Factores relacionados con el control glucémico de pacientes con diabetes tipo 2

Abstract

Objectives: To describe metabolic, lipidic and blood pressure control and to identify blood glucose control predictive factors in patients with type 2 diabetes. Material and methods: Retrospective cohort study. Ambulatory type 2 diabetic patients were selected from 2/1/00 to 14/11/01 if they had been visited yearly at least three years previously. They were classified into three groups: a) initial and final treatment with diet and/or oral glucoselowering drugs; b) insulinized patients during follow-up; and c) initial and final therapy with insulin. Body mass index (BM1), blood pressure, HbA1c and lipid profile were determined at start and at the end of the study. A multiple regression model was used to predict mean HbA1c through follow-up. Results: 320 patients were selected, 199 women (62.2%) and 121 men (37.8%) with mean age of 69 years (SD: 9). Mean follow-up was 5.2 years (SD: 1.1). 106 patients (33.8%) were included into A group, 70 patients (22.4%) into B group and 137 (43.8%) into C group. 63% of patients had values of HbA1c > 7.5%, 36% blood pressure > 140/85 mmHg and 8.5% LDL values >155 mg/dl. HbA1c mean through follow-up was of 8.2% and its independent predictors were baseline HbA1c (0.37; 1C 95% 0.31-0.43; p<0.001), baseline BM1 (0.023; 1C 95% 0.004-0.042; p=0.017), baseline treatment with insulin (0.67; 1C 95% 0.45-0.88; p<0.001) and insulinization during follow-up (0.46; 1C 95% 0.21-0.71; p<0.001). Conclusions: It's difficult to achieve an acceptable blood glucose control. Mean HbA1c predictive factors include baseline HbA1c and BM1 and insulin therapy.