SCREENING INTERVENTIONS FOR TYPE 2 DIABETES IN LOW- ANDMIDDLE-INCOME COUNTRIES: A SYSTEMATIC REVIEW
Author(s)
Catherine Odhiambo, PhD.
PhD Student, University of Sheffield, Sheffield, United Kingdom.
PhD Student, University of Sheffield, Sheffield, United Kingdom.
OBJECTIVES: To identify and categorise screening interventions for type 2 diabetes (T2DM)in low- and middle-income countries (LMICs) and to describe their characteristics,implementation outcomes, and contextual factors.
METHODS: We conducted a systematic review of studies evaluating T2DM screeninginterventions in adult populations (≥18 years) within LMICs. We searched CINAHL,Embase, MEDLINE, PsycInfo, PubMed, and Scopus in March 2026. Two reviewersindependently screened studies, extracted data, and assessed quality using JoannaBriggs Institute (JBI) checklists. A narrative synthesis was performed. From 13,396identified records, 5,613 duplicates were removed. After screening 7,861 titles andabstracts and assessing 73 full-text reports, 18 studies met the inclusion criteria.
RESULTS: The 18 included studies were conducted across 12 countries, with the majorityfrom India (n=9). Screening models included population-based (n=5), targeted (n=7),and opportunistic (n=4) approaches, with two studies using hybrid models. Screeninglocations varied, including community settings (n=10), facilities (n=8), and households(n=2). Detection rates for newly diagnosed T2DM ranged from 0.9% to 21.3%, with thehighest yields observed in targeted approaches. Delivery agents included communityhealth workers, nurses, pharmacists, and physicians. Most studies provided training toscreening personnel, with task-sharing with existing health workers emerging as a keyfacilitator. Although fourteen studies incorporated confirmatory testing and twelvereported linkage to care, only seven documented treatment initiation and just threeassessed glycaemic control. Notably, only two studies reported on all four componentsof the care cascade.
CONCLUSIONS: T2DM screening interventions in LMICs are heterogeneous in design andsetting. Targeted and integrated approaches achieved higher yields and demonstratedfeasibility. However, substantial losses along the care cascade and limited economicevaluations highlight the need for implementation strategies that strengthen linkageto care and are supported by context-specific cost-effectiveness data.
METHODS: We conducted a systematic review of studies evaluating T2DM screeninginterventions in adult populations (≥18 years) within LMICs. We searched CINAHL,Embase, MEDLINE, PsycInfo, PubMed, and Scopus in March 2026. Two reviewersindependently screened studies, extracted data, and assessed quality using JoannaBriggs Institute (JBI) checklists. A narrative synthesis was performed. From 13,396identified records, 5,613 duplicates were removed. After screening 7,861 titles andabstracts and assessing 73 full-text reports, 18 studies met the inclusion criteria.
RESULTS: The 18 included studies were conducted across 12 countries, with the majorityfrom India (n=9). Screening models included population-based (n=5), targeted (n=7),and opportunistic (n=4) approaches, with two studies using hybrid models. Screeninglocations varied, including community settings (n=10), facilities (n=8), and households(n=2). Detection rates for newly diagnosed T2DM ranged from 0.9% to 21.3%, with thehighest yields observed in targeted approaches. Delivery agents included communityhealth workers, nurses, pharmacists, and physicians. Most studies provided training toscreening personnel, with task-sharing with existing health workers emerging as a keyfacilitator. Although fourteen studies incorporated confirmatory testing and twelvereported linkage to care, only seven documented treatment initiation and just threeassessed glycaemic control. Notably, only two studies reported on all four componentsof the care cascade.
CONCLUSIONS: T2DM screening interventions in LMICs are heterogeneous in design andsetting. Targeted and integrated approaches achieved higher yields and demonstratedfeasibility. However, substantial losses along the care cascade and limited economicevaluations highlight the need for implementation strategies that strengthen linkageto care and are supported by context-specific cost-effectiveness data.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EPH3
Topic
Epidemiology & Public Health
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)