Prevalencia y control de la diabetes mellitus tipo 2 entre los médicos de Atención Primaria de España. Estudio PRISMA / Prevalence and control of type 2 diabetes mellitus among primary care physicians in Spain. PRISMA Study

RESUMEN

Objetivo: Describir la prevalencia de la diabetes mellitus tipo 2 (DM2) conocida e ignorada entre los médicos de Atención Primaria (MAP), así como el tratamiento utilizado y el grado de control metabólico. Material y métodos: Estudio descriptivo transversal de ámbito nacional. Fueron elegidos 495 MAP aleatoriamente entre los médicos afiliados a la Fundación redGDPS. A todos se les determinó la HbA1ccapilar con dispositivo A1CNow+(R) y se les aplicó una encuesta específicamente diseñada para el estudio. Resultados: La prevalencia total de DM2 fue del 11,1% (IC 95% 8,33-13,9) (8,1% con DM2 conocida y 3,0% con DM2 ignorada) y del 16,2% para la prediabetes (IC 95% 13,0-19,4). El 62,5% de los MAP con DM2 conocida alcanzan cifras de control de la HbA1c<7% y el 15% tienen cifras superiores a HbA1c>8,5%. El control tensional (PA<140/90mmHg) se alcanza en el 87,5% y el control del colesterol LDL<130mg/dl sin antecedentes de enfermedad cardiovascular es alcanzado por el 88,6% de los casos de DM conocida, y si existen antecedentes de enfermedad macrovascular, el LDL<100mg/dl solo se alcanza en el 42,9% de los casos. El 12,5% son fumadores activos. El 71,4% de los MAP con DM conocida se autotrataban su propia enfermedad, habitualmente con 2 o más fármacos (el 51,4%). El fármaco más utilizado era la metformina (74,3%), seguido por los iDPP4 (el 48,6%). Conclusiones: Los MAP con DM2 tienen un control metabólico algo mejor que la población general. Es necesario estudiar si los pacientes de MAP con DM2 pueden tener una mayor adherencia al tratamiento y alcanzar un mejor control metabólico (AU)

ABSTRACT

Objective: To describe the prevalence of known and ignored type 2 diabetes mellitus (T2DM) among primary care physicians (PCP), as well as the treatment used and the degree of metabolic control reached. Material and methods: Descriptive cross-sectional study on national level. The participants were randomly selected PCPs, members of the redGDPS Foundation. A total of 495 PCP were enrolled. Capillary HbA1c measurement was done with a A1CNow+(R) device and a diabetes-related survey specifically designed for the study was administered to the participants. Results: The total prevalence of T2DM was 11.1% (95% CI 8.33-13.9) (known disease 8,1% and ignored disease 3.0%). The prevalence of prediabetes was 16.2% (95% CI 13.0-19.4). A total of 62.5% of PCPs with known T2DM reached HbA1c<7% and 15% had HbA1c>8.5%. Control of blood pressure (BP<140/90mmHg) was reached in 87.5% and control of LDL cholesterol<130mg/dl with no history of cardiovascular disease was reached in 88.6% of cases of known T2DM. In the PCPs with a history of macrovascular disease, good control of LDL was reached in 42.9% of the cases. A total of 12.5% were active smokers. A total of 71.4% of PCPs with known T2DM self-treated their own disease, usually with 2 or more drugs (51.4%). The most commonly used drug was metformin (74.3%) followed by iDPP4 (48.6%). Conclusions: PCPs with T2DM have better metabolic control than the general population. It is necessary to study whether PCPs with T2DM may have greater adherence to treatment and do they achieve a better metabolic control (AU)