AACE MENA 2025-Endocrine Practice in Resource Limited Settings

Video Transcription

Video Summary

The speaker discusses challenges and opportunities for endocrinology practice in resource-limited settings, emphasizing that “resource limitation” is not only about cost, but also access and quality. Drawing on experience in Pakistan and multiple US practice environments, they show how insurance design, clinic policies (e.g., not accepting Medicaid), and profit-driven systems can restrict access even in high-income countries, while some medications may be cheaper and more obtainable in lower-income settings.<br /><br />Using a type 2 diabetes case, they contrast guideline-preferred therapies (SGLT2 inhibitors/GLP-1s) with what patients can actually obtain, highlighting dramatic price differences between Pakistan and the US. A thyroid cancer case illustrates another limitation: inability to afford thyrogen leading to levothyroxine withdrawal before radioactive iodine, compromising quality of life though outcomes can still be good.<br /><br />Universal challenges include medication shortages, lack of specialists, and uneven geographic access. Opportunities include advocacy and legislation (e.g., insulin access initiatives), adapting international guidelines to local realities (“adolopment”), and leveraging telehealth, CGM data-sharing, low-tech tools, and AI to identify risk, improve communication, detect bias, and expand trial diversity. The talk concludes that equity requires combining evidence with practical implementation, aided by advocacy and technology.

Keywords

endocrinology resource-limited settings

healthcare access and equity

type 2 diabetes medication affordability

SGLT2 inhibitors and GLP-1 receptor agonists

thyroid cancer radioactive iodine preparation

guideline adolopment (adaptation)

telehealth CGM and AI in endocrinology