Objective
Using Mexico as a case study, identify barriers and opportunities and formulate recommendations to strengthen management of type 1 diabetes mellitus (T1DM) in primary health care (PHC), with potential for implementation in other countries of the Region of the Americas.
Methods
A two-stage exploratory qualitative study was conducted. The first stage consisted of a scoping review (2010–2020) of the PubMed, LILACS, and SCIELO databases for reports of successful comprehensive care practices for T1DM, classified into four domains: physical health, emotional health, functional, and social. The second stage consisted of semi-structured interviews with the chief executives of 12 civil society organizations (CSOs) in Mexico, to analyze their strategies for intervention, education, and linkage with public policies.
Results
The scoping review yielded 12 studies, highlighting continuous glucose monitoring, diabetes education, and psychosocial support as key elements. CSOs in Mexico have developed innovative interventions, despite facing barriers such as a lack of basic supplies, nonstandard protocols, and reliance on external funding. Their interventions have had a relevant impact on improving self-care, access to technologies, and emotional support.
Conclusions
The care of patients with T1DM in PHC settings requires a distinct model that combines sustained access to supplies, continuing education, and emotional support. The findings of this study can be used to outline a model adaptable to other countries of the Region of the Americas, based on coordination between the public sector and civil society to improve equity, continuity, and quality of care.