Control glucémico de los pacientes ancianos con diabetes mellitus tipo 2 en España (2015) y su relación con la capacidad funcional y la comorbilidad. Estudio Escadiane / Glycaemic control of elderly patients with type 2 diabetes mellitus in Spain (2015) and its relationship with functional capacity and comorbidity. The Escadiane study

Objetivos. Conocer el estado del control glucémico de los pacientes ancianos con diabetes mellitus tipo 2 en España y su relación con la capacidad funcional y la comorbilidad. Métodos. Estudio transversal, observacional, multicéntrico, de ámbito nacional, en pacientes con diabetes mellitus≥65 años. Se estudiaron variables sociodemográficas, antropométricas, factores de riesgo cardiovascular, datos de exploración clínica y analíticos, comorbilidad asociada y tratamientos utilizados. Se analizó la capacidad funcional mediante el índice de Barthel y la comorbilidad con el de Charlson. Resultados. Se incluyeron 939 pacientes. La edad media fue 76,4±6,7 años. La hemoglobina glucosilada (HbA1c) media fue 7,0±1,2% y la glucemia basal media 137±39,6mg/dl. El nivel de HbA1c presentó diferencias estadísticamente significativas según el grado de discapacidad. En los pacientes con dependencia total, grave, moderada, leve o independientes las concentraciones de HbA1c media fueron de 7,0%, 7,9%, 7,4% y 7,0% (p<0,028) respectivamente. Los niveles de HbA1c fueron de 7,3%, 7,1% y 6,9% en los pacientes con comorbilidad muy alta, alta y media, respectivamente (p<0,001). Conclusiones. Los valores medios de HbA1c en los pacientes ancianos con diabetes tipo 2 analizados en España son inferiores a los recomendados por las principales guías de práctica clínica. Son más elevados en los pacientes que presentan mayor grado de discapacidad funcional y un nivel más alto de comorbilidad (AU)

Objectives. To understand the state of glycaemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity. Methods. Cross-sectional, observational, multicentre national study on patients with diabetes mellitus aged 65 years or older. The study analysed demographic and anthropometric variables, cardiovascular risk factors, clinical and laboratory data, associated comorbidity and treatments. We analysed the functional capacity using the Barthel index and the comorbidity with Charlson index. Results. The study included 939 patients with a mean age of 76.4±6.7 years. The mean glycated haemoglobin (HbA1c) level was 7.0%±1.2%, and the mean basal blood glucose level was 137±39.6mg/dL. The HbA1c level showed statistically significant differences depending on the degree of disability. In the patients who were totally, severely, moderately or slightly dependent or who were independent, the mean HbA1c levels were 7.0%, 7.9%, 7.4% and 7.0%, respectively (P<.028). HbA1c levels were 7.3%, 7.1% and 6.9% in the patients with very high, high and medium comorbidity, respectively (P<.001). Conclusions. Mean HbA1c levels in elderly patients with type 2 diabetes analysed in Spain are below those recommended by the main clinical practice guidelines. The levels are higher in patients who have more functional disability and a higher level of comorbidity (AU)

Glycaemic control of elderly patients with type 2 diabetes mellitus in Spain (2015) and its relationship with functional capacity and comorbidity. The Escadiane study. / Control glucémico de los pacientes ancianos con diabetes mellitus tipo 2 en España (2015) y su relación con la capacidad funcional y la comorbilidad. Estudio Escadiane.

OBJECTIVES: To understand the state of glycaemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity. METHODS: Cross-sectional, observational, multicentre national study on patients with diabetes mellitus aged 65 years or older. The study analysed demographic and anthropometric variables, cardiovascular risk factors, clinical and laboratory data, associated comorbidity and treatments. We analysed the functional capacity using the Barthel index and the comorbidity with Charlson index. RESULTS: The study included 939 patients with a mean age of 76.4±6.7 years. The mean glycated haemoglobin (HbA1c) level was 7.0%±1.2%, and the mean basal blood glucose level was 137±39.6mg/dL. The HbA1c level showed statistically significant differences depending on the degree of disability. In the patients who were totally, severely, moderately or slightly dependent or who were independent, the mean HbA1c levels were 7.0%, 7.9%, 7.4% and 7.0%, respectively (P<.028). HbA1c levels were 7.3%, 7.1% and 6.9% in the patients with very high, high and medium comorbidity, respectively (P<.001). CONCLUSIONS: Mean HbA1c levels in elderly patients with type 2 diabetes analysed in Spain are below those recommended by the main clinical practice guidelines. The levels are higher in patients who have more functional disability and a higher level of comorbidity.

[An analysis of long-term computerized prescriptions for those over and under 65 at a health center]. / Análisis de la prescripción crónica informatizada en mayores y menores de 65 años en un centro de salud.

OBJECTIVES: To analyse the origin, diagnoses and types of medicine used in computerised long-term prescription at our centre, which are classified by age distribution; and to extract, if possible, use parameters for monitoring internal activities. DESIGN: Descriptive study. SETTING: Zumaia Health Centre (Guipúzcoa). PATIENTS: 976 patients divided into those over and those under 65, included in the programme of long-term treatment cards. MEASUREMENTS AND MAIN RESULTS: 54% of patients were over 65 and 46% under. Average medicines per patient were 3.24 and 2.23, respectively. 34% of long-term prescription originated in primary care, although primary care was only the main indicator to a significant degree in group K (CIAP) diagnoses for under-65's. The commonest diagnoses belonged to group K, independently of the origin of the prescription. The most prescribed medicines were those in groups M and C (IMC), significantly higher in the over-65's. CONCLUSIONS: Only one third of the prescriptions originated in PC. A significant reversal of this tendency was observed in young people with chronic group K pathologies. The indication of long-term treatment for psychological problems often escapes the public health system; when the PC doctor indicates this treatment, he/she usually does so on the basis of symptomatic conditions. Monitoring new cases could help us find the efficacy of the corrective measures introduced, both at the level of structural innovations and changes in care procedure.