OBJECTIVES:

Achieving optimal Glycemic Control (GC) is the primary goal of Diabetes care, however information regarding this outcome is scarce for the patient population with Type 1 Diabetes (T1D) in Latin-America. Current reported data is insufficient for conducting localized economic evaluations. We aim to identify critical baseline parameters for conducting economic evaluations in T1D in Latin-American countries, focused on complications and GC.

METHODS:

A comprehensive systematic review was conducted using a PICO strategy. The population was defined as individuals in Latin America with T1D utilizing insulin-based treatments. Outcomes focused on T1D complications and GC. The principal variables of interest were: time in range (TIR), HbA1c, hypoglycemic and hyperglycemic events; and diabetic ketoacidosis (DKA). Publications were retrieved from PubMed, Embase, and Cochrane Library, and data were collected by two investigators.

RESULTS:

A total of 305 studies were found to be relevant. Of them, 12 studies focused on GC in adults with T1D (>18 years) with insulin-based treatments. Eight studies come from Brazil, three from Colombia, and one from Mexico. Sample size ranged from 36 to 7289 patients (median 398). Time horizons ranged from one month to 10 years. No study reported TIR, and only 58.33% of articles reported HbA1c. Hypoglycemic events ranged from 18.1% to 97.4% in 7 months (with 6.86 events per patient per month). One single study focused on hyperglycemia, and zero studies reported DKA.

CONCLUSIONS:

Scarcity of data for GC of T1D adults on insulin-based treatments in Latin America impedes providing baseline parameters for economic studies. Most frequently, studies have prioritized hypoglycemia, to the detriment of hyperglycemia and DKA, despite their role in the expenditure, mortality, hospital length of stay, and re-admissions.