Control de glucosa en pacientes que asistieron al programa de educación DiabetIMSS en Tecate, Baja California

Antecedentes: la diabetes mellitus es actualmente la principal enfermedad crónica y sólo una pequeña proporción de pacientes tiene buen control metabólico en países industrializados, en América Latina o México. Objetivo: evaluar el control metabólico en pacientes que asistieron al programa de educación DiabetIMSS. Material y método: estudio retrospectivo en el que se revisaron los expedientes de pacientes con diabetes mellitus tipo 2 que se integraron a DiabetIMSS durante 2010 y 2011 en una Unidad de Medicina Familiar de Tecate, Baja California, México. Se consideró control metabólico adecuado si al final del programa la glucosa sanguínea en ayunas fue ≤ 130 mg/dL. Resultados: 698 pacientes asistieron a DiabetIMSS, en promedio durante 8.4 meses, 531 tuvieron datos completos de glucemia al inicio y final del programa. La glucosa en sangre disminuyó significativamente (165.4 ± 72.9 a 153.6 ± 67.6 mg/dL, p = 0.002). El porcentaje de pacientes con control metabólico se incrementó de 39.7 a 47.3% al finalizar el programa. Los pacientes con control metabólico al final del programa fueron significativamente más mujeres (53 vs 47%, p = 0.01), tuvieron mayor edad (55.8 vs 53 años, p = 0.04) y menor tiempo de evolución de la diabetes mellitus (73 vs 98 meses, p = 0.001). En 281 (52.9%) pacientes la pérdida de peso promedio fue de 2.9 kg. Conclusiones: hubo buen apego al programa, 77% de los pacientes permanecieron en DiabetIMSS seis meses o más y tuvieron mayor control metabólico que el reportado con los modelos de atención médica habitual en México y otros países. Palabras clave: control de glucosa, programa DiabetIMSS.

Palabras clave: control de glucosa, programa DiabetIMSS

Background: Nowadays diabetes mellitus is the most common chronic disease and a little proportion of patients has an adequate metabolic control in developed countries, as well as in Latin America or MexicoObjective: To assess the metabolic control in patients enrolled in the multidisciplinary and group educational program DiabetIMSS. Methods: A retrospective study was made in which clinical charts of diabetes mellitus type 2 patients enrolled in the DiabetIMSS program during 2010-2011 at a primary care unit in Tecate, Mexico, were reviewed. An adequate metabolic control was defined as a fasting blood glucose ≤ 130 mg/dL. Results: In a mean period of 8.4 months 698 patients assisted to DiabetIMSS program and 531 had complete glucose values at the beginning and at the end of the program. The fasting blood glucose decreased significantly (165.4 ± 72.9 a 153.6 ± 67.6 mg/dL, p = 0.002). The percentage of patients with an adequate metabolic control increased from 39.7% to 47.3%. Patients with adequate metabolic control were more frequently women (53% vs 47%, p = 0.01), older (55.8% vs 53 years, p = 0.04) and had lower disease duration (73 vs 98 months, p = 0.001). Two hundred eighty one (53%) patients lost weight, mean 2.9 kg. Conclusions: There was a good adherence to DiabetIMSS program, since 77% of patients stayed for ≥ 6 months. Patients in DiabetIMSS had a higher frequency of adequate metabolic control than diabetic patients who have been received usual individual care in Mexico or other countries. Key words: glucose control, DiabetIMSS program.

Keywords: glucose control, DiabetIMSS program