Role of social and other determinants of health in the effect of a multicomponent integrated care strategy on type 2 diabetes mellitus

Autor: Rubén Silva-Tinoco, Teresa Cuatecontzi-Xochitiotzi, Viridiana De la Torre-Saldaña, Enrique León-García, Javier Serna-Alvarado, Eileen Guzmán-Olvera, Dolores Cabrera, Juan G. Gay, Diddier Prada
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: International Journal for Equity in Health, Vol 19, Iss 1, Pp 1-11 (2020)
Druh dokumentu: article
ISSN: 1475-9276
DOI: 10.1186/s12939-020-01188-2
Popis: Abstract Background Although important advances in treatment strategies have been developed in type 2 diabetes mellitus (T2DM), large gaps exist in achieving glycemic control and preventing complications, particularly in low-and middle-income countries, which suggests a potential effect of social determinants of health (SDH, i.e., education level and socioeconomic status). However, few studies have determined the role of SDH and other determinants of health (ODH, i.e., diabetes knowledge and self-care scores) in achieving T2DM goals during effective multidisciplinary interventions. We aimed to examine a multicomponent integrated care (MIC) program on diabetes care goals and determine the effect of SDH and ODH on T2DM patients. Methods A before-and-after design (a pretest, a 5-month intervention, and a follow-up) was used in a T2DM population from Mexico City. The SDH included education level and socioeconomic status; the ODH included diabetes knowledge, self-care scores, and deltas (i.e., differences between baseline and follow-up scores). The triple-target goal (glycated hemoglobin, blood pressure, and LDL-cholesterol) was established as a measurement of T2DM goals. Results The DIABEMPIC (DIABetes EMPowerment and Improvement of Care) intervention (n = 498) reduced the glycated hemoglobin levels (mean reduction 2.65%, standard deviation [SD]: 2.02%) and cardiometabolic parameters; it also improved health-related quality of life. From 1.81% at baseline, 25.9% of participants (p-value
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