• Atencion primaria · Nov 2021

    [Uncontrolled type 2 diabetes in primary care health center: Modifiable factors and target population].

    • Francisco J Cuevas Fernández, Adrián Pérez de Armas, Elena Cerdeña Rodríguez, Miguel Hernández Andreu, María José Iglesias Girón, María Rosario García Marrero, Antonio Cabrera de León, and Miguel Ángel García Bello.
    • Atención Primaria, Centro de Salud de Barranco Grande, Servicio Canario de la Salud, Santa Cruz de Tenerife, España; Área de Medicina Preventiva y Salud Pública, Universidad de La Laguna, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España.
    • Aten Primaria. 2021 Nov 1; 53 (9): 102066.

    AimsTo detect modifiable factors and target populations associated with uncontrolled type 2 diabetes in primary care.DesignRetrospective cross-sectional descriptive study.LocationHealth center of Barranco Grande, Tenerife.ParticipantsRandom selection of patients with DM2 attended by 12 family doctors and 12 nurses.Main MeasurementsIn addition to the control of DM2, sociodemographic, clinical data, lifestyle and follow-up of preventive and therapeutic measures were obtained. After bivariate analysis, a multilevel multivariate model was adjusted by taking the quota of patients assisted by each physician as a second-level mixed-effect variable and the rest as first-level variables.Results587 patients were recruited (46.5% female), treated with 1.9-1.1 antidiabetic drugs, with 4.1% therapeutic non-compliance, and suffering 13.8% therapeutic inertia. 23.7% showed poor DM2 control, being significantly worse (p<0.05) in male sex, age <65 years, evolution DM2 -5 years, work-active, upper-middle studies, inadequate diet, metabolic syndrome, ratio TG/HDL-3, complications of DM2, Charlson index<5, nursing visits <3/year, without ECG in the last year, and more drugs prescribed for DM2. The doctor-nurse quota was associated with poor control with an intraclass coefficient of 0.01.ConclusionsMen under 65 years of age with DM2 evolution longer than 5 years are a target population to intensify interventions. Therapeutic non-compliance, inadequate diet, lack of adherence protocols and ratio TG/HDL>3 are the main modifiable factors on which to intervene. The association of the doctor-nurse quota with the control of DM2 is weak, probably due to adequate follow-up of preventive programs.Copyright © 2021. Publicado por Elsevier España, S.L.U.

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