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 .
Treatment of type 2 diabetes mellitus in a primary care setting in Taiwan: comparison with secondary/tertiary care.
BACKGROUND This study investigated the status of diabetes control and management in patients treated in a primary healthcare setting and compared the results with data previously obtained for secondary /tertiary care patients in Taiwan . METHODS This study was conducted at 51 primary healthcare stations r and omly selected isl and -wide in Taiwan in 2001 . A total of 1302 type 2 diabetes patients who had been followed-up for more than 1 year were included .  Blood was collected for central ized HbA1c assay . The remaining data and information were collected by review of medical records and patient interview . RESULTS Compared with the results of a previous study on patients treated in a secondary /tertiary care setting , a significantly smaller percentage of primary care patients were receiving insulin therapy . Primary care patients also had a shorter duration of diabetes , a higher HbA1c level , better blood pressure control and a lower prevalence of complications . The proportion of patients achieving optimal control of glycemia and blood pressure was low . Patients aged < 65 years had a significantly shorter duration of diabetes , poorer diabetes control and better blood pressure control than elderly patients aged > or = 65 years . Primary care patients aged > or = 65 years had a significantly higher frequency of stroke than those aged < 65 years . The elderly group of secondary /tertiary care patients had a significantly higher frequency of coronary heart disease and stroke . Duration of diabetes and hypertension were the leading risk factors for complications in diabetes patients treated in both primary and secondary /tertiary care setting s. CONCLUSION Diabetes control was poorer in primary care than in secondary /tertiary care patients , but control of blood pressure was better in primary care patients . The shorter duration of diabetes and better control of blood pressure in primary care patients and in patients aged < 65 years compared with their elderly counterparts might be related to a lower prevalence of complications
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 .