Abstract:
Professional society and expert guidelines recommend the achievement of glycaemic, blood pressure, and cholesterol targets to prevent the microvascular and macrovascular complications of diabetes. The WHO Diabetes Compact recommends that countries meet and monitor these targets for diabetes management. Surveillance-ie, continuous, systematic measurement, analysis, and interpretation of data-is a crucial component of public health. In this Personal View, we use the case of India as an illustration of the challenges and future directions needed for a diabetes surveillance system that documents national progress and persistent gaps. To address the growing burdens of diabetes and cardiometabolic diseases, the Government of India has launched programmes such as the National Programme for Prevention and Control of Non-Communicable Diseases. Different surveys have provided estimates of the diabetes care continuum of awareness, treatment, and control at the national, state, and, very recently, district level. We reviewed the literature to analyse how these surveys have varied in both their data collection methods and the reported estimates of the diabetes care continuum. We propose an integrated surveillance and monitoring framework to augment decentralised decision making, leveraging the complementary strengths of different surveys and electronic health record databases, such as data obtained by the National Programme for Prevention and Control of Non-Communicable Diseases, and building on methodological advances in model-based small-area estimation and data fusion. Such a framework could aid state and district administrators in monitoring the progress of diabetes screening and management initiatives, and benchmarking against national and global standards in all countries.
摘要:
专业协会和专家指南建议实现血糖,血压,和胆固醇目标,以预防糖尿病的微血管和大血管并发症。世卫组织糖尿病契约建议各国实现并监测这些糖尿病管理目标。监视-即,连续,系统测量,分析,和数据的解释-是公共卫生的重要组成部分。在这个个人观点中,我们以印度为例说明了糖尿病监测系统所需的挑战和未来方向,该系统记录了国家的进步和持续的差距。为了解决糖尿病和心脏代谢疾病日益增长的负担,印度政府启动了《预防和控制非传染性疾病国家方案》等方案。不同的调查提供了对糖尿病护理连续意识的估计,治疗,控制国家,state,and,最近,区一级。我们回顾了文献,以分析这些调查在数据收集方法和报告的糖尿病护理连续体估计方面的差异。我们提出了一个综合的监督和监测框架,以加强分散的决策,利用不同调查和电子健康记录数据库的互补优势,例如国家预防和控制非传染性疾病方案获得的数据,并在基于模型的小区域估计和数据融合的方法上取得了进展。这样的框架可以帮助州和地区管理者监测糖尿病筛查和管理计划的进展。并对照所有国家的国家和全球标准进行基准测试。