Transculturalization Recommendations For Developing Latin American Clinical Practice Algorithms In Endocrinology Proceedings Of The 2015 Pan-American Workshop By The American Association Of Clinical Endocrinologists And American College Of Endocrinology |
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| Institution: | 1. From the Clinical Professor of Medicine Director, Metabolic Support Division of Endocrinology, Diabetes, and Bone Disease Icahn School of Medicine at Mount Sinai, New York, NY;2. Co-Director Memorial Center for Integrative Endocrine Surgery Hollywood, FL;3. Professor of Medicine University of Puerto Rico School of Medicine, Director Endocrinology Section University Hospital San Juan Puerto Rico, President AACE Puerto Rico Chapter, San Juan, Puerto Rico;4. Medical Director, Instituto Salvadoreño del Corazón, Unidad Diagnóstica de Osteoporosis, San Salvador, El Salvador;5. Internal Medicine and Endocrinology, Education Program Director in Diabetes and Risk Factors, Thyroid and Diabetes Clinical Management Director, Hospital Bendaña, Honduras, CA;6. Scientific Director, Colombian Diabetes Association, Professor Endocrinology and Clinical Epidemiology, Javeriana University and San Ignacio University Hospital, Bogotá;, Colombia;7. Professor of Medicine, Loyola University Medical Center, Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Maywood, IL;8. Clinical Professor of Internal, Medicine Division of Internal Medicine, Hospital General “Dr. Manuel Gea González” México City, Mexico;9. Division of Endocrinology, Hospital Cima Director of San Agustin Research Center San José, Costa Rica;10. Catholic University of Rio de Janeiro, State Institute of Diabetes and Endocrinology;11. Clinical Professor of Medicine, Touchstone Diabetes Center, The University of Texas Southwestern Medical Center Dallas, TX;12. Endocrine Division, Harvard Vanguard Medical Associates, Division of Endocrinology, Beth Israel Deaconess Medical Center Boston, MA;13. Department of Nutrition Sciences and the UAB Diabetes Research Center, University of Alabama at Birmingham, and The Birmingham Veterans Affairs Medical Center Birmingham, AL;14. Professor, Faculty of Medicine, UANL: Nutrition, Endocrinology, Internal Medicine, Education Coordinator Endocrinology Service, Hospital Universitario, UANL, Head of the Diabetes Clinic of the Hospital Universitario “Dr. José E. González” UANL, Regional Hospital endocrinologist ISSSTE Monterrey, Policy Coordinating Group for Treatment of Diabetes in the Official Mexican Standar State Program Coordinator for Healthy Eating and Physical Activity Monterrey, Nuevo Leon, Mexico;15. Internal Medicine and Endocrinology Hospital Alemá;n Nicaraguense Hospital Metropolitano Vivian Pellas, Professor Endocrinology and Internal Medicine Universidad Nacional Autónoma de Nicaragua Managua, Nicaragua;16. Medical Director, Obesity Clinical Program, Director of Inpatient Diabetes Program, Joslin Diabetes Center, Harvard Medical School Boston, MA;17. Medical Director & Principal Investigator, Metabolic Institute of America Tarzana, CA;18. President Costa Rican Association of Endocrinologists (ANPEDEM), Professor Endocrinology and Internal Medicine, University of Costa Rica Coordinator Endocrinology Department, Hospital San Vicente de Paul, Costa Rica;19. Medical Director, Thyroid & Endocrine Center of Florida Assistant Clinical Professor, Florida State University College of Medicine, Sarasota, FL;20. Full Professor of Biochemistry and Nutrition, Dean School of Medicine, University of Panama, Panama;21. Professor of Medicine, Dean Post Graduate Studies, Universidad de Ciencias Médicas Head of the Division of Endocrinology Hospital CIMA, Escasu, San Jose, Costa Rica;22. Consultant in Endocrinology Medical Director, Endocrine, Diabetes & Osteoporosis Clinic (EDOC), Sterling, VA.;1. From the Endocrine Institute, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel;2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;3. Endocrine Institute, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel;4. Endocrinology Clinic, Division of Maternal and Fetal Medicine, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel;5. Endocrine Institute, Meir Medical Center, Kfar Saba, Israel. |
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| Abstract: | The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) convened their first Workshop for recommendations to optimize Clinical Practice Algorithm (CPA) development for Latin America (LA) in diabetes (focusing on glycemic control), obesity (focusing on weight loss), thyroid (focusing on thyroid nodule diagnostics), and bone (focusing on postmenopausal osteoporosis) on February 28, 2015, in San Jose, Costa Rica. A standardized methodology is presented incorporating various transculturalization factors: resource availability (including imaging equipment and approved pharmaceuticals), health care professional and patient preferences, lifestyle variables, socio-economic parameters, web-based global accessibility, electronic implementation, and need for validation protocols. A standardized CPA template with node-specific recommendations to assist the local transculturalization process is provided. Participants unanimously agreed on the following five overarching principles for LA: (1) there is only one level of optimal endocrine care, (2) hemoglobin A1C should be utilized at every level of diabetes care, (3) nutrition education and increased pharmaceutical options are necessary to optimize the obesity care model, (4) quality neck ultrasound must be part of an optimal thyroid nodule care model, and (5) more scientific evidence is needed on osteoporosis prevalence and cost to justify intervention by governmental health care authorities. This 2015 AACE/ACE Workshop marks the beginning of a structured activity that assists local experts in creating culturally sensitive, evidence-based, and easy-to-implement tools for optimizing endocrine care on a global scale.Abbreviations:A1C = glycated hemoglobinAACE = American Association of Clinical EndocrinologistsACE = American College of EndocrinologyBG = blood glucoseBMI = body mass indexCPA = Clinical Practice AlgorithmCPG = Clinical Practice GuidelineCVD = cardiovascular diseaseDXA = dual-energy X-ray absorptiometryEDC = endocrine-disrupting compoundFBG = fasting blood glucoseFNA = fine-needle aspirationHCP = health care professionalLA = Latin AmericaPAACE = Pan-American AACESU = sulfonylureaT2D = type 2 diabetestDNA = transcultural Diabetes Nutrition AlgorithmTSH = thyroid-stimulating hormoneWC = waist circumferenceWHO = World Health Organization |
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