Experts Make Progress towards Optimizing Diabetes Care on a Global Scale

New issue of the Annals of Global Health compares diabetes care in 14 countries to help understand and successfully manage the global diabetes epidemic

New York, March 2, 2016

Diabetes is a significant global health problem, afflicting 382 million people worldwide with increasing prevalence rates and adverse effects on health, wellbeing, and society in general. In this special issue of the Annals of Global Health, “Global Dimensions of Diabetes Care,” experts from around the world synthesize a core set of recommendations using information from 14 countries as a basis in order to work towards optimizing diabetes care globally – a critically important initiative to help stem the diabetes epidemic.

Introducing this collection of papers, issue editor Jeffrey I. Mechanick, MD, Director of Metabolic Support and Clinical Professor of Medicine at the Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, explained, “The multi-faceted nature of diabetes requires an assessment of lifestyle, behavior, genetics and epigenetics, and the intrauterine environment. The problems of one country are not only relevant for that country; information gleaned from a portfolio of countries may generate emergent ideas to solve the complex diabetes problem globally.”

Experts describe the diabetes care in their own countries including its infrastructure, socioeconomics, and relevant cultural factors. They also focus on the key drivers for epidemiological transitions (e.g., nutritional, demographic, and economic); specific management strategies and resources (e.g., glucose testing and devices, medications, and other technologies); and unique challenges and solutions. The articles cover eating patterns, attitudes toward doctors and medicines, beliefs, religion, linguistics and communication preferences, and other lifestyle variables.

“Not surprisingly, diabetes prevalence rates are increasing the most in rural and low-middle income areas,” noted Dr. Mechanick. “Cultural differences also have an influence. The lack of guidelines for different target populations and also the interaction of acculturation to Westernized lifestyle with a genetic susceptibility, especially in aboriginal populations, is of concern. Clearly, understanding the effects of one culture in one country can assist diabetes care for patients of the same culture but in another country.”

Organized by world region (Latin America, Europe, Africa, and Asia) with representative countries presenting their data, diabetes management profiles, and opinions regarding challenges and potential solutions, information, each paper provides a different perspective on diabetes care but in aggregate, reveals interesting commonalities and distinguishing features. These include:

  • Very high economic burden, in terms of both direct and indirect costs, of diabetes
  • Insufficient funding to optimize diabetes care, especially in low-to-middle income nations
  • Nascent or early efforts to establish, populate, and/or analyze surveys and registries to base advances on real-world data
  • Need for more governmental policy-making and intervention to provide funding for research, education, reimbursements, and infrastructure (e.g., diagnostics, medications, and self-monitoring), structured lifestyle change, improved awareness and adherence, and coordination and distribution of resources
  • Need to create local or transculturalized foreign evidence-based guidelines and then implement on a national scale

The data have been compiled and critically analyzed. The main findings have been synthesized into a core set of relevant conclusions that can potentially be leveraged into action:

Knowledge base: Each nation needs to assess the region-specific epidemiology, scientific evidence base, especially regarding biological drivers, and population-based transitions to identify higher risk people and establish risk-stratified guidelines for diagnosis and therapeutic interventions.

Public Health: Each nation establishes a public health imperative to acquire the necessary tools (diagnostics, drugs, supplies, etc.) and funding to successfully implement culturally-sensitive guidelines, as well as developing metrics to evaluate and improve these guidelines.

Durability: Each nation commits to education and research, with particular focus on pathophysiology and continued interaction on a multi-national scale, to advance and optimize the recommendations for a durable effect.

“These three recommendations serve as a starting point to address the complex nature of global diabetes care – to treat populations and individuals, to recognize similarities and differences, and to move more quickly than ever, as the diabetes epidemic has thus far been deaf to our calls for action,” commented Dr. Mechanick.


Notes for Editors
“Global Dimensions of Diabetes Care,” guest edited by Jeffrey Mechanick, MD, published by Elsevier in Annals of Global Health, Volume 81, Issue 6. Articles are openly available in advance of the issue at

Contact Eileen Leahy at +1 732-238-3628 or to obtain additional information. Journalists wishing to reach the Dr. Mechanick for comment may contact him directly at +1 914-523-4706 (cell or text) or

Table of Contents

  • Editor’s Page: Global Dimensions of Diabetes: Information and Synthesis
    Jeffrey I. Mechanick, MD
  • Diabetes Care in Brazil

    Walmir F. Coutinho, MD, PhD, Wellington Santana da Silva Junior, MD
  • An Epidemiologic Analysis of Diabetes in Colombia
    Hernando Vargas-Uricoechea, MD, MSc, Luz Angela Cases-Figueroa, MD
  • Diabetes in Panama: Epidemiology, Risk Factors, and Clinical Management
    Anselmo J. McDonald Posso, MD, MSc, Ryan A. Bradshaw Meza, MD, Enrique A. Mendoza Morales, MD, Ycly Jaen, MD, Alberto Cumbrera Ortega, MSc, Enrique Jorge Mendoza Posada, MD, MSc, FACP
  • Diabetes Mellitus in Peru
    Jaime E. Villena, MD
  • Diabetes Care in Venezuela
    Ramfis Nieto-Marinez, MD, MSc, Juan Pablo Gonzalez, MD, Marcos Lima-Martinez, MD, Victoria Stepenka, MD, Alejandro Risquez, MD, Jeffrey I. Mechanick, MD
  • Diabetes Care in Republic of Macedonia: Challenges and Opportunities
    Ivica Smokovski, MD, PhD, Tatjana Milenkovic, MD, PhD, Caroline Trapp, DNP, ANP-BC, CDE, FAANP, Aleksandar Mitov, MD, MSc, MPhil
  • State-of-the-Art Review on Diabetes Care in Italy
    Olga Disoteo, MD, Franco Grimaldi, MD, Enrico Papini, MD, FACE, Roberto Attanasio, MD, PhD, Laura Tonutti, MD, Maria Antonietta Pellegrini, MD, Rinaldo Guglielmi, MD, Giorgio Borretta, MD
  • Epidemiology of and Risk Factors for Type 2 Diabetes in Egypt
    Refaat Hegazi, MD, PhD, Mohamed El-Gamal, MD, MSc, Nagy Abdel-Hady, MD, PhD, Osama Hamdy, MD, PhD
  • Diabetes Care in Nigeria
    Olufemi A. Fasanmade, MD, Samuel Dagogo-Jack, MD
  • Diabetes Care in India
    Shashank R. Joshi, MD, DM, FICP, FACP (USA), FACE (USA), FRCP (Glsg. & Edin.)
  • Diabetes Care in Iran: Where We Stand and Where We Are Headed
    Sina Hoshad, MD, MPH, Mohsen Afarideh, MD, MPH, Behnam Heidari, MD, MPH, Jeffrey I. Mechanick, MD, FACP, FACE, FACN, Alireza Esteghamati, MD
  • Diabetes Care in Malaysia: Problems, New Models, and Solutions
    Zanariah Hussein, Sri Wahyu Taher, Gilcharan Singh Harvinder, Winnie Chee Siew Swee
  • Diabetes Care in the Philippines
    Gerry H. Tan, MD
  • Diabetes in Vietnam
    Nguyen Thy Khue, MD, PhD
  • Synthesis: Deriving a Core Set of Recommendations to Optimize Diabetes Care on a Global Scale
    Jeffrey I. Mechanick, MD, Derek Leroith, MD, PhD

About Annals of Global Health
Annals of Global Health, formerly published as The Mount Sinai Journal of Medicine, is an open-access, peer-reviewed Journal focused on global health. The Journal’s mission is to advance and disseminate knowledge of global health, promote research and foster the prevention and treatment of disease worldwide by supporting open dissemination and lively discourse about a wide range of the most important topics in global health and medicine.

About Elsevier
Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Research Intelligence and ClinicalKey— and publishes over 2,500 journals, including The Lancet and Cell, and more than 35,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group, a world-leading provider of information and analytics for professional and business customers across industries.

Media contact
Eileen Leahy
+1 732-238-3628