Comparing Approaches for Deriving Diabetes Care Cascades to Inform Policy: A Cross-sectional Analysis Using National Data From 88 Countries
Authors' conclusion
Care cascade estimates diverged substantially and consistently across diabetes definitions, skewing policy implications in predictable ways. Harmonizing diabetes performance metrics may improve decision-making and facilitate cross-country comparisons.
Study context
- Population
- Individuals aged ≥25 years from 88 countries, nationally representative cross-sectional data, 2008–2021
- Participants
- 800,348 individuals88 countries
- Exposure
- Diagnosis-based vs treatment-based diabetes definition for deriving care cascades
- Outcome
- Care cascade estimates: proportion with diabetes diagnosed; proportions with diagnosed diabetes who received treatment and attained glycemic control
Methodological detailsnationally representative data, 88 countries
- Nationally representative data
- 88 countries
Main finding
As reported in the abstract
Median difference across countries, diagnosis stage
11.3 %
Diagnosis-based definition vs Treatment-based definition · IQR 5.1-24.7; higher with diagnosis-based definition
Median difference across countries, treatment stage
21.6 %
Between Treatment-based definition and Diagnosis-based definition · IQR 14.5-37.8; lower with diagnosis-based definition
Median difference across countries, control stage
16.4 %
Between Diagnosis-based definition and Treatment-based definition · IQR 7.8-26.8; higher with diagnosis-based definition
Observational data: associations, not effects.
Further findings
Countries meeting WHO 80% glycemic control target
| Outcome | Diagnosis-based definition | Treatment-based definition |
|---|---|---|
| Diabetes prevalence | 12.9% (95% CI 12.1–13.8) | 11.3% (95% CI 10.5–12.1) |
Original publication
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