[Cross-sectional epidemiological study of clinical profiles and glycemic control in diabetic patients in primary care in Spain (the EPIDIAP study)].
OBJECTIVE
To assess the degree of glycemic control and its associated factors in patients with diabetes mellitus (DM) attended by primary care teams in Spain.


METHODS
A cross-sectional multicenter study was carried out using a structured questionnaire in diabetic patients consecutively attended from January to August 2007. Three groups were assessed: patients with type 1 diabetes mellitus (DM) and those with insulin-treated or non-insulin-treated type 2 DM. The diagnosis of DM was established according to the American Diabetes Association (ADA) criteria. Good glycemic control was defined as a glycated hemoglobin (HbA1c) value<or=7%. Sociodemographic characteristics, medical history, and clinical complications were collected. Factors associated with glycemic control were analyzed by means of multiple logistic regression analysis.


RESULTS
A total of 679 patients were included, classified into type 1 DM (11.5%), insulin-treated type 2 DM (26.2%) and noninsulin-treated type 2 DM (62.3%). The mean age was 65.2+/-13.7 years, 52.4% were women, 35.6% were obese, 86.0%, were dyslipidemic and 78.9% had hypertension. A total of 53.1% (CI: 49.3-56.9) showed good glycemic control (distribution among groups: 31.5%, 32.7% and 65.4%, respectively; p<0.001). Predictive factors for unsatisfactory control were age (odds ratio [OR]=0.984), time from diagnosis (OR=1.033) and insulin treatment (OR=4.054) (p<0.001). Only 3% [corrected] of the individuals achieved all the objectives recommended by the American Diabetes Association.


CONCLUSIONS
Glycemic control in diabetic patients can be improved. Only one in two patients with diabetes attended in primary care is properly controlled. The percentage of patients with satisfactory control in the insulin-treated group (types 1 and 2) was half that in the non-insulin-treated group.
de Pablos Velasco
Pedro
P
Departamento de Endocrinología, HUDN, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain.
Franch
Josep
J
Banegas Banegas
José R
JR
Fernández Anaya
Silvia
S
Sicras Mainar
Antoni
A
Díaz Cerezo
Silvia
S
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin