4) Finally, the basic molecular mechanism responsible for the success of vaccines must be taken into account: The individual receives a dead or attenuated pathogen and establishes a primary response, free of the expression of virulence and of the pathological conditions that would enable the agent to hurt the tissues. When the infection occurs, the memory cells react rapidly eliminating the aggressive agent [9-14].
There was a significant increase in the prevalence of diabetes from 1994 to 2006 with rising direct costs (2006: outpatient USD$ 717,764,787, inpatient USD$ 223,581,099) and indirect costs (2005: USD$ 177,220,390), and rising costs of complications (2010: Retinopathy USD$ 10,323,421; Cardiovascular disease USD$ 12,843,134; Nephropathy USD$ 81,814,501; Neuropathy USD$ 2,760,271; Peripheral vascular disease USD$ 2,042,601). The health policy focused on screening and the creation of self-support groups across the country.
Although there have been some efforts to develop a national registry of diabetes, this has not been accomplished yet. The prevalence of diabetes and other diseases at the national, regional and state level have been obtained from diverse national surveys (the National Chronic Disease Survey 1994, the National Nutrition Survey II and National Health Survey 2000) which recently have been consolidated into the Mexican National Nutrition Survey (ENSANUT 2006 and 2012) collected every six years. A representative subsample of fasting serum, blood sugar, blood lipids, and other biochemical indicators  is obtained from participants 20-years and older. These surveys also collect HbA1c from participants that have been previously diagnosed to evaluate control. It also has a section on access to health services. Data on expenditure on medications for diabetes, high blood pressure and obesity and treatments is collected by the National Income and Expenditure Surveys every two years in Mexico by INEGI . Incidence data has been collected from diverse cohorts such as the Mexico City diabetes study, but how representative it is of the entire country is uncertain . Overall, the health statistical system in Mexico has been recognized as one of high quality, mostly due to the Mexican Health and Nutrition Survey. However, as in many other countries, incidence information is scarce .
There are different sets of guidelines and norms in Mexico, however recently an attempt to unify criteria has been made. The NOM (Mexican Official Norm) NOM-015-SSA2-1994 described the general treatment for diabetes in medical practice. A new norm has been released with more updated criteria in 2010 (NOM-015-SSA2-2010). The UNEMES-Crónicas (previously described), have protocols for interdisciplinary treatment of diabetes mellitus and other diseases . IMSS, ISSSTE and other public health services have their own guidelines. There is also consensus in publications from medical societies promoting recommendations for DM treatment as well as position papers [39, 40]. 2b1af7f3a8