Control de las cifras de presión arterial en diabéticos tipo 2 tratados con insulina / Blood pressure control in diabetics type 2 treated with insulin

Objetivo: Valorar el control de las cifras de presión arterial (PA) tras 2 añosde seguimiento, en pacientes diabéticos tipo 2 (DM2) tratados con insulina.Métodos: Estudio prospectivo, longitudinal y multicéntrico, realizado en atenciónprimaria, con la participación de 121 pacientes con DM2 que precisaroninicio o modificación del tratamiento con insulina y con seguimiento de 2 años.Se efectuaron 5 visitas (inclusión y 6, 12, 18 y 24 meses). Se midió la PA endos ocasiones. Se calcularon las medias de PA y el grado de control. Se considerócontrol cuando la PA fue <140 y 90 mmHg para la PAS y la PAD, respectivamente.Resultados: Concluyeron 103 pacientes (85,1%) (edad 66,4años; DE 11,6), de los que 45 (43,69%) eran varones. Las PAS y PAD fueron,respectivamente, de 140,2 (DE 14,2) y 86,1 (DE 9,2) mmHg en la visitainicial, de 140,3 (DE 14) y 86,8 (DE 8,6) mmHg al año, y de 141,3 (DE14,5) y 86,9 (DE 8,3) mmHg a los 2 años (p= NS entre la visita inicial y lafinal). Estaban controlados el 37,8% (IC 95%: 28,4-47,2), el 53,4% (IC95%: 43,8-63) y el 38,8% (IC 95%: 29,43-48,17) por visitas (inicial y 12 y24 meses, respectivamente) (p= NS inicial-final). Conclusiones: El controlde la PA en la DM2 tratada con insulina es muy bajo, no modificándose a los2 años de seguimiento(AU)

Objective: To know the blood pressure (BP) control in patients with type 2 diabetestreated with insulin after two years of follow-up. Setting: 9 health centersof Primary Care. Design: Prospective, longitudinal, multicentric study performedin Primary Care settings. 121 patients with type 2 diabetes who needed initiationor modifi cation of insulin therapy were included. During the 2 years of follow-up,5 visits (inclusion, and 6,12,18, and 24 months) were performed. The compliancewas studied by means of count of insulin. BP was measured in two occasionsand mean BP and degree of BP control was evaluated. Good control wasdefi ned when SBP was <140 mmHg, and DBP was <90 mmHg, respectively.Results: 103 patients (85.1%) (mean age 66.4 years, SD 11.6) concluded thestudy, of which 45 were men (43.69%). SBP and DBP were respectively 140.2(SD 14.2) and 86.1 (SD 9.2) mmHg at the initial visit, 140.3 (SD 14) and 86.8(SD 8.6) mmHg at 1 year and 141.3 (SD 14.5) and 86.9 (SD 8.3) at 2 years(p= NS between initial-fi nal visit). 37.8% (CI 95%: 28.4-47.2), 53.4% (CI 95%:43.8-63) and 38.8% (CI 95%: 29.43-48.17) for visits (initial, 12 and 24months, respectively) (p= NS initial-fi nal) had BP controlled. Conclusions:Blood pressure control in patients with type 2 diabetes treated with insulin is verylow, without changes after 2 years of follow-up(AU)

[Efficacy of an intervention to improve treatment compliance in hyperlipidemias]. / Eficacia de una intervención para mejorar el cumplimiento terapéutico en las dislipemias.

OBJECTIVE: To analyse the efficacy of the intervention through a telephone call about patients' compliance with lipaemia therapy. DESIGN: Controlled, randomised clinical trial. SETTING: Ten clinics at 6 primary care centres. PARTICIPANTS: 126 people diagnosed with hypercholesterolaemia according to Spanish Consensus criteria were chosen. INTERVENTION: Two groups were formed. The control group (CG) of 63 patients, who received the doctor's normal treatment; and the Intervention group (IG) of 63 patients, who received in addition a telephone call at 2 weeks, 2 months and 4 months. MAIN MEASUREMENTS: Pills were counted and cholesterol, triglycerides, HDL-C and LDL-C determined at the start, and at the third and sixth months. Percentages of patients complying (80%-110%), the mean compliance percentage and the degree of control were compared. The reduction of absolute and relative risk (RAR and RRR) and the mean number of people that required an intervention in order to avoid non-compliance (NI) were calculated. RESULTS: 115 people (91.26%) completed the survey, 56 in the IG and 59 in the CG. 77.1% complied with the therapy (CI, 68.4-85.8), (CG=64.4%, CI, 55.3-73.5; IG=93.5%, CI, 88.8-98 [P<.001]). Mean compliance ran at 88.7 +/- 10.2 overall, at 84.4 +/- 12.8 in the CG and at 93 +/- 8.2 in the IG (P<.001). The RAR was 29.1%, the RRR 81%, and the NI was 3.43 patients. The patients controlled ran at 43.9% in the IG (CI, 34.9-52.9) and 23.1% in the CG (CI, 15.4-30.8) (P<.005). CONCLUSIONS: The telephone intervention is an efficacious way of improving the percentage of patients complying with lipaemia treatment.