Diabetes in Mayan Populations: Monitoring of Glycosylated Hemoglobin.

Abstract

Background: Diabetes mellitus (DM) is a global health concern that has affected various populations worldwide. Among the various methods to monitor the progress and management of DM, glycosylated hemoglobin (HbA_1c) serves as a key marker for understanding long-term glucose control. The Mayan populations of Yucatan represent a unique demographic in which the prevalence and management of DM can be distinctively analyzed.

Method: In this study, HbA_1c levels were monitored over 12 months in 1722 patients with DM from 17 medical units of the Mexican Institute of Social Security in the southern region of Yucatan. Based on initial HbA_1c levels, patients were assigned to either standard or intensive treatment. Treatment efficacy was analyzed based on sex, age, and location.

Results: HbA_1c levels significantly decreased in patients receiving intensive treatment, from means (±SD) of 9.7±1.9% to 8.9±2.0% after 12 months (P=.001), with notable reductions in remote areas such as Akil and Huntochac (P<.05). Although slight reductions were observed among women and middle-aged individuals, these reductions were not statistically significant (P=.2 and P=.4, respectively). Despite the initial improvement, standard treatment was more effective for maintaining long-term glycemic stability, with lower variability and better adherence. However, a 10% increase in HbA_1c was observed in this group by the end of the study.

Conclusion: Monitoring of DM in Mayan populations revealed significant HbA_1c reductions with intensive treatment, especially in remote areas. Consequently, strategies to improve primary care and promote self-care in DM patients in the Mayan population must be implemented.