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Updated: May 22, 2026

Multidisciplinary Approach to Obesity Management: A Case Report

Multidisciplinary Approach to Obesity Management: A Case Report

Published on: May 30, 2025

Comparing Approaches for Deriving Diabetes Care Cascades to Inform Policy: A Cross-sectional Analysis Using National

Felix Teufel^1,2, Michaela Theilmann^3,4, Maja E Marcus^3,4,5

¹Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.

|May 20, 2026

Summary

Varying diabetes definitions significantly impact care cascade indicators, affecting national diabetes control efforts and policy decisions. Harmonizing metrics is crucial for accurate global comparisons and improved health policy.

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Last Updated: May 22, 2026

Multidisciplinary Approach to Obesity Management: A Case Report

Multidisciplinary Approach to Obesity Management: A Case Report

Published on: May 30, 2025

Area of Science:

Global health
Endocrinology
Public health policy

Background:

Care cascade indicators are vital for monitoring national diabetes control.
Discrepancies in diabetes definitions across studies can lead to significant variations in care cascade results.
These variations may influence public health policy decisions regarding diabetes management.

Purpose of the Study:

To examine the impact of different diabetes definitions on care cascade estimates.
To quantify the differences in care cascade metrics resulting from diagnosis-based versus treatment-based definitions.
To assess the implications of these differences for policy decisions and international comparisons.

Main Methods:

Analysis of nationally representative cross-sectional data from 800,348 individuals across 88 countries (2008-2021).
Comparison of two diabetes definitions: diagnosis-based (biomarkers or self-reported diagnosis) and treatment-based (biomarkers or self-reported treatment).
Evaluation of care cascade components: diagnosis, treatment, and glycemic control, benchmarked against WHO targets.

Main Results:

Diabetes prevalence differed between definitions (12.9% diagnosis-based vs. 11.3% treatment-based).
The diagnosis-based definition increased diagnosis and control rates but decreased treatment rates compared to the treatment-based definition.
Significant median differences were observed for diagnosis (11.3%), treatment (21.6%), and control (16.4%).
The WHO glycemic control target was met by 22% of countries using the diagnosis-based definition versus only 6% using the treatment-based definition.

Conclusions:

Diabetes definition choice substantially and consistently alters care cascade estimates.
These divergent results can predictably skew policy implications.
Harmonizing diabetes performance metrics is essential for improving decision-making and enabling reliable cross-country comparisons.