[Effect of a clinical practice guideline for the management of diabetes type 2].
OBJECTIVE
To evaluate the efficacy of a clinical practice guideline for treating type-2 diabetes patients in family medicine clinics.


METHODS
Nonrandomized control trial that took place in two family medicine clinics. Patients with more than 10 years of being diabetic were included. The study comprised one intervention group and one control group. The intervention group was treated by family doctors previously trained to use the guideline, while the control group was treated by family doctors unaware of the clinical practice guideline. The clinical practice guideline identifies disease risk factors, classifies the disease, and indicates criteria for diagnosis, pharmacological treatment, monitoring and timely identification of acute complications. It also addresses patients' education regarding dietary and exercise recommendations. The study had three stages: baseline, intervention and post-intervention.


RESULTS
the primary outcome was control of glycemia, determined by HbA1c levels. The criterion for control was an HbA1c value of 7% or below. Secondary outcomes were changes in lifestyle, body mass index, cholesterol and triglyceride levels.


RESULTS
Of the 419 patients with type-2 diabetes included in the study, 340 (81%, 175 intervention group and 165 control group) completed the six-month follow-up. In the final evaluation, the mean HbA1c in the intervention group had decreased from 9 to 8.3%, while it increased from 8.9 to 9.5% in the control group (p < 0.001). The proportion of obese patients decreased in the intervention group but remained the same in the control group.


CONCLUSIONS
The clinical practice guideline was effective in improving the HbA1c level and decreasing the proportion of obese patients.
Pérez-Cuevas
Ricardo
R
Unidad de Investigación Epidemiológica y en Servicios de Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico. ricardoperezcuevas@imss.gob.mx
Reyes-Morales
Hortensia
H
Flores-Hernández
Sergio
S
Wacher-Rodarte
Niels
N
D000465:Algorithms; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic