[Diabetes mellitus in Spain: death rates, prevalence, impact, costs and inequalities]. / La diabetes mellitus en España: mortalidad, prevalencia, incidencia, costes económicos y desigualdades.

OBJECTIVE: Describing the situation of diabetes mellitus (DM) in Spain from a public health perspective. MATERIAL AND METHOD: manual review of books and other documents on diabetes mellitus in Spain was conducted. In addition, a specific research of articles published using MeSH terms diabetes mortality, prevalence, incidence, cost, inequalities and Spain was conducted in Medline through Internet (PubMed). Minimun Basic Data Set was utilized as source for complication description by Communities Autonomus. RESULTS: DM is one of the leading cause of mortality and the third one in women. With regard to Autonomous Communities, Canary Islands, Ceuta y Melilla and Andalusia show the greatest mortality with a downward trend. Diabetics present greater mortality than non diabetic patients, being complications the main cause of the over-mortality, especially ischemic heart disease. Estimations of prevalence for DM2 range from 4.8% to 18.7% and for DM1, from .08% to .2%. In pregnancy, it has been noted a prevalence ranging from 4.5% to 16.1%. With respect to incidence per year, it is estimated a range from 146 to 820 per 100,000 inhabitants for DM2 and a range from 10 to 17 new cases annually per 100,000 inhabitants for DM1. Costs for DM1 show very different results, averaging between 1,262 and 3,311 euro per people and year. There are differences for DM2 costs as well, averaging between 381 and 2,560 euro per patient and year. Total costs estimated range from 758 to 4,348 euro per person and year. Relationship between a low socioeconomic level (LSL) and DM2 risk has been proved. Moreover, it has been noted that the less LSL the worse is the disease control, coupled with a greater frequency and more frequent factors of DM2 risk. CONCLUSIONS: The knowledge about the situation of the DM as a Public Health problem in Spain is limited. Mortality data available does not gather its real magnitude, and prevalence, incidence, costs and inequalities research are very poor and hardly comparable. In spite of this degree of incertitude, we can state that DM is an important public health problem with a continuous increase, especially DM2, if the appropriate prevention and control measures are not taken.

La diabetes mellitus en España: mortalidad, prevalencia, incidencia, costes económicos y desigualdades / Mellitus diabetes in Spain: death rates, prevalence, impact, costs and inequalities

Objetivo: Describir la situación de la diabetes mellitus (DM) en España desde una perspectiva de salud pública. Material y método: Se ha realizado una búsqueda manual de libros y otros documentos sobre DM en España, además una búsqueda específica de artículo usando los términos MeSH diabetes mortality, morbidity, cost, inequalities and Spain, realizada en Medline a través de PubMed. También se han utilizado los últimos datos disponibles de mortalidad y del Conjunto Mínimo Básico de Datos Hospitalarios por Comunidad Autónoma. Resultados: La DM es una de las primeras causas de mortalidad, en las mujeres ocupa el tercer lugar. Por Comunidades Autónomas, Canarias junto con Andalucía y las ciudades autónomas de Ceuta y Melilla presentan la mayor mortalidad, con una tendencia descendente. Los diabéticos tienen una mayor mortalidad que los no diabéticos, sus complicaciones son las principales causas de la mayor mortalidad, sobre todo la enfermedad isquémica del corazón. Las estimaciones de prevalencia de DM tipo 2 (DM2) en España varían entre el 4,8 y el 18,7%, las de DM tipo 1 (DM1) entre el 0,08 y el 0,2%. Para la DM en el embarazo se han descrito prevalencias entre el 4,5 y el 16,1%. En cuanto a incidencia anual, se estima entre 146 y 820 por 100.000 personas para la DM2 y entre 10 y 17 nuevos casos anuales por 100.000 personas para la DM1. Los costes económicos de la DM1 van de 1.262 a 3.311 €/persona/ año. Los costes de la DM2 oscilan entre 381 y 2.560 €/paciente/ año. Los estudios que estiman costes totales los sitúan entre 758 y 4.348 €/persona/año. Se ha demostrado que a menor nivel socioeconómico peor es el control de la enfermedad y mayores su frecuencia y los otros factores de riesgo de DM2. Conclusiones: Se puede afirmar que la DM es un importante problema de salud pública que irá incrementándose en los próximos años (fundamentalmente la DM2) si no se toman las medidas de prevención y control oportunas (AU)

Objective: Describing the situation of diabetes mellitus (DM) in Spain from a public health perspective. Matherial and method: A manual review of books and other documents on diabetes mellitus in Spain was conduced. In addition, a specific research of articles published using MeSH terms diabetes mortality, prevalence, incidence, cost, inequalities and Spain was conduced in Medline through Internet(PubMed). Minimun Basic Data Set was utilized as source for complication description by Communities Autonomus. Results: DM is one of the leading cause of mortality and the third one in women. With regard to Autonomous Communities, Canary Islands, Ceuta y Melilla and Andalusia show the greatest mortality with a downward trend. Diabetics present grater mortality than non diabetic patients, being complications the main cause of the over-mortality, especially ischemic heart disease. Estimations of prevalence for DM2 range from 4.8% to 18.7% and for DM1, from.08% to.2%. In pregnancy, it has been noted a prevalence ranging from 4.5% to 16.1%. With respect to incidence per year, it is estimated a range from 146 to 820 per 100 000 inhabitants for DM2 and a range from 10 to 17 mew cases annually per 100 000 inhabitants for DM1. Costs for DM1 show very different results, averaging between 1,262 and 3,311 e per people and year. There are differences for DM2 costs as well, averaging between 381 and 2,560 e per patient and year. Total costs estimated range from 758 to 4,348 e per person and year. Relationship between a low socioeconomic level (LSL) and DM2 risk has been proved. Moreover,it has been noted that the less LSL the worse is the disease control, coupled with a greater frequency and more frequent factors of DM2 risk. Conclusions: The knowledge about the situation of the DM as a Public Health problem in Spain is limited. Mortality data available does not gather its real magnitude, and prevalence, incidence, costs and inequalities research are very poor and hardly comparable. In spite of this degree of incertitude, we can state that DM is an important public health problem with a continuous increase, especially DM2, if the appropriate prevention and control measures are not taken (AU)