[Effects of a revision program on the control of type 2 diabetics followed at the primary care level. Diabetes First program]. / Efectos de un programa de revisión en el control de los diabéticos tipo 2 seguidos en atención primaria. Programa Diabetes First.

BACKGROUND AND OBJECTIVE: To analyze the evolution of the glycosylated hemoglobin and other parameters after performing a control program and follow-up by nurses to improve the control of the patients with type 2 diabetes mellitus (Diabetes First). PATIENTS AND METHOD: Intervention study in type 2 diabetes mellitus patients from Murcia. The inclusion criterium was to be a type 2 diabetes mellitus patient badly controlled on diabetes parameters (glycosylated haemoglobin > or = 7%). We included 831 patients from 8 primary care centers. The program consisted of three visits (first one, after three months and after six months), where the patients received diabetic education. RESULTS: The mean initial glycosylated haemoglobin value was 8.1% +/- 1.3%, after 3 months it decreased to 7.5% +/- 1.1%, and after 6 months from the first visit its value was 7.5% +/- 2.6%. There was a statistically significant (p < 0.001) difference between the initial glycosylated haemoglobin and the values three months later. There was not such a difference between the second and third visit. Total and low-density liporpotein cholesterol decreased significantly after 3 months (p < 0.05). High-density lipoprotein cholesterol and triglycerides showed no difference. Systolic and diastolic blood pressure significantly decreased after three months (p < 0.0001 and p < 0.005). CONCLUSIONS: A simple nursing intervention program performed in primary care centers has a very positive impact on the control and treatment of patients with type 2 diabetes mellitus.

Efectos de un programa de revisión en el control de los diabéticos tipo 2 seguidos en atención primaria. Programa Diabetes First / Effects of a revision program on the control of type 2 diabetics followed at the primary care level. Diabetes First program

Antecedentes y objetivo: Analizar la evolución de la glucohemoglobina y otros parámetros tras aplicar un programa de revisión y seguimiento de enfermería (Diabetes First) para mejorar el control de sujetos con diabetes mellitus tipo 2. Pacientes y método: Estudio de intervención, realizado con pacientes diabéticos tipo 2 de la Región de Murcia. El criterio de inclusión era ser diabético tipo 2 no controlado (glucohemoglobina ¡Ý 7%). Se obtuvo una muestra final de 831 pacientes pertenecientes a ocho centros de salud. El programa constaba de tres visitas (inicial, a los 3 y a los 6 meses) en las que se daba educación diabetológica. Resultados: La glucohemoglobina inicial fue una media del 8,1% ¡À 1,3%; a los 3 meses descendió al 7,5% ¡À 1,1%, y a los 6 meses de la visita inicial era del 7,5% ¡À 2,6%. La comparación de los valores de la visita inicial y a los 3 meses mostró significación estadística (p < 0,001). Entre la segunda visita (3 meses) y la tercera (6 meses) no hubo diferencias significativas. Las cifras de colesterol total y colesterol de las lipoproteínas de baja densidad disminuyeron significativamente entre el inicio y los 3 meses (p < 0,05). El colesterol de las lipoproteínas de alta densidad y los triglicéridos no mostraron diferencias. Respecto a la presión arterial sistólica y diastólica, disminuyeron significativamente las cifras entre el inicio y los 3 meses (p < 0,0001 y p < 0,005 respectivamente). Conclusiones: Un programa de intervención enfermera sencillo realizado en las consultas de atención primaria tiene un impacto muy favorable en el control y el tratamiento de los pacientes diabéticos tipo 2 (AU)

Background and objective: To analyze the evolution of the glycosylated hemoglobin and other parameters after performing a control program and follow-up by nurses to improve the control of the patients with type 2 diabetes mellitus (Diabetes First). Patients and method: Intervention study in type 2 diabetes mellitus patients from Murcia. The inclusion criterium was to be a type 2 diabetes mellitus patient badly controlled on diabetes parameters (glycosylated haemoglobin ¡Ý 7%). We included 831 patients from 8 primary care centers. The program consisted of three visits (first one, after three months and after six months), where the patients received diabetic education. Results: The mean initial glycosylated haemoglobin value was 8.1% ¡À 1.3%, after 3 months it decreased to 7.5% ¡À 1.1%, and after 6 months from the first visit its value was 7.5% ¡À 2.6%. There was a statistically significant (p < 0.001) difference between the initial glycosylated haemoglobin and the values three months later. There was not such a difference between the second and third visit. Total and low-density liporpotein cholesterol decreased significantly after 3 months (p < 0.05). High-density lipoprotein cholesterol and triglycerides showed no difference. Systolic and diastolic blood pressure significantly decreased after three months (p < 0.0001 and p < 0.005). Conclusions: A simple nursing intervention program performed in primary care centers has a very positive impact on the control and treatment of patients with type 2 diabetes mellitus (AU)