The Diabetes Mellitus Metabolic Check-up Objectives Met in the Rural Area of Ourense, Spain

Abstract

Background: To evaluate the degree to which the metabolic check-up objectives among Type II diabetes patients were met in rural primary care by comparing them to the values recommended by the American Diabetes Association (ADA) and the Diabetes in Primary Care Study Group (GEDAPS). Methods: Descriptive cross-sectional study. A sample size was calculated based on the glycosolated hemoglobin (HbA1c) test in 119 individuals. A total of 253 patients with Type II diabetes followed up for at least two years at their healthcare facility took part. The patients in question were selected at random from among 17 medical lists at 11 rural healthcare facilities in the province of Ourense (Spain). Demographic variables, cardiovascular risk factors, pharmacological treatment, self-analyses, eye fundus, tactile sensitivity, HbA1c, lipid profile, blood pressure and body mass index data were taken from the patients´ clinical records. Results: A total of 44.3% of those in the sample had undergone an HbA1c test within the immediately prior six-month period, showing a value of under seven percent (7%). A total of 21.2% had a blood pressure of under 130/80, and 19.8% a LDL cholesterol level of under 100 mg/dl. A total of 40.7% of those patients with a LDL cholesterol level over 100 were not undergoing any hypolipemiant treatment. A total of 20.4% of the patients showing high blood pressure readings were not undergoing any blood pressure lowering treatment. On the basis of these three factors, a total of 2.5% met the check-up objectives. Thirty-six percent (36%) were antiaggregated with AAS. Conclusions: A major deficit is revealed both in the frequency of the check-ups conducted by the healthcare professionals as well as the number of interventions performed for achieving the proposed objectives, showing results far below what is recommended in the clinical practice guidelines.