ABSTRACT
Background: Information regarding diagnosis, treatment, and follow-up of patients with type 1 diabetes (PWT1D) in Mexico is limited. We developed an on-line platform Registro Nacional de Pacientes con Diabetes Tipo 1 (RENACED-DT1). Objective: The objective of the study was to describe the characteristics and healthcare of PWT1D registered in RENACED-DT1. Methods: Analyses of 965 PWT1D from July 2014 to January 2018 in different endocrinology clinics around Mexico. Results: Sixty-one percent were female with median age of 21 years, age at diagnosis 11 years, and disease duration at inclusion 8.2 years. Treatment regimen was basal-bolus in 61% and insulin-pumps in 21% (mainly in the private sector); 33.3% with self-monitoring of blood-glucose (SMBG) ≥4 times/day. Mean HbA1c at last follow-up was 8.7 ± 2.1% (72±23 mmol/mol), 18% had HbA1c < 7% (53 mmol/mol), and 35% > 9% (75 mmol/mol). SMBG ≥ 4 times/day was associated with HbA1c < 7%. Time since diagnosis > 10 years, female sex, BMI ≥ 30 kg/m2, SMBG < 4 times/day, and any hypoglycemia were associated with microvascular complications (p < 0.05). Conclusions: Percentage of patients achieving HbA1c < 7% is low; increased blood glucose monitoring is associated with better glycemic control. The achievement of optimal glycemic control must be increased to reduce the incidence of chronic complications and improve quality of life in PWT1D.
Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 1/epidemiology , Quality of Life , Blood Glucose , Glycated Hemoglobin/analysis , Blood Glucose Self-Monitoring , Registries , Hypoglycemic Agents , Insulin , Mexico/epidemiologyABSTRACT
La osteítis del pubis es una rara enfermedad que afecta el pubis y sus ramas apareciendo como complicación post-operatoria en cirugía abdominal infraumbilical, característicamente luego de prostatectomía transvesical. Clínicamente se presenta con dolor en la región pubiana que aparece 7 a 20 días después de la intervención, presencia de flogosis local y más raramente fístula urinaria. Se acompaña de deterioro del estado general y fiebre. Presentamos un paciente de 60 años que evolucionó como un síndrome febril prolongado durante 5 meses, a quien se le diagnosticó osteítis pubiana con la aparición tardía de signos clínicos, radiográficos y centellográficos compatibles. Se confirmó el diagnóstico por una biopsia por punción del pubis cuyo cultivo fue negativo. Ante la refractariedad a los tratamientos instituidos (antibióticos, reposo, yeso pervipédico, antiinflamatorios no esteroideos) se inició anticoagulación con heparinato de calcio subcutáneo, siendo muy buena la respuesta al mismo