Background Within the last decades, diabetes has become a serious health problem in Mexico. According to the International Diabetes Federation, more than 11 million people have diabetes corresponding to 15% of the adult population. With one in three adults being obese, the increasing rates of overweight and obesity are significant contributors to the growing epidemic. Despite the magnitude of the problem, the quality of diabetes care remains poor and many people with diabetes are undiagnosed. The complication rates therefore continue to rise, which has led diabetes to become one of the leading causes of death in the country. Objectives The aim of this project is to strengthen primary level diabetes care and raise awareness of diabetes in a high-burden urban area at the Mexico-U.S. border.
Approach To improve the quality of diabetes care, 15 diabetes clinics will be created and provided with basic equipment. An electronic patient registry for diabetes patients will be established and at least 100 health care professionals will receive extensive training in diabetes management. Diabetes care and counselling will be provided at the targeted clinics and will include eye and foot examinations and individual nutritional counselling. In order to increase awareness of diabetes, 150 peer educators will be trained in peer-to-peer education to improve self-care behaviours in patients with diabetes and to increase awareness of chronic disease. In the attempt to improve diabetes care and evaluate the effect of the program, a comprehensive baseline data collection on medical and nutritional indicators will be carried out and medical and educational follow-up visits will be conducted. A monitoring and communication network will be implemented between the 15 clinics and the Multidisciplinary Diabetes Centre of the Border (MDCB) and the quality of patient care will be continuously monitored using the data from the electronic registry. The targeted clinics belong to the MoH public health system whereby all services of the project is accessible for free. If the project demonstrates that quality diabetes care is possible to establish at the primary level of the public health system, the results may prove useful in the creation of a state-wide intervention.
Results at completion • Capacity building 15 public primary health care centres completed • 150 doctors and nurses trained, 90 community health workers trained• 100 patients trained to become peer educators• 3,000 patients provided improved diabetes care including patient education• 16,000 people screened for diabetes of who 1,900 were diagnosed and provided care