[Effectiveness of PRECEDE model for health education in metabolic control and reduction of cardiovascular risk factors in patients with diabetes type 2]. / Eficacia del modelo PRECEDE, de educación para la salud, en el control metabólico y de los factores de riesgo cardiovascular en pacientes con diabetes mellitus tipo 2.

OBJECTIVE: To evaluate the effectiveness of PRECEDE model for health education, in the metabolic control and the reduction of cardiovascular risk factors, in type 2 diabetic patients followed for over two years in primary health care services. MATERIALS AND METHODS: PRECEDE model for health education was used in 318 patients with type 2 diabetes, from five primary health care centres. The study was conducted during two years of monitoring. RESULTS: After two years of follow-up was observed decrease in diastolic and systolic pressures (p < 0.05), as well as in levels of total cholesterol and LDL-cholesterol (p < 0.05). Patients with good metabolic control (glycated hemoglobin A1c < 7% and LDL cholesterol < 100 mg/dl), increased from 9.9% to 16.8% (p < 0,05). On the other hand, 27% of patients improved their level of therapeutic adherence, and there was a decreased in the number of patients with microalbuminuria from 8.4% to 6.3% (p = 0.05). Finally, we found no differences in levels of glycated hemoglobin A1c, BMI and cardiovascular risk. Mortality after two years was 0.7%. DISCUSSION: PRECEDE model for health education is a useful method in the management of type 2 diabetes, that reduce the levels of blood pressure both systolic and diastolic, decrease the lipid levels, and improve the level of therapeutic adherence in type 2 diabetic patients, followed for two years.

Eficacia del modelo PRECEDE, de educación para la salud, en el control metabólico y de los factores de riesgo cardiovascular en pacientes con diabetes mellitus tipo 2 / Effectiveness of PRECEDE model for health education in metabolic control and reduction of cardiovascular risk factors in patients with diabetes type 2

Objetivo: Evaluar el modelo PRECEDE como educación diabetológica, a medio (un año) y largo plazo (dos años), valorando los cambios en el riesgo cardiovascular (RCV) y en los factores de riesgo cardiovasculares de mayor importancia en los pacientes con diabetes tipo 2 (hipertensión arterial, obesidad y lípidos), respecto a los valores iniciales previos a la intervención educativa. Material y métodos: La población a estudiar se compuso de un total de 318 pacientes diagnosticados de diabetes tipo 2, a los que se sometió a una educación diabetológica mediante el modelo PRECEDE. El estudio se llevó a cabo durante dos años de seguimiento. Resultados: Al final de los dos años de seguimiento se observó la disminución de la tensión arterial diastólica (TAD) y la tensión arterial sistólica (TAS) (p < 0,05), así como de los niveles de colesterol total y colesterol LDL (p < 0,05). Los pacientes con buen control metabólico global (hemoglobina glucosilada A1c (HbA1c) < 7% y colesterol LDL < 100 mg/dl), aumentaron del 9,9 al 16,8% (p < 0,05), y un 27% de los pacientes mejoraron el nivel de cumplimiento terapéutico. Por otro lado, disminuyó el número de pacientes con microalbuminuria del 8,4 al 6,3% (p = 0,05). No se encontraron diferencias en los niveles de HbA1c, el índice de masa corporal (IMC) y el RCV. La mortalidad a los dos años fue del 0,7%. Discusión: La educación diabetológica basada en el modelo PRECEDE es un método útil en el tratamiento integral del paciente con diabetes tipo 2, al contribuir a disminuir los niveles de la tensión arterial tanto sistólica como diastólica y mejorar el perfil lipídico y el diferencial positivo entre los pacientes que incrementan su nivel de cumplimiento terapéutico y el de los que lo empeoran (AU)

Objective. To evaluate the effectiveness of PRECEDE model for health education, in themetabolic control and the reduction of cardiovascular risk factors, in type 2 diabeticpatients followed for over two years in primary health care services.Materials and methods. PRECEDE model for health education was used in 318 patientswith type 2 diabetes, from fi ve primary health care centres. The study was conductedduring two years of monitoring.Results. After two years of follow-up was observed decrease in diastolic and systolicpressures (p < 0.05), as well as in levels of total cholesterol and LDL-cholesterol (p <0.05). Patients with good metabolic control (glycated hemoglobin A1c < 7% and LDLcholesterol < 100 mg/dl), increased from 9.9% to 16.8% (p < 0,05). On the other hand,27% of patients improved their level of therapeutic adherence, and there was a decreasedin the number of patients with microalbuminuria from 8.4% to 6.3% (p = 0.05). Finally, wefound no differences in levels of glycated hemoglobin A1c, BMI and cardiovascular risk.Mortality after two years was 0.7%.Discussion. PRECEDE model for health education is a useful method in the managementof type 2 diabetes, that reduce the levels of blood pressure both systolic and diastolic,decrease the lipid levels, and improve the level of therapeutic adherence in type 2diabetic patients, followed for two years(AU)