Percepción de la insulinoterapia en pacientes con diabetes mellitus tipo 2 descontrolada / Perception of insulin therapy in uncontrolled patients with type 2 diabetes mellitus

OBJETIVO: Conocer la percepción de la insulinoterapia en los pacientes con diabetes mellitus tipo 2 descontrolada tratados con hipoglucemiantes orales o con insulina. DISEÑO: Transversal comparativo prospectivo. Emplazamiento: Unidad de Medicina Familiar número 53 de la Delegación Guanajuato del Instituto Mexicano del Seguro Social. PARTICIPANTES: Pacientes de 40 a 80 años afectos de diabetes tipo 2, descontrolados, en tratamiento con insulina o hipoglucemiantes orales. MEDICIONES PRINCIPALES: La percepción se evaluó con la escala de percepción del tratamiento de insulina (Insulin Treatment Appraisal Scale [ITAS]). La calificación de la encuesta es de 20 a 100 puntos, de tal manera que cuanto mayor es la puntuación, mayor es la opinión negativa. RESULTADOS: Se encuestaron 459 pacientes, 261 (56,9%) tratados con hipoglucemiantes orales (HO) y 198 (43,1%) con insulina sola o combinada con hipoglucemiantes orales (IN). La calificación global de la percepción del tratamiento con insulina fue de 56,95 ± 7,78 en el grupo HO y de 49,55 ± 8,89 en el grupo IN (p < 0,001). CONCLUSIONES: La percepción de la insulinoterapia es más negativa en los sujetos que usan hipoglucemiantes orales que en los que usan insulina

OBJECTIVE: To determine the perception of insulin therapy by patients with uncontrolled type 2 diabetes mellitus, who have been treated with oral hypoglycaemic agents or insulin. DESIGN: Prospective comparative cross-sectional study. SETTING: Family Medicine Unit No.53 León, Guanajuato of Mexican Institute of Social Security. PARTICIPANTS: Patients between 40 and 80 years old with uncontrolled type 2 mellitus diabetes, treated with insulin or oral hypoglycaemic agents. MAIN MEASUREMENTS: Perception was assessed using the insulin treatment appraisal scale (ITAS). The rating of the survey is from 20 to 100 points, as such that when score increases the greater is the negative opinion. RESULTS: A sample of 459 diabetes patients were interviewed and split into 2 groups of patients according to their treatment. The OH group were patients treated with oral hypoglycaemic drugs only (56.9%), and the IN group were patients treated with insulin alone or combined with an oral hypoglycaemic (43.1%). Perception score was significantly higher in OH group (56.95 ± 7.78 versus 49.55 ± 8.89 points) than in the IN group (P <.001). CONCLUSIONS: The perception of insulin therapy was worse in patients treated with only oral hypoglycaemic agents than in patients using insulin

[Perception of insulin therapy in uncontrolled patients with type 2 diabetes mellitus]. / Percepción de la insulinoterapia en pacientes con diabetes mellitus tipo 2 descontrolada.

OBJECTIVE: To determine the perception of insulin therapy by patients with uncontrolled type2 diabetes mellitus, who have been treated with oral hypoglycaemic agents or insulin. DESIGN: Prospective comparative cross-sectional study. SETTING: Family Medicine Unit No. 53 León, Guanajuato of Mexican Institute of Social Security. PARTICIPANTS: Patients between 40 and 80years old with uncontrolled type2 mellitus diabetes, treated with insulin or oral hypoglycaemic agents. MAIN MEASUREMENTS: Perception was assessed using the insulin treatment appraisal scale (ITAS). The rating of the survey is from 20 to 100 points, as such that when score increases the greater is the negative opinion. RESULTS: A sample of 459 diabetes patients were interviewed and split into 2 groups of patients according to their treatment. The OH group were patients treated with oral hypoglycaemic drugs only (56.9%), and the IN group were patients treated with insulin alone or combined with an oral hypoglycaemic (43.1%). Perception score was significantly higher in OH group (56.95±7.78 versus 49.55±8.89 points) than in the IN group (P<.001). CONCLUSIONS: The perception of insulin therapy was worse in patients treated with only oral hypoglycaemic agents than in patients using insulin.

[Rehabilitation service in a primary care unit]. / Impacto del servicio de rehabilitación en el primer nivel de artención.

OBJECTIVE: to evaluate the impact of rehabilitation service in two primary care units (PCU). METHODS: a comparative cross-sectional study was performed in two PCU (No. 53 and No. 51). The former has a rehabilitation service and the second one refers to a rehabilitation consultant at a specialized hospital. The variables evaluated were: amount of cases, days of disability, average days/cases, and average cost/case according to specific disease considering the five main medical disease required disability for general or risk work disease. We used descriptive statistics for results and Student's t test to evaluate significance. RESULTS: back pain was the first cause of disablement; the average in opportunity care was seven days. The average number of days disability benefit for hand trauma, ankle sprain, and for back pain was lower in PCU No. 53, as well as for cervical sprain, but slightly higher for knee sprain. Evaluating the global incapacity days average and cost for each case, we found a significant difference to PCU No. 53. CONCLUSIONS: recovery time to return work was faster and lower the average cost in patients from to the PCU No. 53 which has its own rehabilitation service.