A scoping review of barriers and possible solutions to type 2 diabetes remission in Latin America and the Caribbean
Keywords:
AMÉRICA LATINA; DETERMINANTES SOCIALES DE LA SALUD; DIABETES MELLITUS TIPO 2; FACTORES SOCIOECONÓMICOS; OBSERVATORIOS DE SALUD., LATIN AMERICA; SOCIAL DETERMINANTS OF HEALTH; DIABETES MELLITUS, TYPE 2; SOCIOECONOMIC FACTORS; HEALTH OBSERVATORY., AMÉRICA LATINA; DETERMINANTES SOCIAIS DA SAÚDE; DIABETES MELLITUS TIPO 2, FATORES SOCIOECONÔMICOS; OBSERVATÓRIOS DE SAÚDE.Abstract
Background: Latin America and the Caribbean (LAC) faces a rapidly escalating epidemic of Type 2 Diabetes (T2D), characterized by high prevalence, significant mortality, and profound health inequities. While T2D remission—the sustained return to non-diabetic glycemic status without medication—offers a transformative therapeutic goal, its implementation is severely challenged by the region's unique socio-economic, cultural, and systemic barriers. This scoping review systematically maps the existing literature to identify the reported multi-level barriers and context-appropriate solutions for achieving and maintaining T2D remission in the LAC context. Methods: A comprehensive scoping review protocol, guided by the Population, Concept, and Context (PCC) framework, was developed. A systematic search was conducted across major biomedical databases, focusing on literature published since 2020. Data were extracted, synthesized, and subjected to an in-depth thematic analysis, documented via a PRISMA-ScR flow diagram and detailed synthesis tables. Results: The review identified a complex web of barriers, with Social Determinants of Health (SDoH), such as food insecurity and socioeconomic adversity, acting as the root cause of disparities 13 14 . Other key barriers include Cultural (e.g., traditional high-carbohydrate diets, language barriers) and Systemic (e.g., access inequities, delayed access to innovative therapies). Possible solutions center on Community-Based Interventions (e.g., leveraging familismo for support, culturally sensitive dietary education 17 ) and Systemic Reforms (e.g., integrating telemedicine, policy changes to improve access to modern T2D management tools). Conclusion: T2D remission is a biologically sound strategy for the LAC population, with a high number of registered clinical trials demonstrating local research interest.
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