Scaling-up of and evidence-based intervention programme in older people with Diabetes and Frailty in LatinAmerica

Project Information

DIABFRAIL-LATAM

Grant agreement ID: 825546

DOI

10.3030/825546

Project closed

EC signature date 3 December 2018

Start date 1 January 2019

End date 31 December 2024

Funded under

• SOCIETAL CHALLENGES - Health, demographic change and well-being

Total cost

€ 3 991 925,00

EU contribution

€ 3 891 925,00

Coordinated by

CONSORCIO CENTRO DE INVESTIGACION BIOMEDICA EN RED M.P.
Spain

Periodic Reporting for period 4 - DIABFRAIL-LATAM (Scaling-up of and evidence-based intervention programme in older people with Diabetes and Frailty in LatinAmerica)

Reporting period: 2023-07-01 to 2024-12-31

Summary of the context and overall objectives of the project

Diabetes is a high prevalence disorder in ageing populations (20% in people ≥ 65 yrs) with a chronic disease time-course and is associated with considerable medical co-morbidity, functional decrease and frailty, visual and lower limb disability, multiple medication usage and impaired quality of life and results in a high personal and social health burden, and a significant public health burden.
Stemming from the results of three EU-funded projects (MIDFRAIL, FRAILOMIC and VIVIFRAIL), DIABFRAIL-LATAM intends to make a scaling up of a multimodal intervention in older people with diabetes very vulnerable because of their frailty status. The project will take place in 4 Latin-American countries and the scaling up in different settings of care.
The primary outcome consists in the changes in function and quality of life as measured by changes in the scores used to assess them between baseline and 1-year follow-up. Function will be assessed by the Short Physical Performance Battery-SPPB.
This study is focused on an older population (≥ 65 years) with diabetes and a frail or prefrail status.
Diabfrail Latam initiative is original (never previously studied; both the intervention, the outcomes and the settings are unique for studies in diabetes), relevant (it addresses a topic of interest for around 30% of people with diabetes, that is the old frail and pre-frail people with diabetes), pertinent (it is focused on function, that is the main component of quality of life and the most important outcome in this population) and feasible (it will be carried out by senior researchers with previous relevant contributions in the fields of frailty and diabetes and its complications in older people). It will contribute to improve the quality of care in diabetic and frail patients and lees burden to health services

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

DIABFRAIL-LATAM is a multicenter initiative funded by the European Union’s Horizon 2020 Programme, aiming to scale up scientifically validated interventions—specifically, an exercise and education program—for older adults (≥65 years) with diabetes and frailty or pre-frailty in Latin America. The project builds on prior EU-funded research (MIDFRAIL, FRAILOMIC, VIVIFRAIL) and is coordinated by the Spanish Public Biomedical Network Research Center (CIBER) in collaboration with the Pan American Health Organization (PAHO) and academic partners across Latin America and Europe.
Geographic Scope and Participants: Clinical trial for validation of the intervention and implementation activities have taken place in Chile, Colombia, Mexico, and Peru, involving more than 700 older frail and prefrail adults with diabetes.Tailored exercise and education programs were developed, taking into account the specific needs and contexts of each country. All ethical approvals were secured, and necessary equipment (e.g. activity monitors, dynamometers) was distributed to trial sites. Sites were properly activated and monitored during the follow up.
The intervention, combining structured exercise and educational components, has shown positive results in improving functional capacity and quality of life among frail and pre-frail older adults with diabetes.
Improvements were measured using standardized tools such as the Short Physical Performance Battery (SPPB), showing significant functional gains from baseline to one-year follow-up.
The intervention has demonstrated feasibility and acceptability in diverse healthcare settings across the participating countries.
With positive preliminary results the scaling up of the intervention started during the last part of the project, aiming for integration into routine care for older adults with diabetes in Latin America. Diabfrail Latam intervention has been scaled-up to 11 countries in the region.
PAHO is actively leading the expansion, with engagement from national and regional offices to support country-level implementation.
Training sessions and workshops were held for healthcare professionals in participating countries to ensure standardized delivery of the intervention. The project has fostered collaboration among universities, hospitals, public health organizations, and NGOs, enhancing regional capacity for managing diabetes and frailty in older adults.
DIABFRAIL-LATAM addresses a critical gap, as approximately 30% of people with diabetes in Latin America are older and frail or pre-frail.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

DIABFRAIL-LATAM multimodal intervention—combining exercise, education, nutrition, and personalized therapeutic targets—has led to significant improvements in the quality of life and physical function of older adults with diabetes and frailty or pre-frailty. Participants have incorporated healthier habits, especially regular exercise, which is shown to prevent or delay diabetes complications and functional decline. Participants gain a better understanding of diabetes, its management, and self-care practices. The program teaches them to recognize and manage hypoglycemia, malnutrition, and other complications, fostering greater autonomy and confidence in managing their condition. The intervention helps reduce hospitalizations, disability, and the economic burden on health systems and caregivers. DIABFRAIL-LATAM demonstrates that non-drug strategies (exercise, nutrition, education) are essential in the management of older adults with diabetes, supporting a shift in clinical guidelines and public health policies. The intervention is feasible, effective, and now is being scaled up across multiple Latin American countries, with the support of the Pan American Health Organization (PAHO) and local governments, setting a precedent for regional collaboration in chronic disease management. Its methodology, based on WHO and EU recommendations, ensures that the intervention can be adapted and expanded to diverse health systems. DIABFRAIL-LATAM supports global and regional strategies for healthy aging and chronic disease control, aligning with the goals of the Global Alliance for Chronic Diseases, PAHO, WHO, and the European Commission

Dissemination event at Santa Marta, Colombia

Project coordinator at training Chile

Training session Chile

Project team Training Chile

Project team Bucaramanga

Final meeting in MAdrid_Dec 2024

Project meeting Washington

Dr Viña at dissemination event at Santa Marta, Colombia

Training session Colombia

Project Coordinator at dissemination event at Santa Marta, Colombia

Project team Training Colombia

Washington_PAHO