ABSTRACT
OBJECTIVES: To find the prevalence of diabetes mellitus (DM) and disturbed basal glucaemia in the population over 24 years old and the relationship of this to factors of risk of becoming diabetic. DESIGN: Descriptive, cross-sectional population study. SETTING: Community, county (Baix Ebre-Montsià-Terra Alta) and primary care (9 health districts) context. PATIENTS: Inhabitants of the three most southerly counties of Catalonia over 24 years old (106,551 out of 132,938). INTERVENTIONS: We randomised from the data base of the computer service of the Catalan Institute of Health (100% coverage), for an estimated prevalence of 15%, losses of 20%, 95% CI and +/- 5% accuracy, a sample of 245 people (we studied 198). We informed each doctor of his/her patients in the study. If the patient was diabetic, his/her doctor filled out a questionnaire; if not, the doctor also requested from the laboratory two glucaemia analyses taken after fasting. MEASUREMENTS AND MAIN RESULTS: Using the diagnostic criteria and screening methods of the ADA-1997, we obtained the following results: 1. 14.1% prevalence of DM (1.5% new diagnoses); 4% prevalence of disturbed basal glucaemia. 2. Likelihood of diabetes: age > 45 (4.7 times greater); triglyceridaemia > 250 mg/dl (4.5 times greater); BMI > 27 (2.9 times). CONCLUSIONS: High prevalence of DM, with high proportion known through primary care. We know the prevalence of disturbed basal glucaemia. DM-related risk factors in our population were: age > 45, BMI > 27 and hyper-triglyceridaemia. Our primary care focus can better manage the resources dedicated to DM.
Subject(s)
Diabetes Mellitus/epidemiology , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Risk Factors , Societies, Medical , Spain/epidemiology , United StatesABSTRACT
OBJECTIVES: To investigate the results of metabolic control among type-2 diabetics who practise self-monitoring of their blood glucose (MBG) and compare them with those who do not; the adequacy of MBG prescription according to clinical criteria and frequency of use; and to analyse the presence of factors predicting metabolic control. DESIGN: Descriptive and retrospective study covering 1995, 1996 and 1997. SETTING: The seven health districts in the territorial ambit of Tortosa Primary Care. PATIENTS: 597 type-2 diabetes patients were evaluated: 286 practising MBG, and 311 not doing so. All of them belonged to the health districts reference population. The sample was systematized and stratified by health districts in order to obtain data through a pre-designed data collection form. MEASUREMENTS AND MAIN RESULTS: 41.06% of diabetics practised MBG on a stable basis, without any significant differences showing in either HbA1c percentage, in any of the biological variables defining metabolic control in relation to the practice or otherwise of MBG, or in its frequency. An inverse relationship (p = 0.012) between the frequency of MBG and age was shown. Some clinical indication for prescribing MBG existed in 78.22% of the total diabetic population. In the diabetic population using MBG, inappropriate use of quantity was 54.89% (84.07% by too little, 15.92% in excess). Only 37.9% displayed quantitative and qualitative concordance simultaneously. The logistic model applied to the total diabetic population predicted 73.19% metabolic control with the variables of BMI (OR = 1.0542). Karnofsky index (OR = 0.9768) and presence of macroangiopathy (OR = 0.4249). CONCLUSIONS: 1. The practice of MBG is questionable, since the effectiveness found was not superior. 2. There is an imbalance between the real practice of MBG according to the clinical recommendations and consumption, which tends to be deficient. 3. The results do not seem to depend so much on MBG practice as on other linked circumstances which cannot be modified by MBG practice.
