Clinical characteristics and management of type 2 diabetes in primary care in Spain. SED2 Study
Violeta Antonio-Arques1, Berta Fernandez Camins2, Bogdan Vlacho2
1Fundación redGDPS, Spain; Fundación IDIAP Jordi Gol, Barcelona, Spain; ABS La Ràpita-Alcanar, Institut Català de la Salut, Gerència Territorial Terres de l'Ebre, Tortosa, Tarragona, Spain.
Introduction:
Type 2 diabetes mellitus (DM2) is a prevalent chronic disease with major complications. Primary care (PC) plays a crucial role in the management of this disease.
Objectives:
To evaluate the organization and resources available in PC for the care of patients with DM2 in Spain.
Material And Methods:
Descriptive, cross-sectional, observational study in 65 health centers (HC) selected by opportunistic sampling. Data were collected through a structured survey.
Results:
Half of the HCs have a diabetes referent, two thirds have specific protocols and almost 90% involve nurses in diabetes education. Access to non-mydriatic retinography is limited (38.5%) and its interpretation varies. Diabetic foot examination is mainly performed by nurses (47.7%) and there is the possibility of referral to vascular surgery or specialized units in most cases. The most frequent analytical tests are the HbA1c every 6 mo (67.7%). 63.1% of the HCs can perform telematic consultations to hospital specialists and most of them have access to patients' medical records at the hospital. Significant variations are observed in some aspects between autonomous communities.
Conclusions:
Care for patients with DM2 in PC in Spain is uneven and presents opportunities for improvement. Comprehensive diabetes care in PC needs to be strengthened, including the training of professionals, the implementation of protocols and the provision of adequate resources. Measures are needed to reduce variations in care between autonomous communities.
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