Gabriela Allard
Mexican Diabetes Association

Sealing Economic Leaks Through Prevention

Wed, 09/05/2018 - 11:55

In Mexico, the burden of diabetes and the health expenditure for chronic diseases could increase as the rates of obesity and overweight continue to rise. According to the National Nutrition Survey 2016 (ENSANUT), 12 percent of the population lives with diabetes, while FUNSALUD says that treatment is costing the Mexican government more than MX$180 billion a year, almost 1 percent of the country’s GDP. One strategy to battle the disease is to attack the problem at its roots.

Gabriela Allard, Director of the Mexican Association of Diabetes (AMD), believes that to reduce costs and improve patients’ health, the focus of prevention must be on prediabetics. AMD’s priority is to control metabolic syndrome and impact health management. “Metabolic syndrome is our window of opportunity. Today, a patient with diabetes costs the health system MX$60,000 per year while treating a patient with metabolic syndrome costs about MX$3,000,” says Allard.

AMD has been providing services across Mexico since 1989. It focuses on controlling metabolic syndrome, which includes symptoms such as high blood pressure, high levels of blood sugar, excess body fat around the waist and high cholesterol levels. These conditions increase the risk of suffering from type 2 diabetes (T2D) or cardiac disease. According to AMD, each diabetic patient will cost the system MX$1.8 million in 30 years. “By the time patients become diabetic, we have lost many opportunities. But if we work on prevention, the health system will save a lot of money.”

Gallard says obesity rates in the country suggest a worsening problem to come. “Twelve percent of the population is suffering from diabetes and almost 40 percent from metabolic syndrome. In terms of obesity, the statistics we have are very high, so there is a strong chance the penetration of diabetes will increase to 40 percent.”

AMD is working on prevention with a group of health promoters by educating the public on the development of willpower. “Our first effort should be to develop people’s willpower and emphasize the importance of their decisions on their health.” The association is also training first-level doctors from the National System for Integral Family Development (DIF) and dispatching health brigades into communities to measure people’s weight and height to carry out glucose and blood pressure tests and to conduct oral examinations.

Diet is also in the crosshairs. AMD belongs to a coalition called Contrapeso that supports the Special Tax on Production and Services (IEPS) on sugary beverages. “It is scientifically proven that sugary drinks are a direct cause of obesity.”

Another population segment AMD is especially concerned about is teenage mothers. According to ENSANUT, Mexico ranks first in teenage obesity with a 36-percent penetration and, according to the Ministry of Health, the most frequent pregnancy cases are among teenagers aged between 11 and 17. Allard explains that most pregnant teenage girls do not visit a doctor until the pregnancy is well-advanced. As a result, they do not control their glucose levels. If they have a prediabetic condition, they are prone to developing gestational diabetes. “If a girl becomes pregnant while obese and is not treated, she is exposed to two risks. First, the baby could be born with a high chance of developing T2D in the future and the mother will probably develop gestational diabetes, which will then become T2D,” says Allard, who adds that the penetration of gestational diabetes increased by 5 percent in 2016.

AMD has also focused on prevention in the prediabetic phase to avoid cost increases and improve health. “People with diabetes become less productive and incur absenteeism, affecting their companies.” According to the US Chamber of Commerce, the loss in productivity caused by employees with chronic disease represents almost 5 percent of Mexico’s GDP. The association’s priority is to help the population living with diabetes control the disease through education and access to complete treatments.