2010, Number 4
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Med Int Mex 2010; 26 (4)
Glycated hemoglobin in 1,152 subjects with diabetes, who participated in the strategy UNEME Health Tours in Mexico in 2009
Lezana FMÁ, Álvarez LCH, Álvarez MEM, Velázquez A, Ortiz SG, Dávila LGY, Lara EA
Language: Spanish
References: 20
Page: 337-345
PDF size: 356.46 Kb.
ABSTRACT
Background: Today, Mexico faces a complex situation of public health diseases still suffer from underdevelopment, such as those associated with infectious diseases and malnutrition while facing challenges from advanced countries, such as cancer, obesity, heart disease and diabetes. Diabetes is a disease of high prevalence in our country and is undoubtedly the biggest challenge facing the national health system. Besides being the leading cause of death, is the leading cause of demand for outpatient care, a major hospital and the disease that consumes the largest share of spending of our public institutions (about 20%). One in five diabetics (19.6%) identified through the ENSANUT 2006 had figures of less than 8% of glycosylated hemoglobin (HbA1c), 40.0% ranged between 8 and 12%, and the remainder (40.4) showed levels greater than 12%, reflecting a coverage of 20% control in the country, much lower than desired.
Material and Methods: Observational, transversal and descriptive random sample. Diabetic patients were identified to attend the “Tour of Your Health” whom HbA1c was measured during the period from January 1 to December 31, 2009 and analyzed with the statistical package with a confidence level of 95%.
Results: 1.152 persons were studied: 73% female and 27% male, with a ratio of 3:1, respectively. There was an average of 55.6 years, median and mode of approximately 56 years, with standard deviation of 13.1423091. We found that people with percentages less than or equal to 7% recommended by the ADA as appropriate, corresponding to 484 people (42%) compared with 668 individuals (58%) with concentrations greater than 7%. There was an arithmetic mean HbA1c of 8.1% with a standard deviation of 2.44299135, a mode of 5.9% and a median of 7.6%.
Conclusions: The main method by which clinicians have to relate the individual control of blood glucose with the risk of complications is the measurement of HbA1c.
REFERENCES
Programa Nacional de Salud 2007-2012 por un México sano: construyendo alianzas para una mejor salud. 1ª ed. México: Secretaría de Salud, 2007.
Villalpando S, et al. Prevalence and distribution of type 2 Diabetes mellitus in Mexican adult population. A probabilistic survey. En prensa: Revista de Salud Publica de México.
Programa de Acción Específico 2007-2012 Diabetes Mellitus. 1a ed. México: Secretaría de Salud, 2008.
Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, y col. ENSANUT 2006. Cuernavaca: Instituto Nacional de Salud Pública, 2006.
Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (adult treatment panel III) JAMA 2001;285:2486-2497.
Landon B, Hicks LRS, O’Malley AJ, Lieu T, et al. Improving the management of chronic disease at community health centers. N Engl J Med 2007;356:921-934.
Renders CM, Valk GD, Griffin S, Wagner EH, et al. Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Cochrane Database of Systematic Reviews 2000; Issue 4. Art No. CD001481.
Shultz EK, Nazareth I, Donegan C, Haines A. Evaluation of general practice computer templates: lessons from a pilot randomized controlled trial. Method Inf Med 1999;38:177-181.
Marrero DG, Vandagriff JL, Kronz K, Fineberg NS, et al. Using telecommunication technology to manage children with diabetes: The Computer-linked outpatient clinic (CLOC) study. Diabetes Educ 1995;21:313-319.
Renders CM, Valk G, Griffin S, Wagner E, et al. Interventions to improve the management of diabetes in primary care, outpatient, and community settings. Diabetes Care 2001;24:1821- 1833.
Rendición de Cuentas en Salud 2008. 1a ed. México: Secretaría de Salud, 2009.
American Diabetes Association. “Standards of Medical Care in Diabetes 2010”. Diabetes Care 2010;33: Suppl.
Pérez-Pastén L. Educación en el Automanejo de la Diabetes. Guía para el paciente y el educador en diabetes. 4a ed. México, 2008;p:298-299.
International Diabetes Federation. Consultative Section on Diabetes Education. Diabetes Education Modules. Brussels, Belgium, 2007.
International Diabetes Federation. Clinical Guidelines Task Force. Guía Global para la Diabetes tipo 2. Bruselas, Bélgica, 2006.
American Association of Diabetes Educators. Diabetes Education Review Guide. 2th ed. Chicago, Illinois, 2009.
American Association of Clinical Endocrinologists-American College of Endocrinology. Consensus Panel on type 2 Diabetes Mellitus: An Algorithm for Glycemic Control. Endocrine Practice 2009;15(6).
Organización Panamericana de la Salud. “Guías de la Asociación Latinoamericana de Diabetes (ALAD) de diagnóstico, control y tratamiento de Diabetes Mellitus tipo 2”. Washington, 2008.
Canadian Diabetes Association. Clinical Practice Guidelines for de Prevention and Management of Diabetes in Canada. Canadian Journal of Diabetes 2008;32(Suppl 1).
Secretaría de Salud. Norma Oficial Mexicana para la Prevención, Tratamiento y Control de la Diabetes Mellitus. NOM. México, 2010.