Achievement of diabetes treatment goals in Mexico from 2016-2022: A retrospective analysis of nationally representative surveys

BACKGROUNDEffective cardiovascular disease (CVD) risk management is a cornerstone of optimal diabetes care. Here, we estimated the prevalence and determinants of CVD risk factor control amongst individuals with diagnosed diabetes in Mexico. METHODSWe analyzed data from individuals with diagnosed diabetes [≥]20 years from the 2016-2023 Mexican National Health and Nutrition Surveys. We estimated the prevalence of glycemic, blood pressure (BP), non-current smoking, and combined CVD risk factor control. LDL-C control was assessed using SCORE2-Diabetes risk categories. We estimated the prevalence of BP-lowering, cholesterol-lowering, and glucose-lowering medication use, and explored determinants of control achievement using logistic regression. RESULTSWe analyzed data representing 43.2 million adults with diagnosed diabetes during 2016-2023. In 2023, glycemic control was 29% (95%CI 21%-38%), BP control 22.9% (95%CI 14%-31%), and non-current smoking 89% (95%CI 81%-96%). The proportion of people classified as high or very-high CVD risk increased from 59.8% (95%CI 52.1%-67.0%) in 2016 to 68.4% (95%CI 55.6%-78.9%) in 2023, representing [~]5.1 million adults. LDL-C control prevalence increased from 2.8% (95%CI 1.2%-4.4%) in 2016 to 6.6% (95%CI 1.9%-11.2%) in 2023. Combined risk factor control achievement was low primarily due to suboptimal LDL-C control, despite high medication use; this was more likely achieved in females, younger individuals, and those with college education or living in states with higher socioeconomic position. CONCLUSIONSDespite increasing CVD risk during this period, comprehensive glycemic and CVD risk factor management for adults with diabetes in Mexico remains suboptimal. Our findings highlight the need for strategies to address gaps in CVD risk management to reduce premature mortality in this population. Lay summaryThis study examined how well adults with diabetes in Mexico are controlling key risk factors for cardiovascular disease, such as blood glucose levels, blood pressure, smoking, and cholesterol levels. Authors used nationally representative surveys from 2016-2023 analyzing data which represents over 43.2 million adults living with diagnosed diabetes. O_LIIn 2023, fewer than one-third of individuals with diabetes had adequate blood glucose control, and fewer than one in ten met recommended cholesterol targets, despite high rates of medication use. Cardiovascular risk increased for those at the highest risk by nearly 9% between 2016 and 2023. C_LIO_LIBetter control of these risk factors was more common among women, younger individuals, those with higher education, and those living in more socioeconomically advantaged areas. C_LI GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=81 SRC="FIGDIR/small/24313926v2_ufig1.gif" ALT="Figure 1"> View larger version (39K): org.highwire.dtl.DTLVardef@66e47dorg.highwire.dtl.DTLVardef@122fd03org.highwire.dtl.DTLVardef@10f992org.highwire.dtl.DTLVardef@71094f_HPS_FORMAT_FIGEXP M_FIG C_FIG