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

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...

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Published in:International journal for equity in health 2020-05, Vol.19 (1), p.75-75, Article 75
Main Authors: Silva-Tinoco, Rubén, Cuatecontzi-Xochitiotzi, Teresa, De la Torre-Saldaña, Viridiana, León-García, Enrique, Serna-Alvarado, Javier, Guzmán-Olvera, Eileen, Cabrera, Dolores, Gay, Juan G, Prada, Diddier
Format: Article
Language:English
Subjects:
Activities of daily living
Blood cholesterol
Blood pressure
Body mass index
Case management
Cholesterol
Cholesterol tests
Complications
Design
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes therapy
Diet
Education
Effect
Empowerment
Glucose
Glycosylated hemoglobin
Health aspects
Health care
Health care policy
Health education
Hemoglobin
Interdisciplinary aspects
Intervention
Knowledge
Levels
Literacy
Low density lipoprotein
Low density lipoproteins
Metabolism
Multicomponent integrated care strategy
Objectives
Primary care
Quality of life
Social determinants of health
Socioeconomic factors
Socioeconomic status
Socioeconomics
Type 2 diabetes
Type 2 diabetes mellitus
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cited_by cdi_FETCH-LOGICAL-c597t-e72cdd1dfa3f736617dbb231ffdc9e18f4f9ebaf6bf094316a302ec046bee78e3
cites cdi_FETCH-LOGICAL-c597t-e72cdd1dfa3f736617dbb231ffdc9e18f4f9ebaf6bf094316a302ec046bee78e3
container_end_page 75
container_issue 1
container_start_page 75
container_title International journal for equity in health
container_volume 19
creator Silva-Tinoco, Rubén
Cuatecontzi-Xochitiotzi, Teresa
De la Torre-Saldaña, Viridiana
León-García, Enrique
Serna-Alvarado, Javier
Guzmán-Olvera, Eileen
Cabrera, Dolores
Gay, Juan G
Prada, Diddier
description 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. 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. 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
doi_str_mv 10.1186/s12939-020-01188-2
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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. 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. 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&lt; 0.001) achieved the triple-target goal. We found a significant association between education level (p-value = 0.010), diabetes knowledge at baseline (p-value = 0.004), and self-care scores at baseline (p-value = 0.033) in the delta (change between baseline and follow-up assessments) of HbA1c levels. Improvements (increase) in diabetes knowledge (p-value = 0.006) and self-care scores (p-value = 0.002) were also associated with greater reductions in HbA1c. MIC strategies in urban primary care settings contribute to control of T2DM. SDH, such as education level, and ODH (diabetes knowledge and self-care scores at baseline) play a key role in improving glycemic control in these settings.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>32448267</pmid><doi>10.1186/s12939-020-01188-2</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-6517-156X</orcidid><oa>free_for_read</oa></addata></record>
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ispartof International journal for equity in health, 2020-05, Vol.19 (1), p.75-75, Article 75
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1475-9276
language eng
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source Publicly Available Content Database; PAIS Index; PubMed Central
subjects Activities of daily living
Blood cholesterol
Blood pressure
Body mass index
Case management
Cholesterol
Cholesterol tests
Complications
Design
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes therapy
Diet
Education
Effect
Empowerment
Glucose
Glycosylated hemoglobin
Health aspects
Health care
Health care policy
Health education
Hemoglobin
Interdisciplinary aspects
Intervention
Knowledge
Levels
Literacy
Low density lipoprotein
Low density lipoproteins
Metabolism
Multicomponent integrated care strategy
Objectives
Primary care
Quality of life
Social determinants of health
Socioeconomic factors
Socioeconomic status
Socioeconomics
Type 2 diabetes
Type 2 diabetes mellitus
title Role of social and other determinants of health in the effect of a multicomponent integrated care strategy on type 2 diabetes mellitus
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