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Transculturalizing Diabetes Prevention in Latin America

By August 1, 2017September 24th, 2020No Comments


Annals of Global Health

Ramfis Nieto-Martínez 1 ,
Juan P González-Rivas 2 ,
Pablo Aschner 3 ,
Noël C Barengo 4 ,
Jeffrey I Mechanick 5

Background: Type 2 diabetes (T2D) imposes a heavy burden in developing countries,
requiring effective primary prevention policies. Randomized clinical trials
have identified successful strategies in T2D prevention. However,
translating these results to real-life scenarios and adapting to
ethnocultural differences is a major challenge. Transculturalization allows
incorporating cultural factors to diabetes prevention strategies to
optimize implementation of clinical trials results. The purpose of this
paper is to review the transcultural adaptations developed for T2D
prevention in Latin America (LA).
Methods: A comprehensive literature review spanning 1960-2016 was performed, using
“Diabetes,” “Latin America,” “Prevention,” “Screening,” and “Tools” as key
Results: Two major tasks are underway in LA: adaptation of screening tools for
high-risk individuals, and implementation of diabetes prevention programs.
The Finnish Diabetes Risk Score (FINDRISC) is the most widely used
screening tool to detect new cases of T2D and people with prediabetes, and
it has been adapted (LA-FINDRISC) to include the waist circumference cutoff
values appropriate for LA population (≥94 cm for men and ≥90 cm for women).
The validation of the LA-FINDRISC performance depends on the local
characteristics. A LA-FINDRISC score >10 may be the best cutoff to identify
individuals with impaired glucose regulation in population-based studies,
but a higher score (>12-14) might be more appropriate in a clinical
setting. A shorter version of the FINDRISC using only the 4 variables with
highest impact has been developed and validated in Colombia (ColDRISC). The
translation of the Diabetes Prevention Program study in a Latino population
in Venezuela found a significant improvement in cardiometabolic risk
factors. An adaptation of the Diabetes Prevention Study in the DEMOJUAN
study in Barranquilla, Colombia, reduced 2-hour postload glucose.
Conclusion: Successful transculturalization strategies have been implemented in
screening tools and prevention programs in LA.


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