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dc.titlePost-Diagnosis Trajectories in Treatment, Adiposity, Glycemic Control, and Dietary Behavior Among Adults with Type 2 Diabetes in Mexico
dc.contributor.authorGarcía-Díaz, Rocío
dc.contributor.authorTalamas Marcos, Miguel Ángel
dc.contributor.authorServán-Mori, Edson
dc.contributor.authorMiraldo, Marisa
dc.contributor.authorCastillo, Ernesto del
dc.contributor.orgunitDepartment of Research and Chief Economist
dc.coverageMexico
dc.date.available2026-07-22T00:07:00
dc.date.issue2026-07-22T00:07:00
dc.description.abstractType 2 diabetes mellitus (T2DM) is a major public health challenge in low- and middle-income countries, yet little is known about how treatment, behavior, adiposity, and glycemic control evolve after diagnosis. Using repeated cross-sectional data from ENSANUT (2006, 2012, 2018), we analyzed 9,277 Mexican adults aged 20 and older with prior physician-diagnosed T2DM, examining post-diagnosis trajectories in treatment use, household expenditure on non-recommended foods, body mass index (BMI), overweight, obesity, glycosylated hemoglobin (HbA1c), and fasting blood glucose, using pooled models with fixed effects for age-at-diagnosis-by-sex and municipality, and testing heterogeneity by sex and socioeconomic status (SES). Treatment uptake rose and remained elevated with time since diagnosis, reaching 24.4 percentage points at 12 years (p0.01), while household expenditure on non-recommended foods showed little sustained change. BMI declined gradually, remaining 2.54 kg/m lower at 12 years (p0.01); obesity was 16.9 percentage points lower (p0.01); overweight followed a less consistent trend. Glycemic control did not improve: HbA1c remained elevated at longer durations, reaching 1.01 percentage points at 12 years (p0.01), with fasting glucose showing a similar pattern. Diagnosis is associated with rapid increases in clinical engagement, but glycemic control remains persistently poor despite rising treatment use, suggesting that improving outcomes may require integrated care combining pharmacological management with sustained behavioral support, closer metabolic monitoring, and attention to the social conditions shaping long-term self-management.
dc.format.extent38
dc.identifier.doihttp://dx.doi.org/10.18235/0014414
dc.identifier.urlhttps://publications.iadb.org/publications/english/document/Post-Diagnosis-Trajectories-in-Treatment-Adiposity-Glycemic-Control-and-Dietary-Behavior-Among-Adults-with-Type-2-Diabetes-in-Mexico.pdf
dc.language.isoen
dc.publisherInter-American Development Bank
dc.subjectHuman Health
dc.subjectPopulation Aging
dc.subjectHealth
dc.subjectWomen
dc.subjectDisease
dc.subjectObesity
dc.subjectElectronic Health Records
dc.subjectMunicipal Government
dc.subjectIndigenous People
dc.subject.jelcodeI12 - Health Behavior
dc.subject.jelcodeI14 - Health and Inequality
dc.subject.jelcodeI18 - Government Policy • Regulation • Public Health
dc.subject.jelcodeI15 - Health and Economic Development
dc.typeWorking Papers
idb.identifier.pubnumberIDB-WP-01846
idb.operationRG-K1415
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