Glycemic control, treatment and complications in patients with type 1 diabetes amongst healthcare settings in Mexico.

Autor: Antonio-Villa NE; MD/PhD (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico; Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., García-Tuomola A; Departamento de Endocrinología y Metabolismo. Instituto Nacional de Ciencias Médicas y Nutrición'Salvador Zubirán, Mexico City, Mexico; Endocrinology, Centro Medico ABC, Mexico City, Mexico., Almeda-Valdes P; Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Departamento de Endocrinología y Metabolismo. Instituto Nacional de Ciencias Médicas y Nutrición'Salvador Zubirán, Mexico City, Mexico., Vidrio-Velázquez M; Endocrinology, HGR 110 IMSS, Guadalajara, Jalisco, Mexico., Islas-Ortega L; Pediatric Endocrinology, Hospital del Niño DIF Hidalgo, Pachuca, Hidalgo, Mexico., Madrigal-Sanromán JR; Endocrinology and Diabetes, Clinica EnDi, Mexico City, Mexico., Zaballa-Lasso C; Nutrition, Clínica EnDi, Mexico City, México., Martínez-Ramos-Méndez A; Pediatric Endocrinology, Hospital Español, Mexico City, Mexico., De la Garza-Hernández NE; Endocrinology, CEMEDIN, San Pedro Garza García, Nuevo León, Mexico., Bustamante-Martínez JF; Internal Medicine Department, Servicios de Salud de Nayarit, Hospital General de Tepic, Tepic, Nayarit, Mexico., González-Galvez G; Endocrinology, Instituto Jalisciense de Investigación en Diabetes y Obesidad S. C, Guadalajara, Jalisco, Mexico., Valadez-Capetillo M; Hospital de Especialidades del Niño y la Mujer, Querétaro, Querétaro, México., Sanchez-Ruiz KL; Clínica de Diabetes, Secretaría de Salud del Estado de Durango, Durango, Durango, Mexico., Castillo-Galindo C; Endocrinology and Diabetes, Clinica EnDi, Mexico City, Mexico., Yepez-Rodríguez AE; Endocrinology, Corporativo Hospital Satélite, Estado de México, Mexico., Polanco-Preza MA; Endocrinology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico., Ceballos-Macías JJ; Endocrinology, Especialidades Médicas SEDENA, Mexico., Valenzuela-Montoya JC; Pediatric Endocrinology, Hospital De Gineco-Pediatría No. 31 IMSS, Mexicali, Baja California Norte, Mexico., Escobedo-Ortiz AR; Endocrinology, Hospital General Dr. Miguel Silva, Secretaria de Salud, Morelia, Michoacán, Mexico., Ferreira-Hermosillo A; Endocrinology, Unidad de Investigación Médica en Enfermedades Endocrinas. Centro Médico Nacional Siglo XXI, IMSS, Mexico., Rodríguez-Sanchez E; Diabetes Service, Hospital Rovirosa, Secretaria de Salud, Villahermosa, Tabasco, Mexico., Romero-Zazueta A; Endocrinology, Clinica de Endocrinologia, Culiacan, Sinaloa, Mexico., Miracle-López S; Endocrinology, Hospital Angeles Lomas, Huixquilucan, México; Associate Investigator, Centro de Investigación en Ciencias de la Salud (CICSA) Universidad, Anáhuac, Mexico., Figueroa-Andrade MH; Endocrinology, Hospital General de Zona #1 IMSS, Colima, Colima, Mexico., Faradji RN; Endocrinology and Diabetes, Clinica EnDi, Mexico City, Mexico; Endocrinology, Centro Medico ABC, Mexico City, Mexico. Electronic address: rfaradji@gmail.com.
Jazyk: angličtina
Zdroj: Diabetes research and clinical practice [Diabetes Res Clin Pract] 2021 Oct; Vol. 180, pp. 109038. Date of Electronic Publication: 2021 Sep 04.
DOI: 10.1016/j.diabres.2021.109038
Abstrakt: 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.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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