Tratamiento de los pacientes con diabetes mellitus tipo 2 en atención primaria en España

Arroyo, Jaime; Badı́a, Xavier; Calle, Hermenegildo de la; Díez, J.M. Baena; Estmatjes, Enric; Fernández, I. Fernández; Filozof, Claudia; Franch, Josep; Gambús, Gemma; Gomis, Ramón; Navarro, Javier; Pablos, P. de; pro-Star, Grupo

doi:10.1157/13077139

Cited by 48 publications

(12 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The number of smokers in our sample was lower than in other studies, although the prevalence of smoking in diabetic male subjects under the age of 60 was higher than in the general population in Catalonia [16]. Controlling this risk factor should be prioritized in diabetics in light of the relationship between smoking and micro- and macrovascular complications and mortality [13,22].…”

Section: Discussionmentioning

confidence: 75%

“…A previous study ( TranSTAR study ) [17], found that HbA1c was controlled in 18.8% of patients. Using the binomial distribution, 390 patients with type-2 diabetes would provide an accuracy of 4% for estimating the proportion of diabetic patients with good HbA1c control, with a 95% confidence interval, assuming that 10% of patients would not be valid for the analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Despite these recommendations [14,15], multifactorial control of risk factors in diabetes is still insufficient [16-18]. Thus, for example, Mostaza et al [19], reported that optimal control of all risk factors was found in just 7% of diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multifactorial control and treatment intensity of type-2 diabetes in primary care settings in Catalonia

Mengual¹,

Roura²,

Serra

et al. 2010

Cardiovasc Diabetol

View full text Add to dashboard Cite

BackgroundMany studies on diabetes have demonstrated that an intensive control of glycaemia and the main associated risk factors (hypertension, dislipidaemia, obesity and smoking) reduce cardiovascular morbi-mortality. Different scientific societies have proposed a multifactorial approach to type 2 diabetes.The objective of this study was to identify the degree of control of glycosylated haemoglobin (HbA1c) and of cardiovascular risk factors in type 2 diabetic patients, using the GedapS 2004 guidelines, and to analyse the type and intensity of drug treatment.MethodsThis cross-sectional, multicentre, epidemiological study was conducted in a primary care setting in Vallès Occidental South, Catalonia. Data were collected of 393 patients aged 18 and above who were diagnosed with diabetes mellitus type 2. Biodemographic and clinical data, cardiovascular risk factors, associated cardiovascular disease, and treatment were assessed. Descriptive and multivariable analysis with logistic regression was realized.ResultsA total of 392 patients with a mean age of 66.8 years (SD = 10.6) (45.4% male patients) were analyzed. The duration of diabetes was 8.4 years (SD = 7.6). The degree of multifactorial control of risk factors was only 2.6%, although in more than 50% individual cardiovascular risk factor was controlled, except for LDL cholesterol (40.6%) and systolic blood pressure (29.6%). Furthermore, only 13.0% of subjects had an optimal BMI, 27.5% an optimal waist circumference. Treatment for diabetes was prescribed in 82.7% of patients, for hypertension 70.7%, for dyslipidaemia 47.2% and 40.1% were taking antiplatelets.ConclusionOver 50% of type 2 diabetic patients presented optimal control of the majority of individual cardiovascular risk factors, although the degree of multifactorial control of diabetes was insufficient (2.6%) and should be improved. Drug treatment can be intensified using a larger number of combinations, particularly in patients with target organ damage and associated clinical cardiovascular disease.

show abstract

Section: Discussionmentioning

confidence: 75%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Multifactorial control and treatment intensity of type-2 diabetes in primary care settings in Catalonia

Mengual¹,

Roura²,

Serra

et al. 2010

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…A number of observational studies performed in Spain (10–14) and elsewhere (15–22) have shown that there is a gap between recommendations and daily clinical practice. Several studies have indicated that only 7–9% of diabetic patients achieve optimal control of all CVRFs (11,13,23). The current generalization of electronic clinical records systems in Spain allowed us to access the data of the entire diabetic population registered in the public health care system for our study, unlike previous studies that were based on population samples.…”

mentioning

confidence: 99%

Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Vinagre

Mata-Cases²,

Hermosilla³

et al. 2012

Diabetes Care

209

104

View full text Add to dashboard Cite

OBJECTIVEThe objective of this study was to analyze the clinical characteristics and levels of glycemic and cardiovascular risk factor control in patients with type 2 diabetes that are in primary health care centers in Catalonia (Spain).RESEARCH DESIGN AND METHODSThis was a cross-sectional study of a total population of 3,755,038 individuals aged 31–90 years at the end of 2009. Clinical data were obtained retrospectively from electronic clinical records.RESULTSA total of 286,791 patients with type 2 diabetes were identified (7.6%). Fifty-four percent were men, mean (SD) age was 68.2 (11.4) years, and mean duration of disease was 6.5 (5.1) years. The mean (SD) A1C value was 7.15 (1.5)%, and 56% of the patients had A1C values ≤7%. The mean (SD) blood pressure (BP) values were 137.2 (13.8)/76.4 (8.3) mmHg, mean total cholesterol concentration was 192 (38.6) mg/dL, mean HDL cholesterol concentration was 49.3 (13.2) mg/dL, mean LDL cholesterol (LDL-C) concentration was 112.5 (32.4) mg/dL, and mean BMI was 29.6 (5) kg/m2. Thirty-one percent of the patients had BP values ≤130/80 mmHg, 37.9% had LDL-C values ≤100 mg/dL, and 45.4% had BMI values ≤30 kg/m2. Twenty-two percent were managed exclusively with lifestyle changes. Regarding medicated diabetic patients, 46.9, 22.9, and 2.8% were prescribed one, two, or three antidiabetic drugs, respectively, and 23.4% received insulin therapy.CONCLUSIONSThe results from this study indicate a similar or improved control of glycemia, lipids, and BP in patients with type 2 diabetes when compared with previous studies performed in Spain and elsewhere.

show abstract

“…En particular, la prevalencia de la diabetes en adultos de mediana edad oscila entre el 7 y el 16% en función del área geográfica y de los criterios diagnósticos utilizados (1,2). La DM2 es una de las principales causas de muerte en la mayoría de los países desarrollados.…”

Section: Abstract Background and Objective: To Perform A Cost-effectiunclassified

Análisis coste-efectividad del uso de atorvastatina en pacientes diabéticos de tipo 2: modelo farmacoeconómico del estudio CARDS

Bobadilla

Troncoso

et al. 2006

An. Med. Interna (Madrid)

View full text Add to dashboard Cite

INTRODUCCIÓNLa diabetes está transformándose en un problema de dimensiones epidémicas. Se calcula que en poco más de 20 años la cantidad de personas afectadas por dicha enfermedad crecerá aproximadamente un 120% en todo el planeta, fenó-meno que se estima habrá de ser más marcado en los países en [0212-7199 (2006) RESUMENFundamento y objetivo: Efectuar un análisis coste-efectividad del uso de Atorvastatina 10 mg en la prevención primaria de la enfermedad cardiovascular en el paciente con Diabetes Mellitus tipo 2 (DM2).Método: Se elaboró un modelo retrospectivo y determinístico basado en un análisis de decisión a partir del estudio CARDS (Collaborative Atorvastatin Diabetes Study). En el estudio CARDS se había demostrado que Atorvastatina 10 mg versus placebo en prevención primaria en pacientes con DM2 y alguna patología asociada, reduce la morbimortalidad cardiovascular (5,8 vs. 9,0%, p = 0,001). En el presente análisis coste-efectividad, las unidades de efectividad utilizadas fueron años de vida ganados (AVG) y años de vida ajustados por calidad (AVAC), obtenidos a partir de las diferencias de morbimortalidad y de la esperanza de vida de los diabéticos, con y sin eventos previos, obtenidos de la literatura. El consumo de recursos de las alternativas en evaluación se ha extraído del estudio CARDS aplicando costes españoles.Resultados: El cociente coste-efectividad incremental derivado de utilizar Atorvastatina 10 mg versus placebo fue 5.886 € por AVG y de 8.046 € por AVAC. Los análisis de sensibilidad confirmaron la estabilidad del modelo.Conclusiones: En la prevención primaria del riesgo cardiovascular en pacientes diabéticos tipo 2, el uso de Atorvastatina 10 mg es coste-efectivo, con un coste por AVG y por AVAC por debajo de otras alternativas empleadas ampliamente en el Sistema Nacional de Salud español, y también por debajo de un valor que podría considerarse como un umbral razonable para nuestro país, situado oficiosamente en torno a los 30.000 € por AVAC. PALABRAS CLAVE: Diabetes mellitus. Prevención primaria. Coste efectividad. Atorvastatina. ABSTRACT Background and objective: To perform a cost-effectiveness analysis of the use of Atorvastatin 10 mg in the primary prevention of cardiovascular disease in patients with type 2 diabetes (DM2). Method: A deterministic and retrospective model by a decision analysis based on CARDS study (Collaborative Atorvastatin Diabetes Study) was performed. In the CARDS study, a significant reduction in cardiovascular morbimortality by the use of Atorvastatin 10 mg versus placebo (5.8 vs. 9.0%, p=0.001) in DM2 patients with an additional condition, had previously been demonstrated. In the present cost-effectiveness analysis, effectiveness units were life years gained (LYG) and quality adjusted life years (QALY), obtained from differences in morbimortality and life expectancy in DM2 patients, with and without previous cardiovascular events. Costs of the evaluated alternatives were obtained from the CARDS results.Results COST-EFFECTIVENESS ANALYSIS OF THE USE OF ATORVAS-T...

show abstract

Tratamiento de los pacientes con diabetes mellitus tipo 2 en atención primaria en España

Cited by 48 publications

References 35 publications

Multifactorial control and treatment intensity of type-2 diabetes in primary care settings in Catalonia

Multifactorial control and treatment intensity of type-2 diabetes in primary care settings in Catalonia

Control of Glycemia and Cardiovascular Risk Factors in Patients With Type 2 Diabetes in Primary Care in Catalonia (Spain)

Análisis coste-efectividad del uso de atorvastatina en pacientes diabéticos de tipo 2: modelo farmacoeconómico del estudio CARDS

Contact Info

Product

Resources

About