New diabetes treatments: What do we have and how do we have access to them in Latin America?

Abstract

The Argentine Diabetes Society, along with other societies and associations of people with diabetes mellitus (DM), has worked diligently to update the "Standards for the Provision of Medications and Supplies for People with DM," incorporating pharmacological and technological advances through Ministerial Resolution 2091/25. These standards are based on current scientific evidence, including systematic reviews and randomized clinical trials. The main objective of these standards is to guarantee people with DM full access to pharmacological treatments and devices for managing their prescribed treatment. They cover people with type 1 and type 2 DM, as well as special situations such as pregnant women with DM. The standards stipulate that social security organizations, private health insurance companies, and public entities must guarantee 100% coverage for:

• Human insulins and rapid- and long-acting analogues.
• Continuous subcutaneous insulin infusion (CSI) devices.
• Continuous glucose monitoring systems (CGM, CGM-i, CGM-tr).
• Syringes, needles, test strips, lancets, and glucagon.
• Oral antidiabetic medications, such as metformin, DPP-4 inhibitors, and SGLT2 inhibitors (empagliflozin, dapagliflozin), for individuals with cardiovascular events or chronic kidney disease.
• The resolution includes education for self-management, specifying the educator's profile and the content to be covered.

These services are incorporated into the Mandatory Medical Program (PMO) to ensure that all healthcare providers comply with the regulations, promoting equity and continuity of treatment.

Despite this significant progress, there are differences in implementation and compliance. Many oral antidiabetic medications are covered at 70%, and significant bureaucracy creates a barrier to access for individuals. Furthermore, the 24 provincial social security organizations apply different criteria and must adhere to this regulation. The current economic crisis has led many private health insurance members to switch to the public healthcare system, straining provincial budgets. It is the task of scientific societies and people with diabetes to continue advocating for equitable universal coverage in order to reduce diabetes complications and improve quality of life.