The impact of the humanitarian crisis in Venezuela on care for noncommunicable diseases (NCDs) such as diabetes is unknown. This study aims to document health system performance for diabetes management in Venezuela during the humanitarian crisis. This longitudinal study on NCDs is nationally representative at baseline (2014-2017) and has follow-up (2018-2020) data on 35% of participants. Separate analyses of the baseline population with diabetes (n = 585) and the longitudinal population with diabetes (n = 210) were conducted. Baseline analyses constructed a weighted care continuum: all diabetes; diagnosed; treated; achieved glycaemic control; achieved blood pressure, cholesterol, and glycaemic control; and achieved aforementioned control plus non-smoking. Weighted multinomial regression models controlling for region were used to estimate the association between socio-demographic characteristics and care continuum stage. Longitudinal analyses constructed an unweighted care continuum: all diabetes; diagnosed; treated; and achieved glycaemic control. Unweighted multinomial regression models controlling for region were used to estimate the association between socio-demographic characteristics and changes in care continuum stage. Among 585 participants with diabetes at baseline, 71% were diagnosed, 51% were on treatment, and 32% had achieved glycaemic control. Among 210 participants with diabetes in the longitudinal population, 50 (24%) participants' diabetes management worsened, while 40 (19%) participants improved. Specifically, the proportion of those treated decreased (60% in 2014-2017 to 51% in 2018-2020), while the proportion of participants achieving glycaemic control did not change. Although treatment rates have declined substantially among people with diabetes in Venezuela, management changed less than expected during the crisis.

Department of Global Health and Population and Epidemiology Harvard T H Chan School of Public Health Boston Massachusetts United States of America

Department of Nutrition Harvard T H Chan School of Public Health Boston Massachusetts United States of America

Foundation for Clinic Public Health and Epidemiology Research of Venezuela Caracas Venezuela

Global Academy of Agriculture and Food Systems The University of Edinburgh Midlothian United Kingdom

Institute of Applied Health Research University of Birmingham Birmingham United Kingdom

International Clinical Research Center St Ann's University Hospital Brno Czech Republic

Precision Care Clinic Corp Saint Cloud Florida United States of America

Public Health Research Unit Department of Social and Preventive Medicine School of Medicine Universidad Centro Occidental Lisandro Alvarado Barquisimeto Venezuela

Research Department Endocrine Associates of Florida Orlando Florida United States of America

Venezuelan Society of Internal Medicine Caracas Venezuela

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