Glycemic control, treatment and complications in patients with type 1 diabetes amongst healthcare settings in Mexico
Por:
Eduardo Antonio-Villa, Neftali, Garcia-Tuomola, Aili, Almeda-Valdes, Paloma, Vidrio-Velazquez, Maricela, Islas-Ortega, Laura, Madrigal-Sanroman, Juan R., Zaballa-Lasso, Carmenmari, Martinez-Ramos-Mendez, Angelica, De la Garza-Hernandez, Natalia E., Bustamante-Martinez, Jorge F., Gonzalez-Galvez, Guillermo, Valadez-Capetillo, Mayra, Sanchez-Ruiz, Karla L., Castillo-Galindo, Carmen, Yepez-Rodriguez, Alicia E., Polanco-Preza, Miguel A., Ceballos-Macias, Jose J., Valenzuela-Montoya, Julio C., Escobedo-Ortiz, Ana R., Ferreira-Hermosillo, Aldo, Rodriguez-Sanchez, Ester, Romero-Zazueta, Alejandro, Miracle-Lopez, Sigfrido, Figueroa-Andrade, Mario H., Faradji, Raquel N., RENACED-DT1 Res Grp
Publicada:
1 oct 2021
Resumen:
Aims: Type 1 diabetes (T1D) is a growing chronic disease. Evidence of
whether the healthcare setting affects management and glycemic control
is scarce. We evaluate outcomes in patients with T1D in private and
public healthcare settings in Mexico, registered in the National T1D
Registry in Mexico (RENACED-DT1). Methods: Biochemical parameters,
diabetes education, and treatment were analyzed considering the data
registered in the last visit. Development of chronic complications was
determined during follow-up. Results: We included 1,603 patients; 71.5%
(n = 1,146) registered in the public system, and 28.5% (n = 457) in a
private institution. Patients in the public setting had higher HbA1c
(8.6%, IQR: 7.3%-10.5% vs 7.7%, IQR: 7.0%-8.8%; p < 0.001).
Indicators of diabetes education, glucose monitoring, and use of
insulin-pumps were lower in the public setting. Patients in the public
setting were at higher risk of diabetic chronic kidney disease,
retinopathy, and neuropathy. Diabetes knowledge was a mediator between
type of healthcare setting and the likelihood of achieving glycemic
control. Conclusions: Patients registered in public healthcare settings
have an adverse metabolic profile and higher risk of complications.
Social factors need to be addressed in order to implement
multidisciplinary measures focused on diabetes education for patients
with T1D in Mexico. CO 2021 Elsevier B.V. All rights reserved.
Filiaciones:
Eduardo Antonio-Villa, Neftali:
Univ Nacl Autonoma Mexico, Fac Med, Mexico City, DF, Mexico
Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Unidad Invest Enfermedades Metab, Mexico City, DF, Mexico
Garcia-Tuomola, Aili:
Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Endocrinol & Metab, Mexico City, DF, Mexico
Ctr Med ABC, Endocrinol, Mexico City, DF, Mexico
Almeda-Valdes, Paloma:
Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Unidad Invest Enfermedades Metab, Mexico City, DF, Mexico
Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Endocrinol & Metab, Mexico City, DF, Mexico
Vidrio-Velazquez, Maricela:
HGR 110 IMSS, Endocrinol, Guadalajara, Jalisco, Mexico
Islas-Ortega, Laura:
Hosp Nino DIF Hidalgo, Pediat Endocrinol, Pachuca, Hidalgo, Mexico
Madrigal-Sanroman, Juan R.:
Clin EnDi, Endocrinol & Diabet, Av Paseo Las Palmas 745-401B Lomas de Chapultepec, Mexico City 11000, DF, Mexico
Zaballa-Lasso, Carmenmari:
Clin EnDi, Nutr, Mexico City, DF, Mexico
Martinez-Ramos-Mendez, Angelica:
Hosp Espanol, Pediat Endocrinol, Mexico City, DF, Mexico
De la Garza-Hernandez, Natalia E.:
CEMEDIN, Endocrinol, San Pedro Garza Garcia, Nuevo Leon, Mexico
Bustamante-Martinez, Jorge F.:
Hosp Gen Tepic, Internal Med Dept, Serv Salud Nayarit, Tepic, Nayarit, Mexico
Gonzalez-Galvez, Guillermo:
Inst Jalisciense Invest Diabet & Obesidad SC, Endocrinol, Guadalajara, Jalisco, Mexico
Valadez-Capetillo, Mayra:
Hosp Especialidades Nino & Mujer, Queretaro, Queretaro, Mexico
Sanchez-Ruiz, Karla L.:
Secretaria Salud Estado Durango, Clin Diabet, Durango, Durango, Mexico
Castillo-Galindo, Carmen:
Clin EnDi, Endocrinol & Diabet, Av Paseo Las Palmas 745-401B Lomas de Chapultepec, Mexico City 11000, DF, Mexico
Yepez-Rodriguez, Alicia E.:
Corp Hosp Satelite, Endocrinol, Naucalpan, Estado De Mexic, Mexico
Polanco-Preza, Miguel A.:
Hosp Civil Guadalajara Fray Antonio Alcalde, Endocrinol Serv, Guadalajara, Jalisco, Mexico
Ceballos-Macias, Jose J.:
Especialidades Med SEDENA, Endocrinol, Mexico City, DF, Mexico
Valenzuela-Montoya, Julio C.:
Hosp Gineco Pediat 31 IMSS, Pediat Endocrinol, Mexicali, Baja California, Mexico
Escobedo-Ortiz, Ana R.:
Hosp Gen Dr Miguel Silva, Secretaria Salud, Endocrinol, Morelia, Michoacan, Mexico
Ferreira-Hermosillo, Aldo:
IMSS, Unidad Invest Med Enfermedades Endocrinas, Endocrinol, Ctr Med Nacl Siglo XXI, Mexico City, DF, Mexico
Rodriguez-Sanchez, Ester:
Hosp Rovirosa, Diabet Serv, Secretaria Salud, Villahermosa, Tabasco, Mexico
Romero-Zazueta, Alejandro:
Clin Endocrinol, Endocrinol, Culiacan, Sinaloa, Mexico
Miracle-Lopez, Sigfrido:
Hosp Angeles Lomas, Endocrinol, Huixquilucan, Mexico
Ctr Invest Ciencias Salud CICSA Univ, Anahuac, Mexico
Figueroa-Andrade, Mario H.:
IMSS, Endocrinol, Hosp Gen Zona 1, Colima, Colima, Mexico
Faradji, Raquel N.:
Clin EnDi, Endocrinol & Diabet, Av Paseo Las Palmas 745-401B Lomas de Chapultepec, Mexico City 11000, DF, Mexico
Ctr Med ABC, Endocrinol, Mexico City, DF, Mexico
|