Observatorio de Diabetes de Colombia
Title: The pattern of the rules of halves in diabetes mellitus tested with data from Colombia
Noel C Barengo has received his academic training at the University of Kuopio (Finland), the Karolinska Institute (Sweden) and the University of Zurich (Switzerland): MD (1999); Master in Public Health (2001); PhD (2006); adjunct professor in Public Health at the University of Helsinki (2009). His research interests are prevention of diabetes mellitus and cardiovascular diseases. He currently works at the Colombian Ministry of Health and Social Protection as expert in diabetes mellitus. Furthermore, he is a research consultant at the University of Tolima. He has published more than 50 peer-reviewed papers and acts as academic editor for PLOS ONE medicine.
The rule of halves in diabetes mellitus (DM) refers to the pattern that half of people with the disease is undetected, half of those diagnosed are untreated and half of those treated patients are not controlled. The objective of this study was to test whether the rules of halves applies to the Colombian setting using local data. Information regarding distribution of the Colombian population was retrieved from the National Administrative Department of Statistics. Data on the number of diagnosed DM was obtained from the National Risk Factor Survey 2007 (ENS 2007), an organization of the healthcare insurers to trace high expenditure diseases. Data on number of patients treated for DM was obtained by the Integral Information System of Social Protection and the High Cost Account (CAC), an organization to trace high expenditure diseases. In addition, a systematic review of studies conducted in Colombia in regard control of DM was performed to receive the respective estimates. According to recent estimates, there may be up to 2 000 000 cases of DM in Colombia among 25-79 years-old people with 1 200 000 cases officially diagnosed (60%). The number of DM patients receiving treatment was 500 000 (42%). The percentage of people with DM reaching the treatment targets of HbA1C <7% ranged between 43-59%. Our study showed that the rule of halves fits rather well into the Colombian setting. However, further research is needed to get more recent estimates in order to test the concept of the rule of halves more precisely.