Improving Management of Type 2 Diabetes, Hypertension and Dyslipidemia in the Caribbean: A Systematic Review of Intervention Studies.

Persaud-Lachhman, Marissa; Andall-Brereton, Glennis; Jaacks, Lindsay M

OBJECTIVE To evaluate published interventions aimed at improving the management of type 2 diabetes, hypertension and dyslipidemia in the Caribbean. METHODS We conducted a systematic review of four databases in accordance with PRISMA guidelines. Inclusion criteria were: conducted in the Caribbean among adults ≥18 years who had type 2 diabetes, hypertension or dyslipidemia; controlled trials, interventions, or comparative studies with pre-post designs; and reported on at least 1 of the clinical outcomes of interest. RESULTS 17 studies met the criteria for inclusion. The majority were conducted in Cuba and Trinidad & Tobago and 35% were conducted over 10 years ago. Samples were small, and largely consisted of older adult females and patients with type 2 diabetes. Four of 8 (50%) studies that reported on HbA1c, 5 of 12 (42%) that reported on blood pressure and 2 of 7 (29%) that reported on body mass index observed significant improvements. Study heterogeneity precluded our ability to conduct a meta-analysis. The overall quality of evidence based on GRADE criteria was low for all outcomes assessed. CONCLUSION There is insufficient evidence on interventions to address type 2 diabetes, hypertension and dyslipidemia in the Caribbean.