[Adaptation and validation of the SMP-T2D questionnaire in Spanish for evaluating self-management of high blood pressure and type 2 diabetes: PAG-DT2+HTA]. / Adaptación y validación al español del cuestionario SMP-T2D para evaluar la autogestión de la hipertensión arterial más diabetes tipo 2: PAG-DT2+HTA.

BACKGROUND: High blood pressure is one of the most common chronic conditions worldwide. It affects one in every 3 adults over 40, while one in 10 suffers from diabetes. For both diseases, adherence to pharmacological treatment is over 30%, and self-management, which takes into account diet and physical activity, is still unknown, as there is no tool available to measure self-management. Therefore, the object of this study was to adapt and validate the Spanish version of the self-management profile for type 2 diabetes (SMP-T2D) questionnaire in patients with type 2 diabetes and high blood pressure among users of first level care in the social security institution of Mexico. METHODS: The SMP-T2D was adapted to Spanish by translation into Spanish, and being used only in patients with high blood pressure and type 2 diabetes-hypertension. A convergent and discriminatory validation was performed. Patients over 50 years old with high blood pressure were include. Those that did not complete the questionnaire or give informed consent were rejected. RESULTS: The Spanish version of the SMP-T2D was called PAG-DT2+HTA, and was applied to 145 people with hypertension: 54.4% with hypertension only, and 43.6% with hypertension and type 2 diabetes. Mean age was 66.14 years (SD=10.78), with 34.7% women and 65.3% men. Internal consistency by α-Cronbach for the questionnaire was 0.561 (P=.000). The correlation between the PAG-DT2+HTA and Morisky-Green was significant. The ability to discriminate between people with and without education and with and without economic means was obtained. CONCLUSION: The Spanish version of SMP-T2D (PAG-DT2+HTA) that measures self-management in type 2 diabetes, can be used to measure self-management in people with type 2 diabetes-hypertension.

Overweight and obesity as markers for the evaluation of disease risk in older adults.

OBJECTIVES: To explore disease risk through the measurement of BMI scores and waist circumferences in older Mexican adults with favorable health statuses and to determine how this risk is associated with sociodemographic characteristics. METHODS: Using data from the National Health and Nutrition Survey of 2006, we created a cross-sectional design and selected 878 participants (60 years or older) who had favorable health statuses. The demographic data, health status, body mass index (BMI), waist circumference (WC), and an estimation of disease risk (arterial hypertension, diabetes type 2, and metabolic syndrome) were obtained through the survey. RESULTS: The prevalence of overweight, obesity, and abdominal obesity were 42.1%, 29.7%, and 80.9%, respectively. Disease risks, which were classified as least, increased, high, or very high, were 14.7%, 17.5%, 38.7%, and 29.1%, respectively. We observed that younger age has a higher risk for disease and that this decreases as age increases until it becomes minimal. After controlling for some risk factors such as tobacco, alcohol, and physical activity, we observed that being female, younger, and married are all factors significantly associated with a high and very high risk for disease. On the other hand, being indigenous, having a low education level, living in a rural setting are all protective factors with a minimum disease risk. CONCLUSIONS: The prevalence rates of overweight, obesity, and abdominal obesity are high among older Mexican adults. We observed that as age increases, disease risk decreases, which also occurs with some lifestyle factors such as living in a rural setting, being indigenous, having a low education level, and being married.

Cost-effective analysis of genotyping using oral cells in the geriatric population.

We evaluated the cost-effectiveness of using buccal swab brushes in comparison with blood samples for obtaining DNA for large epidemiological studies of the elderly population. The data reported here are from the third phase of the Integral Study of Depression among the Elderly in Mexico City's Mexican Institute of Social Security, conducted in 2007. The total cost of the two procedures was determined. The measurement of effectiveness was the quality and quantity of DNA measured in ng/µL and the use of this DNA for the determination of apolipoprotein E (APO E) polymorphism by PCR. Similar rates of amplification were obtained with the two techniques. The cost of the buccal swab brushes, including sample collection and DNA extraction, was US$16.63, compared to the cost per blood sample of US$23.35. Using the buccal swab, the savings was US$6.72 per patient (P < 0.05). The effectiveness was similar. Quantity and quality of DNA obtained were similar for the oral and blood procedures, demonstrating that the swab brush technique offers a feasible alternative for large-scale epidemiological studies.