Tamez-Pérez HE, Quintanilla-Flores DL, Hernández-Coria MI, Ceja-Barrera L, Gómez-de-Ossio MD

Language: Spanish
References: 14
Page: 535-538
PDF size: 191.17 Kb.

ABSTRACT

Background: Today, type 2 diabetes mellitus is a serious health problem because of its high prevalence, late diagnosis and chronic complications involving greater morbidity and mortality.
Objective: The purpose of this study was o determine the preferences in diagnosis and follow-up of diabetic patients by a group of medical specialists according to international criteria.
Methods: We performed an observational cross-sectional study applying an unvalidated eight-item survey to internal medicine physicians from public and private institutions, collecting demographic data, type of institution where they work, number of years practicing medicine, and Type 2 Diabetes Mellitus (T2DM) diagnostic procedures and control methods most frequently used in their clinical practice.
Results: We applied a total of 28 surveys. Distribution by gender was 8 (28%) women and 20 (72%) men. Average age was 47 ± 10.4 years. The average number of years practicing medicine was 21 ± 11. For diagnosis, 13 (46%) prefer a single method: 9 (32%) fasting glucose, 3 (11%) HbA1c and 1 (4%) glucose tolerance test with a 75 g dose, and 15 (54 %) of the specialists use two or more. For follow-up, the preferences were the following: 19 (68%) prefer only one method: 13 (46%) use HbA1c, 4 (14%) fasting glucose and 2 (7%) postprandial glucose, and 9 (32%) prefer two or more methods.
Conclusions: The variability that exists with regard to the diagnosis and follow-up of patients with DM reflects the importance of promoting training for specialists about these criteria.

REFERENCES

1. Vázquez-Martínez J, Mercadillo-Pérez M, Celis-Quintal J. Demanda de atención médica por diabetes mellitus en el primer nivel de atención. Rev Med Inst Mex Seguro Soc 2011;49:225-231.

2. Association AD. Standards of medical care in diabetes - 2011. Diabetes Care 2011;34:S11-S61.

3. Saudek CD, Derr RL, Kalyani RR. Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin a1c. JAMA 2006;295:1688-1697.

4. Monnier L, Colette C. Target for glycemia control: Concentrating on glucose. Diabetes Care 2009;32:S199-204.

5. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. Translating the a1c assay into estimated average glucose values. Diabetes Care 2008;31:1473-1478.

6. Dib J. Estimated average glucose: A new term in diabetes control. Ann Saudi Med 2010;30:85.

7. Sacks D. Correlation between hemoglobin a1c (hba1c) and average blood glucose: Can hba1c be, 2007.

8. Weykamp C, John WG, Mosca A. A review of the challenge in measuring hemoglobin a1c. J Diabetes Sci Technol 2009;3:439-445.

9. Phillips PJ, Phillipov G. A1c--frequently asked questions. Aust Fam Physician 2005;34:663-667.

10. Herman W, Fajans S. Hemoglobin a1c for the diagnosis of diabetes. Pol Arch Med Wewn 2010;120:37-41.

11. Cavalot F, Petrelli A, Travesa M, Bonomo K, et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particulary in women: Lessons from the san luigi gonzaga diabetes study. J Clin Endocrinol Metabol 2006;91:813-819.

12. Bonora E, Muggeo M. Postprandial blood glucose as a risk factor for cardiovascular disease in type 2 diabetes: The epidemiological evidence. Diabetologia 2001;44:2107-2114.

13. Rodríguez-Moctezuma R, Magdaleno-Tobías M, Munguía- Miranda C, Hernández-Santiago J, Casas-de la Torre E. Factores de los médicos familiares asociados al control glucémico de sus pacientes con diabetes mellitus. Gac Méd Mex 2003;139:112-117.

14. Sabido Siglher M, Viniegra Velázquez L. Competencia y desempeño clínicos en diabetes. Rev Invest Clin 1998;50:211-216.