Prevalence of diabetes and impaired glucose tolerance in Aragón, Spain.

OBJECTIVE: To determine the prevalence of diabetes and impaired glucose tolerance (IGT) and to investigate their associated cardiovascular risk factors in Aragón, Spain. RESEARCH DESIGN AND METHODS: We performed a population-based cross-sectional study with stratified and purposive sampling of residents aged 10-74 years. A sample of 935 subjects (427 men and 508 women) was selected. All except those with a previous history of diabetes underwent an oral glucose tolerance test (OGTT), and World Health Organization (WHO) criteria were used for diagnosis of undiagnosed diabetes and IGT. Plasma lipid levels, blood pressure, BMI, and waist-to-hip ratio were also measured. RESULTS: The prevalence of diagnosed and undiagnosed diabetes and IGT was 3.1, 3.0, and 7.2%, respectively. In the age range of 30-64 years, the age-adjusted prevalence of diabetes (using the world population of Segi) was 7.1% in men and 5.6% in women. Both diabetes and IGT were associated with high blood pressure, high triglyceride levels, low HDL cholesterol levels, and overweight and upper-body fat distribution. Only upper-body fat distribution in women was significantly higher in subjects with diabetes than in subjects with IGT. CONCLUSIONS: The prevalence of diabetes in Aragón was moderately high (6.1%) and comparable with that reported in other white populations around the world. The proportion of unknown cases of diabetes was nearly 50%. Cardiovascular risk factors associated with diabetes and IGT supported the existence of an insulin resistance or metabolic syndrome, but there were not sufficient differences between diabetes and IGT to suggest a possible pathogenetic relation of hyperinsulinemia and associated risk factors.

[The results of the introduction of a protocol of preventive activities in a primary care center]. / Resultados de la implantación de un protocolo de actividades preventivas en un centro de atención primaria.

A sample of 360 people was analyzed. They had received the protocol of preventive activities of the "Unitat Docent de Medicina Familiar i Comunitària de Barcelona" during 1989. The results of those activities directed to the prevention of cardiovascular risk and to the detection of excessive alcohol intake are reported, as they are those with the easiest and widest implementation. Overall results include hypercholesterolemia in 43.9%, abnormal blood pressure in 10.5%, a rate of smokers of 31.7%, 7.7% with an excessive alcohol intake, and 51.9% of obese individuals. The results are also shown by age and sex groups. In the discussion, the results are compared with those expected for our population. It is concluded that preventive measures should be encouraged by primary health are teams.

[Self-application of preventive measures in a primary health care team]. / Autoaplicación de medidas preventivas en el equipo de atención primaria.

As the Program of Systematic Preventive Activities for the adult population is beginning to be operative, the authors have found it adequate to investigate the degree of compliance of the health care staff with the established preventive measures. One of the more relevant results was the low vaccination index (tetanus and influenza) among the health staff. Nearly one fifth of females was unaware of their protection against rubella, and one fourth of the surveyed population had never undergone tuberculin skin testing. Blood pressure and weight had been measured in most cases. 69.7% of the staff had had their plasma cholesterol measured following the protocol, with a significant female predominance. The rate of smokers was 47.4%, and the daily amount of consumed alcohol was minimal. Exfoliative cytology was carried out in four out of five females. In conclusion, the degree of compliance among health care staff was not as satisfactory as it should be.