INTEGRATION OF ENVIRONMENTAL PREVENTIVE TECHNOLOGIES INTO REGIONALIZED DIABETES CARE

Abstract

Background: Type 2 diabetes mellitus (T2DM) represents a significant global health challenge, with its prevalence continuing to rise and placing an immense burden on healthcare systems worldwide. In Uzbekistan, the growing burden of T2DM and its associated complications necessitates the development of effective regionalized care models that improve both quality and accessibility of medical services.

Objective: This research aims to improve medical care for patients with complications of type 2 diabetes mellitus through the evaluation of existing organizational frameworks, the development and implementation of an optimal integrated regionalization (patient routing) model to reduce the burden on primary healthcare, and the integration of preventive medical technologies.

Methods: A prospective interventional study was conducted at the clinics of Tashkent State Medical University from January 2023 to December 2024, encompassing 15 regional healthcare facilities and 1,247 patients with T2DM and various complications. The study implemented a comprehensive regional care organization model including the establishment of specialized regional diabetes centers, standardized referral protocols, telemedicine support networks, mobile specialist teams, integrated laboratory services, and environmental health monitoring for endocrine-disrupting chemicals.

Results: Implementation of the regional assistance program demonstrated significant improvements: early detection of complications increased by 58% (p<0.01), time to specialist consultation reduced from 42 to 11 days, hospital admission rates decreased by 31.6% (p<0.05), progression of nephropathy reduced by 35%, and patient satisfaction scores improved by 67%. The integration of GC-MS/MS screening for pesticide residues revealed detectable levels of chlorpyrifos and dimethoate in 23.4% of vegetable samples, with associated metabolic disturbances in exposed populations.

Conclusion: Structured regional assistance programs significantly improve the management of T2DM complications. The integration of preventive technologies, including environmental health monitoring for diabetogenic endocrine disruptors, provides a comprehensive approach to reducing the burden of T2DM and its complications in Uzbekistan.