Exploring prediabetes remission in public primary care in Mexico: A cascade analysis.

Abstract

Introduction: Diabetes poses a significant global health challenge, with prediabetes serving as a critical phase for intervention to prevent or delay its progression. While evidence-based strategies have shown promise, their implementation within healthcare systems - particularly in low- and middle-income countries - remains a formidable challenge. This study shares preliminary findings from a regional quality improvement (QI) initiative aimed at identifying and managing prediabetes within Mexico's public healthcare framework.

Materials and methods: The Diabetes Prevention Squad programme introduced a regional clinical service focusing on individuals at risk for diabetes or diagnosed with prediabetes in primary care settings. This QI initiative adopted a comprehensive approach, guiding participants from initial screening to engagement in a diabetes prevention programme emphasising lifestyle modifications. A cascade analysis was conducted, with results drawn from a pretest-posttest design comprising 14 visits over 1 year.

Results: Of the 1,256 participants screened, 90 were diagnosed with prediabetes. Among those who completed the intensive phase, 57% achieved prediabetes remission, and 37% experienced significant weight loss.

Conclusion: This QI initiative demonstrated a promising prediabetes remission rate among participants, underscoring the importance of a complete care pathway from screening to remission. Prediabetes remission and significant weight loss are vital outcomes in diabetes prevention. Integrating interventions focused on prediabetes remission into healthcare pathways is essential to reducing the diabetes burden.