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[The effect of a program of care for the diabetic on control of the disease]
F Fernández Suárez1, A Trueba, J A Ferrús
1Unidad Docente de Medicina de Familia y Comunitaria, Logroño.
Objective:
To study the association between the application of a diabetic care programme and modifications in glycated haemoglobin and the Body Mass Index.
Design:
Descriptive study.
Setting:
Two health centres.
Patients:
199 patients were studied, the total number of type II diabetics found in three general medicine practices.
Intervention:
Patients followed, at different levels, a programme of diabetic care. Variation of glycated haemoglobin and the Body Mass Index were measured in each patient during the 1991-1992 period. These were then related to their continuation in the programme and whether they were included in this programme at the moment of the examination.
Results:
The average drop in glycated haemoglobin was -15.3% (12.2 +/- 18.4) (p < 0.001). Average variation of the Body Mass Index was 0.2% (-0.6 +/- 1.00), not significant. Average drop in glycated haemoglobin in those included was -16% (12.5 +/- 19.5) (p < 0.001) and in those not included, -12.6% (5.3 +/- 19.9) (p < 0.001), no significant difference. The correlation between the degree of continuation in the programme and the variation of glycated haemoglobin had a r = -0.04 (p = 0.7) and between the degree of continuation and variation in the Body Mass Index, a r of 0.15 (p = 0.06). When the initial value of glycated haemoglobin was equal to or above 7.5, its average drop was -22.3% (17.8 +/- 26.9) (p < 0.001).
Conclusions:
The drop in glycated haemoglobin is significant and more important, the greater the initial value. But it has not been possible to link it with the level of continuance in the programme nor with whether patients were included in the programme. The Body Mass Index does not vary.