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 .
Cardiovascular risk factors in type 2 diabetic patients: multifactorial intervention in primary care.
BACKGROUND Cardiovascular disease is the main cause of morbidity and mortality in patients with type 2 diabetes mellitus ( DM ) . Intervention on  cardiovascular risk factors  ( CVRF ) is essential to obtain clinical results reducing the excess of cardiovascular risk ( CVR ) in these patients . METHODS The objective of this study was to describe the association of type 2 DM with modifiable cardiovascular risk factors and the degree of control of these in a population of type 2 diabetics in attendance in primary care clinics , and also to establish prospect ively whether an integral and multifactorial intervention on uncontrolled cardiovascular risk factors , carried out in conditions of routine clinical practice by applying an open protocol , could significantly reduce the estimated CVR according to the Framingham scale . The proposed intervention included both actions aim ed at modifying habits , and pharmacologic intervention to achieve an optimum level of control in accordance with international recommendations for the objectives and treatment for type 2 diabetes . RESULTS A total of 3466 patients with a mean age of 58 + /- 7.5 years were studied and followed-up for 1 year . Of these , 90.4 % of patients had high blood pressure ; 60.1 % of men and 32.7 % of women presented CVR > 20 % in 10 years according to the Framingham scale by categories . Intervention at 1 year of follow-up had achieved statistically significant reductions in blood pressure , glycated hemoglobin , and lipid levels , but not of patients ' body weight . After 1 year of follow-up , 29 % of males and 24 % of women with a high CVR ( > 20 % ) at the start of the study presented reduced risk levels . CONCLUSION The results of the study demonstrate that an integrated and multifactorial intervention in type 2 diabetic patients can achieve clinical ly significant reductions in CVR . However , conducted in effective conditions , it is not able to achieve optimum levels of control in spite of the initial proposal , possibly due to some degree of inertia in routine clinical practice
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 .