[Management of type 2 diabetic patients in primary care in Spain].
OBJECTIVE
We assess the metabolic control, complications, quality of life related to health (QLRH) and the type and amount of medical resource consumption (MRC) in type 2 diabetic patients (2DMp) followed by primary care physicians (PCP) in Spain.


METHODS
We studied 628 2DMp divided in 4 cohorts: 1. Either newly diagnosed 2DMp who required pharmacological treatment or failed to non-pharmacological measures; 2. Patients pharmacologically treated for less than 1 year; 3. Patients with pharmacological treatment for more than 1 year; 4. Patients with impaired fasting glucose (control group).


RESULTS
Eighty percent of the subjects were overweight. At baseline, 27.9, 23.5 and 36.9% of patients from cohorts 1, 2 and 3, respectively, had HbA1C < 8%. After 6 months of follow-up, 14.6, 21.3 and 22.8% of patients from cohorts 1, 2 and 3, respectively, still had "bad control". At baseline, 38.0%, 21.2% and 20.7% of patients from cohorts 1, 2, and 3, respectively, had "bad lipid profile". After 6 months, 57.4%, 54.2% and 45.3% of cohorts 1, 2 and 3, respectively, still had plasma cLDL levels > 130 mg/dl. Complications were more frequent in cohort 3. During the 6-month period, MRC was higher among 2DMp than controls (p < 0.05) and higher among patients from cohort 3 (p < 0.05) compared with all the other patients. More diabetic than control patients and more patients from cohort 3 than patients from cohort 1 and 2 reported that their expected quality of life would be better without diabetes.


CONCLUSIONS
One out of four of diabetic patients studied had HbA1C and lipids higher than the limits suggested by guidelines. Type 2 diabetes is associated with higher MRC and worse QLRH. This situation is worse among long-term diabetic patients.
Arroyo
Jaime
J
Cap Sant Fèlix, Sabadell, Barcelona, Spain.
Badía
Xavier
X
de la Calle
Hermenegildo
H
Díez
Javier
J
Esmatjes
Enric
E
Fernández
Isabel
I
Filozof
Claudia
C
Franch
Josep
J
Gambús
Gemma
G
Gomis
Ramón
R
Navarro
Jorge
J
Navarro
Javier
J
de Pablos
Pedro
P
D000368:Aged; D001786:Blood Glucose; D048909:Diabetes Complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018434:Sickness Impact Profile; D013030:Spain / Q000453:epidemiology
D001786:Blood Glucose; D007004:Hypoglycemic Agents