Adapting Global Diabetes Management Guidelines for Low Resource Settings
Pragmatic Approaches to Care Delivery in north Africa and Beyond
الكلمات المفتاحية:
Type 2 diabetes mellitus، Low-resource settings، Low- and middle-income countries، Diabetes management، Metforminالملخص
Background: Type 2 diabetes mellitus (T2DM) is increasing rapidly in low- and middle-income countries (LMICs), where limited resources often restrict the implementation of international diabetes management guidelines. Adapting these recommendations to local healthcare systems is essential to improve patient outcomes.
Objective: To evaluate the applicability of current diabetes management guidelines in low-resource settings and identify practical strategies that balance clinical effectiveness with affordability and accessibility.
Methods: A narrative review of international guidelines and published literature was conducted to compare evidence-based recommendations with the realities of diabetes care in LMICs. The review focused on treatment efficacy, safety, cost-effectiveness, medication accessibility, and healthcare delivery models.
Results: Metformin remains the preferred first-line therapy because of its proven efficacy, safety, and affordability. Second-generation sulfonylureas continue to provide a practical and cost-effective second-line option where access to newer agents is limited. Although SGLT2 inhibitors and GLP-1 receptor agonists offer important cardiovascular and renal benefits, their high cost limits widespread use. Strengthening primary care, ensuring access to essential medicines, implementing simplified treatment protocols, and expanding community-based care can substantially improve diabetes management.
Conclusion: Diabetes care in LMICs requires pragmatic adaptation of international guidelines. Prioritizing affordable therapies and context-specific care models can improve glycemic control, reduce complications, and support sustainable diabetes management.
المراجع
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