Diabetes Care in Venezuela

Area of Science:

• Endocrinology and Metabolic Diseases
• Public Health and Epidemiology
• Health Policy and Management

Background:

• Rising incidence and economic burden of type 2 diabetes (T2D) in Venezuela present significant public health challenges.
• The country's socio-economic turmoil exacerbates difficulties in managing the escalating T2D epidemic.

Purpose of the Study:

• To conduct a comprehensive review of diabetes mellitus and its complications in Venezuela.
• To analyze the prevalence, etiological factors, prevention strategies, management approaches, health policies, and associated challenges.

Main Methods:

• A literature review from 1960 to 2015, including non-indexed literature.
• Estimation of weighted prevalence for diabetes and prediabetes using population-based studies.
• Analysis of existing diabetes care strategies and health system's approach.

Main Results:

• Weighted prevalence of diabetes at 7.7% and prediabetes at 11.2% in Venezuela.
• Diabetes as the fifth leading cause of death (7.1% in 2012), with a 7% annual mortality increase (1990-2012).
• Cardiovascular disease and diabetes combined were the leading cause of disability-adjusted life years in 2012; T2D drivers include genetics, lifestyle, obesity, and insulin resistance, with suboptimal screening and fragmented care.

Conclusions:

• Recommended strategies include resource enhancement, cost reduction, improved education, and implementing screening tools like the Latin America Finnish Diabetes Risk Score.
• Promoting dedicated diabetes care units and optimizing diagnostic and treatment guidelines (e.g., metformin as first-line therapy) are crucial.
• Reducing health system fragmentation and utilizing adapted algorithms for lifestyle and pharmacologic interventions can aid primary care physicians.