{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T18:27:39Z","timestamp":1777487259936,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T00:00:00Z","timestamp":1536537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011102","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["FP7\/2007\u20132013"],"award-info":[{"award-number":["FP7\/2007\u20132013"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011102","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["305279"],"award-info":[{"award-number":["305279"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the characteristics and management of Diabetes mellitus (<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>) patients from low\u2010 and middle\u2010income countries (<jats:styled-content style=\"fixed-case\">LMIC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically characterised consecutive <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> patients attending public health services in urban settings in Indonesia, Peru, Romania and South Africa, collecting data on <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> treatment history, complications, drug treatment, obesity, HbA1c and cardiovascular risk profile; and assessing treatment gaps against relevant national guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients (median 59 years, 62.9% female) mostly had type 2 diabetes (96%), half for &gt;5 years (48.6%). Obesity (45.5%) and central obesity (females 84.8%; males 62.7%) were common. The median HbA1c was 8.7% (72 mmol\/mol), ranging from 7.7% (61 mmol\/mol; Peru) to 10.4% (90 mmol\/mol; South Africa). Antidiabetes treatment included metformin (62.6%), insulin (37.8%), and other oral glucose\u2010lowering drugs (34.8%). Disease complications included eyesight problems (50.4%), <jats:styled-content style=\"fixed-case\">EGFR<\/jats:styled-content> &lt;60 ml\/min (18.9%), heart disease (16.5%) and proteinuria (14.7%). Many had an elevated cardiovascular risk with elevated blood pressure (36%), <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content> (71.0%) and smoking (13%), but few were taking antihypertensive drugs (47.1%), statins (28.5%) and aspirin (30.0%) when indicated. Few patients on insulin (8.0%), statins (8.4%) and antihypertensives (39.5%) reached treatment targets according to national guidelines. There were large differences between countries in terms of disease profile and medication use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> patients in government clinics in four <jats:styled-content style=\"fixed-case\">LMIC<\/jats:styled-content> with considerable growth of <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> have insufficient glycaemic control, frequent macrovascular and other complications, and insufficient preventive measures for cardiovascular disease. These findings underline the need to identify treatment barriers and secure optimal <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> care in such settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13137","type":"journal-article","created":{"date-parts":[[2018,8,14]],"date-time":"2018-08-14T06:55:08Z","timestamp":1534229708000},"page":"1118-1128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Disease characteristics and treatment of patients with diabetes mellitus attending government health services in Indonesia, Peru, Romania and South Africa"],"prefix":"10.1111","volume":"23","author":[{"given":"Nanny N. 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