSD group achieved an HbA1c level . < 7 % compared with 2.2%at baseline ( p=0.002 ) . Healthcare costs were less and patient satisfaction with the NSD s was significantly better(p<0.001 ) , while maintaining the same QOL . CONCLUSION NSD s using treatment protocol s are able to provide effective care for patients with DM 2 , comparable with the care provided by an internist , with respect to clinical parameters , and superior with respect to healthcare costs and patient satisfaction
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 .