Bridging The Gap, A Comparison of Factors Preventing Control of Diabetes in Low-Income Settings of the USA and Guatemala

The aim of this study is to evaluate the type II diabetes status and health beliefs of individuals living in villages in Northeast Guatemala, and compare them to the same parameters in a free medical clinic in a resource poor area of Toledo Ohio. This was done with anonymous survey data, except in except in situations of illiteracy when the surveys were administered by a healthcare worker fluent in the patient’s native language. By comparing data from 21 diabetics in Petén, Guatemala to 34 diabetics in Toledo, Ohio, we combined their responses to determine areas of emphasis for medical mission work compared to humanitarian efforts in urban America. In Toledo, the three largest barriers were lack of ambition to treat a disease with no current symptoms, lack of eagerness to comply with chronic treatment, and lack of feelings of control over their disease/ mistrust of the medical system. In Guatemala, the biggest detriments to successful diabetic management was lack of access to healthcare resources, and a lack of education of the pathogenesis of diabetes and its potential complications. In Petén, the individual’s claimed to have trust in their medical system and in foreign aid from medical missionaries, however this may be overreported since many of the surveys conducted in Guatemala were not anonymous due to illiteracy of many of the patients. In America, the largest area of emphasis is to create a therapeutic alliance with the patients and establishing their intrinsic locus of control. In Guatemala, medication supply, and delivering education to individuals, concerning their diabetes is necessary to implement lifestyle changes and help manage the disease.

Keywords: Diabetes, Guatemala, Petén, Access, Ambition, Eagerness, Education, Compliance, Control, Culture, Low-income, Medical Missions, Health Education.