Title: Undetected diabetes in Colombia

Authors: Andres Ignacio Vecino-Ortiz; Antonio J. Trujillo; Fernando Ruiz

Addresses: Health Systems Program, Department of International Health, Johns Hopkins University-Bloomberg School of Public Health, 615 North Wolfe St., Suite E8009, Baltimore, Maryland 21205, USA. ' Health Systems Program, Department of International Health, Johns Hopkins University-Bloomberg School of Public Health, 615 North Wolfe St., Suite E8142, Baltimore, Maryland 21205, USA. ' Centro de Proyectos para el Desarrollo (CENDEX), Pontificia Universidad Javeriana, Carrera 7 N. 40-90, Edificio Emilio Arango, 5 Piso, Bogota DC, Colombia

Abstract: Undetected diabetes (UD) worsens prognosis, increases healthcare costs and reduces productivity in the long term. However, its determinants have not been previously explored in developing countries. In this paper, we assess the determinants of UD in Colombia. We conducted logistic regression analyses using the 2007 Colombian National Health Survey. Taking into account undetected cases (individuals with fasting glucose tests ≥ 126 mg/dL reporting no previous diabetes diagnosis), we found a diabetes prevalence of 5% in Colombia, where 1/3 are undetected cases. Undetected individuals are as likely as detected diabetics to visit a physician during the last 12 months. Despite we found no differences in prevalence between urban and rural settings, diagnoses rates were lower in the later, challenging traditional conceptions on urban diabetes and supporting the hypothesis of a supply-side issue driving undetected diabetes in Colombia. We discuss UD in Colombia using a supply-demand framework. These lessons may be extrapolated to other Latin American countries where policymakers will find them useful to improve diabetes screening activities.

Keywords: Colombia; type 2 diabetes; undetected diabetes; health services; healthcare quality; medical prognoses; healthcare costs; productivity; developing countries; determinants; logistic regression analysis; health surveys; undetected cases; fasting glucose tests; diabetes diagnoses; diabetes prevalence; undetected individuals; urban areas; rural areas; diagnoses rates; supply-side issues; supply-demand frameworks; Latin America; policymakers; diabetes screening; public policy.

DOI: 10.1504/IJPP.2012.048724

International Journal of Public Policy, 2012 Vol.8 No.4/5/6, pp.362 - 373

Received: 12 Dec 2011
Accepted: 29 May 2012
Published online: 31 Jul 2014 *

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