{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T16:36:25Z","timestamp":1773160585524,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The focus of health system interventions for noncommunicable diseases and diabetes focus mainly on primary health care responses. However, existing interventions are not necessarily adapted for the complex management of type 1 diabetes (T1DM). We aimed to identify and describe health system interventions which have been developed to improve the management of T1DM globally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a scoping review by searching MEDLINE, Embase, and Global Health using OVID for peer\u2010review articles published in either English, Spanish, Portuguese or French in the last 10\u00a0years. We classified the intervention strategies according to the Effective Practice and Organization of Care (EPOC) taxonomy for health system interventions and the World Health Organization (WHO) health system building blocks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This review identified 159 health system interventions to improve T1DM management. Over half of the studies focused only on children or adolescents with type 1 diabetes. Only a small fraction of the studies were conducted in low\u2010and\u2010middle income countries (LMICs). According to the EPOC taxonomy, the most frequently studied category was delivery arrangement interventions, while implementation strategies and financial arrangements were less frequently studied. Also, governance arrangements domains were not studied. The most common combination of intervention strategies included self\u2010management with either telemedicine, use of information and smart home technologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a need to expand potential interventions to other EPOC strategies to assess their potential effect on health outcomes in people with T1DM, as well as to involve more LMIC settings as the impact may be greater in these settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14805","type":"journal-article","created":{"date-parts":[[2022,2,6]],"date-time":"2022-02-06T07:38:15Z","timestamp":1644133095000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Health system responses for type 1 diabetes: A scoping review"],"prefix":"10.1111","volume":"39","author":[{"given":"Jessica H.","family":"Zafra\u2010Tanaka","sequence":"first","affiliation":[{"name":"CRONICAS Center of Excellence in Chronic Diseases Universidad Peruana Cayetano Heredia  Lima Peru"},{"name":"Division of Tropical and Humanitarian Medicine University of Geneva and Geneva University Hospitals  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7229-3920","authenticated-orcid":false,"given":"David","family":"Beran","sequence":"additional","affiliation":[{"name":"Division of Tropical and Humanitarian Medicine University of Geneva and Geneva University Hospitals  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6834-1376","authenticated-orcid":false,"given":"Antonio","family":"Bernabe\u2010Ortiz","sequence":"additional","affiliation":[{"name":"CRONICAS Center of Excellence in Chronic Diseases Universidad Peruana Cayetano Heredia  Lima Peru"},{"name":"Universidad Cient\u00edfica del Sur  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"The World Health Report 2000 \u2010 Health Systems: Improving Performance","author":"Wolrd Health Organization","year":"2000"},{"key":"e_1_2_8_3_1","volume-title":"Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care in Low\u2010Resource Settings","author":"World Health Organization","year":"2010"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010021\u201005571\u20108"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30148-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.09.010316"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12801"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02247-9"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1010539511412177"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.9.2136"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69704-3"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.651589"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.03.029"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.2145"},{"key":"e_1_2_8_15_1","volume-title":"Monitoring the Building Blocks of Health Systems: a Handbook of Indicators and their Measurement Strategies","author":"World Health Organization (WHO)","year":"2010"},{"issue":"1","key":"e_1_2_8_16_1","first-page":"210","article-title":"Global inequality in type 1 diabetes: a comparison of Switzerland and low\u2010and middle\u2010income countries","volume":"17","author":"Marques NA","year":"2020","journal-title":"Pediatr Endocrinol Rev"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0611-x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_2_8_19_1","unstructured":"Alliance for Health Policy and Systems Research World Health Organization (WHO).Health system strengthening interventions: making the case for impact evaluation;2007."},{"key":"e_1_2_8_20_1","unstructured":"Effective Practice and Organisation of Care (EPOC).The EPOC taxonomy of health systems interventions.2016. 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