Background:Georgia belongs to low-middle-income country where rates of not only rural, but urban diabetes are not yet documented.Around 414.7 USD are spent per person with/per year. Though existing data indicate, that diabetes urban, as well as rural prevalence should be high and increasing. Rural population in Georgia is 1 591 181 million (46%)g.Absence of data on rural diabetes prevalence induced Georgia Red Cross Society(GRCS) to address Georgian Union of Diabetes and Endocrine Associations (GUDEAS) for co-operation. A  Project aimed at “Diabetes Prevention in Rural Georgia”was fulfilled in 2014-2016. Methods: The Project was carried out in Gardabani, a rural region inhabited by Georgian and Azeri population(86% rural population, 52% Azeri population, 50% of people live in extreme poverty) . This area was selected as for local population it is time consuming and quite difficult to get to nearest centers where they can receive adequate medical/diabetes care,quality of locally provided care  (at the ambulatories and out-patient departments), healthcare providers (HCPs) knowledge on diabetes diagnosis, management, screening and prevention, and public awareness on diabetes and its risk factors among the local population and are  very low. At the moment of the Project initiation there were 94 registered cases of adult diabetes (type 2 diabetes).Very often diabetes stays undiagnosed for a long time and at the moment of diagnosis a number of complications are already present. It was planned to train 210 volunteers, 25 master trainers, 70 general practitioners (GPs), 70 endocrinologists, 110 nurses, 210 paramedics; screen 12.000 people at-risk; diagnose800 new cases;  increase awareness on diabetes and its risk factors in 50.000 people. Results: In total 73 local doctors, 110 nurses, working at the rural medical settings, including ambulatories, 216 paramedics, 50 master trainers and 216 volunteers were trained. Throughout 2014 two 3-day trainings for HCPs were carried out, the 3-rd training was carried out in 2015. HCPs received latest information on screening, prevention, diagnosis, management of diabetes and its complications and patient education, and were trained in carrying out screening and prevention interventions. Diabetes awareness campaigns were organized, they enrolled 62 037, including 469 teachers, 2 585 young people under the age of 25 (school children and students), 3 619 parents (of school and kindergarten students). In total 197 screening visits of a mobile unit were carried out, 13 614 persons were screened (6 172 - in 21 villages without Public Health Unit,  and 7 442  - in 19 villages with Public Health Unit); 1468 new cases of diabeteswere registered in the project period and in the target area. All these people  were sent to specialized Centers for  proper management. Besides, 45 self-support groups, that unite 1042 persons with diabetes and their carers; 10 Walk and Talk Clubs; 10 Cooking Clubs and 22 Information and Education Centers were founded  Conclusion: It is of utmost importance to have HCPs that can not only provide adequate support, but increase public awareness in all age groups, unite people with diabetes and their carers and those at risk of diabetes, and  collectreal data on the prevalence and incidence of diabetes and impaired glucose tolerance in rural communities. Implementation of this and other Projects will permit to  provide culturally appropriate education and increase public awareness among people with diabetes and those at risk, obtain reliable data on diabetes prevalence, increase access to diabetes care and improve the quality of care provided.

Diabetes prevention in rural Georgia: joint project, Georgian Red Cross and Union of Diabetes and Endocrine Associations