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 .
The effect of integrated health management model on the health of older adults with diabetes in a randomized controlled trial.
The objective of this study was to evaluate the effect of integrated health management model on the health of older adults with diabetes . The 100 older adults with diabetes who gave informed consent were r and omly allocated 1:1 into management and control groups . The integrated health management model was applied in the former while the latter was only given usual care . This model included the following components : health record establishment , health evaluation and health management ( such as : diet advice , psychological aspects of health , education/skills training on health self-management , regular blood glucose monitoring , long-term diabetes drug monitoring , etc . ) . After 18 months , differences in three categories of variables ( subjective grading items , objective measurement health indices and health service utilization ) between the two groups before and after the intervention were assessed with t-test , χ(2)-test and mixed model analysis . The management group demonstrated improvement on the following variables : health knowledge score , self-evaluated psychological conditions , overall self-evaluated health conditions , diet score , physical activity duration per week , regular blood sugar monitoring , waist-to-hip ratio , diastolic blood pressure and fasting blood sugar , the days of hospital admissions in the preceding 6 months . Mixed model analysis showed that gender , age , self-evaluated health status , self-evaluated psychological status , education level and resident status were important factors affecting health indices . This study demonstrated that integrated health management model was effectiveness in improving the health of older adults  with diabetes
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 .