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People with diabetes in several countries do not get effective treatment, and health insurance, not personal wealth, plays a big role in determining which diabetics get good care, US researchers say.
"Too many people are not being properly diagnosed with diabetes and related cardiovascular risk factors. Those who are diagnosed aren't being effectively treated," Dr Stephen Lim of The Institute for Health Metrics and Evaluation at the University of Washington in Seattle said.
"This is a huge missed opportunity to lower the burden of disease in both rich and poor countries," said Dr Lim. He also worked on the study, which appeared in the online Bulletin of the World Health Organization.
The research team used data from national health surveys to study diabetes diagnosis and treatment rates in the Colombia, England, Iran, Mexico, Scotland, Thailand and the US.
90% of diabetics fail target
In the US, nearly 90% of adult diabetics –or more than 16 million adults aged 35 and older, fail to meet widely accepted targets for healthy levels of blood sugar, blood pressure and cholesterol.
In Mexico, 99% of adult diabetics are not meeting those targets. In the US, the most successful country in the study, 88% are not meeting the targets.
In Thailand, up to 62% (or more than 663,000 men) of those surveyed are either undiagnosed or untreated for diabetes.
"The cost of leaving individuals with diabetes untreated in the future will be huge, and a lot of the costs could be averted by better management of the health risks of these individuals," Dr Emmanuela Gakidou, who led the study, said.
Surprisingly, personal wealth and education were not a significant factor in the rates of diagnosis and treatment in any of the countries except in Thailand.
Health insurance important
"In countries where we had information on health insurance, it actually played a significant role in getting diagnosed and effectively treated for diabetes," Dr Gakidou said.
The effect was the strongest in the United States, where adult diabetics who had insurance were twice as likely to be diagnosed and treated as those who had no insurance.
"That is a big effect in a country with a large population of adults with diabetes," she said.
(Reuters Health, Julie Steenhuysen, March 2011)
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