Características de una población de personas con diabetes mellitus en un programa de enfermedades crónicas

Resumen La Diabetes Mellitus (DM) es una enfermedad cronica no transmisible con una prevalencia en Argentina del 9,8%. El seguimiento de pacientes con DM se realiza en un Programa de Enfermedades Cronicas desarrollado en la obra social universitaria DASPU, de la Universidad Nacional de Cordoba Argentina. Objetivo: describir caracteristicas clinicas de personas con DM de un programa de seguimiento. Identificar variables de control metabolico asociadas a la presencia de complicaciones. Material y metodo. Estudio observacional, transversal, descriptivo. Se incluyeron datos de pacientes con DM bajo programa del ano 2010. Las variables categoricas se describen como proporciones y las numericas como media ±DE. La comparacion de medias se realizo mediante test de Student. Resultados: total 1017 casos, edad media 61 ±14 anos, 54,6% masculinos, DM tipo 1: 8,5%, DM tipo 2: 90,9%, DM gestacional: 0,7%. Factores de riesgo cardiovascular: hipertension arterial en 78%, dislipemia en 35%. Complicaciones microvasculares: 25,5%, macrovasculares: 18,6%. La enfermedad coronaria fue la complicacion mas frecuente: 14,5%. El 69% presento valores de hemoglobina glicosilada (HbA1C) ? 7,4%; el promedio de colesterol total fue 185 mg/dl y de colesterol LDL 111 mg/dl. El promedio de HbA1C fue mas elevado en pacientes con complicaciones microvasculares que sin complicaciones: 7,47% vs 7,18% (p=0,009). En pacientes con complicaciones macrovasculares hubo una tendencia inversa, no significativa (7,21% vs 7,26%; p=0,65). El promedio de colesterol total fue menor en el grupo con complicaciones macrovasculares (173 mg/dl vs 189 mg/dl; p=0,001). Igual comportamiento se observo en relacion al C-LDL (101 vs 113 mg/dl; p=0,001). Conclusion: Las caracteristicas clinicas evaluadas coinciden en su distribucion y complicaciones con estudios epidemiologicos reportados en la bibliografia, los valores de HbA1C y colesterol total alcanzan valores optimos en un gran porcentaje de nuestra poblacion, con menores niveles en los pacientes con complicaciones macrovasculares. Summary Diabetes Mellitus (DM) is a chronic noncommunicable disease with a prevalence of 9.8% in Argentina. A Chronic Disease Program was developed for monitoring of patients with DM at the Ambulatory Center of DASPU, in National University of Cordoba Argentina. Objective: To describe clinical characteristics of DM patients under a chronic disease program and to identify metabolic control variables associated with the presence of complications. Material and methods. Observational, cross-sectional, descriptive study of DM Patients who attended at ambulatory center of DASPU since 2010. Categorical variables were described as proportions and number as mean ± SD. The comparison of means was performed using student test. Results: 1017 patients were analyzed with mean age of 61 ± 14 years, with 54.6% of male, 8.5% had type 1 DM, and 90.9% had DM type 2: O.7% had gestational DM. Cardiovascular risk factor were: hypertension in 78%, dyslipidemia in 35. 25.5% of patients had micro vascular complications and 18.6% had macro vascular complications. Coronary heart disease was the most frequent complication in 14.5% of the patients. 69% had values of glycated hemoglobin (HbA1C) ? 7, 4%; the average total cholesterol was 185 mg / dl and LDL cholesterol 111 mg / dl. The average HbA1C was higher in patients with micro vascular complications, HbA1c 7.47% vs. 7.18% (p = 0.009). In patients with macrovascular complications there was no significant inverse trend, HbA1c 7.21% vs 7.26% with and without complications (p = 0.65). The average total cholesterol was lower in the group with macro vascular complications 173 mg / dl and 189 mg / dl (p = 0.001). Similar result was observed in LDL-C: 101 vs 113 mg / dl (p = 0.001) in patients with and without complications, respectively. Conclusion: Clinical characteristics of the patients under the program were similar to other studies reported in the literature, but the values of HbA1c and total cholesterol have better results, achieving optimal values in a large percentage of the population, with lower levels in patients with macrovascular complications.