Control of glycemia and cardiovascular risk factors in patients with type 2 diabetes in primary care in Catalonia (Spain)

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From: Diabetes Care(Vol. 35, Issue 4)
Publisher: American Diabetes Association
Document Type: Article
Length: 4,916 words
Lexile Measure: 1550L

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OBJECTIVE--The objective of this study was to analyze the clinical characteristics and levels of glycemic and cardiovascular risk factor control in patients with type 2 diabetes that are in primary health care centers in Catalonia (Spain).

RESEARCH DESIGN AND METHODS--This was a cross-sectional study of a total population of 3,755,038 individuals aged 31-90 years at the end of 2009. Clinical data were obtained retrospectively from electronic clinical records.

RESULTS--A total of 286,791 patients with type 2 diabetes were identified (7.6%). Fifty-four percent were men, mean (SD) age was 68.2 (11.4) years, and mean duration of disease was 6.5 (5.1) years. The mean (SD) A1C value was 7.15 (1.5)%, and 56% of the patients had A1C values [less than or equal to] 7%. The mean (SD) blood pressure (BP) values were 137.2 (13.8)/76.4 (8.3) mmHg, mean total cholesterol concentration was 192 (38.6) mg/dL, mean HDL cholesterol concentration was 49.3 (13.2) mg/dL, mean LDL cholesterol (LDL-C) concentration was 112.5 (32.4) mg/dL, and mean BM1 was 29.6 (5) kg/[m.sup.2]. Thirty-one percent of the patients had BP values [less than or equal to] 130/80 mmHg, 37.9% had LDL-C values [less than or equal to] 100 mg/dL, and 45.4% had BMI values [less than or equal to] 30 kg/[m.sup.2]. Twenty-two percent wer

CONCLUSIONS--The results from this study indicate a similar or improved control of glycemia, lipids, and BP in patients with type 2 diabetes when compared with previous studies performed in Spain and elsewhere.

Diabetes Care 35:774-779, 2012

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Type 2 diabetes is a chronic disease with a prevalence of 13.8% in people over 18, with up to 6% of the population remaining undiagnosed, according to a recent Spanish study (1). Because diabetic patients have a higher risk of developing microvascular disease and a two- to fourfold higher risk of developing macrovascular disease than the general population, type 2 diabetes is considered to be among the top conditions with the greatest health and economic impact (2). Many studies have shown that the occurrence of these complications depends largely on the degree of glycemic control and intensive control of cardiovascular risk factors (CVRFs) (3-5).

In the last few decades, a consensus toward the implementation of a multidisciplinary approach to prevention and control of patients with type 2 diabetes in primary care has been reached. Since 1993, the Spanish Group of Study of Diabetes in Primary Health Care (Gedaps) has published up-to-date guidelines with the main recommendations for diagnosis, control, and treatment of diabetes. The Catalan Health Institute has subsequently incorporated these recommendations into its own guidelines (6). Current targets include an A1C value [less than or equal to] 7%, blood pressure (BP) values [less than or equal to] 130/80 mmHg, a total cholesterol (TC) value [less than or equal to]200 mg/dL, and an LDL cholesterol (LDL-C) value [less than or equal to] 100 mg/dL (7).

Despite scientific evidence and the publication of international (8,9) and national guidelines (6,7), adequate control of these patients' health remains beset with challenges. A number of observational studies performed in Spain (10-14)...

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Gale Document Number: GALE|A286113887