Guyana faces a growing burden of diabetes. According to the Pan American Health Organization, Guyana has the highest age-standardized death rate from diabetes in the Americas. As of 2020, there was a prevalence rate of 18% amongst their total population of 826,000 individuals. This can be attributed in part to the nation’s unique ethnic, cultural, and geographic makeup. Other factors include the wide variation of resource allocation and healthcare accessibility, which create disparities across different localities and regions. Currently, the in-country healthcare system is not well-equipped to manage diabetes to this degree. Previously developed treatment guidelines were instated with the support of U.S-based health organizations, but did not effectively incorporate the input of in-country primary care clinicians. As such, the algorithm did not reflect the reality of the clinical setting or the Guyanese patient population. For example, the treatment decision pathway did not reflect the disproportionate impact of diabetes on female patients, or the limited availability of certain medications in Guyana.

The state of diabetes care prior to our current initiative necessitated tailored guidelines for effective screening, diagnosis, and management of diabetes. The Family Medicine Service Line at Northwell Health, in collaboration with the Family Medicine Residency Program at the Georgetown Public Hospital in Guyana, sought to update and improve the guidelines for early detection and management of diabetes among the Guyanese population. Paramount to this co-development process was the lived experience of in-country clinicians. By forging close partnerships and encouraging them to lead these efforts, new guidelines were created to better suit the nation’s diabetes profile. Revisions included expanded screening criteria, the addition of culturally appropriate lifestyle changes, and re-designation of first and second-line treatments based on the accessibility of those medications. These new guidelines have been accepted by the Guyana Minister of Health for national adoption, with the goal of enhancing community health and quality of care across the country.