Decrease of glycated hemoglobin based on evaluation of diabetes intervention programs in low-and middle-income countries: A systematic review
Résumé
Background
Diabetes is a chronic disease characterized by hyperglycemia that can be responsible for blindness, heart attacks, strokes, kidney failure and amputations. In 2014, about 415 million people were estimated to live with diabetes, which represents 8•5% of global population. The prevalence of diabetes will keep rising in the years to come, particularly in low-and middle-income countries (LMICs).
Methods
5 databases (Medline, Google Scholar, Web of Science, Cochrane Library, and Scopus) were searched for studies about intervention programs on type 2 diabetes in LMICs from 2009 to 2019. This research was made according to PRISMA recommendations.
Results
74 studies were included, of which 42 had quantitative results (HbA1c level). Most of these interventions were educational programs that took place in Asia (69%) and in Upper-Middle-Income Countries (77%). A monthly decrease of glycated hemoglobin level (HbA1c) by 0•156% was found in patients who had the intervention compared to the patients of the control group.
Conclusion
Interventional programs on diabetes in LMICs had a positive effect on glycemic control. Further studies are necessary in order to improve knowledge on other criteria such as cost-efficiency ratio. These studies shall be less focused on Asian countries and also put forward Low-Income Countries (LICs) in order to have a global vision in LMIC