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Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence of the International Diabetes Management Practices Study (IDMPS) – published online 04/01/2020

Aschner figure

Pablo Aschner, Juan J. Gagliardino, Hasan Ilkova, Fernando Lavalle, Ambady Ramachandran, Jean Claude Mbanya, Marina Shestakova, Jean-Marc Chantelot, Juliana C. N. Chan

Management of type 2 diabetes has advanced considerably over the past decade, but there are limited data from developing countries. The International Diabetes Management Practices Study (IDMPS) is an ongoing, international, observational study that documents current practices in diabetes management in developing countries. In this issue, Aschner et al (https://doi.org/10.1007/s00125-019-05078-3) report that data from across seven cross-sectional ‘waves’, from 2005 to 2017 (including >65,000 people with type 2 diabetes), indicate that HbA1c target attainment in these countries remains poor and has, in fact, decreased significantly over time; this is despite increased use of insulin and a higher proportion of patients undergoing frequent HbA1c measurements. While receipt of diabetes education increased over time, this was predominantly provided only by physicians. In summary, the authors state that, while some encouraging trends in care improvements were observed, system changes are needed to improve access to structured education, self-monitoring tools and appropriate medications. They propose that such changes will support self-management and enable care providers to intensify treatment as recommended in guidelines.

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