METABOLIC CONTROL IN DIABETIC-PATIENTS AT THE PRIMARY-CARE LEVEL IN MEXICO

In Mexico, several programs in the prevention, diagnosis, and treatmen t of diabetes mellitus (DM) have been implemented. However, there are no reported studies focusing on practice performed in the metabolic co ntrol of diabetics. The purpose of this study was to determine the pra ctice performed by clinicians in the metabolic control of diabetic pat ients at the primary care level in the Institute Mexicano del Seguro S ocial (IMSS) outpatients clinics in Tijuana, Mexico, which has not bee n done hitherto in Mexico; to detect fasting blood glucose (FBG), tota l cholesterol, glycosylated hemoglobin (HbA(1C)), and to analyze the r elationship between FBG and selected clinical variables. A cross-secti onal analysis was conducted from data obtained from the outpatient cli nic files in Tijuana. Odds-ratio, in relation with levels of FBG were calculated. Results included FBG in 94.1%, cholesterol in 66.1%, with HbA(1C) in none and diet treatment in 4% of patients. FBG level greate r than 120 mg/dl was seen in 82.6% of patients, subjects with body mas s index (BMI) greater than 36 kg/m(2) had higher levels of FBG, odds-r atio, 1.6, and those with hypertension had lower odds-ratio, 0.8. Thes e results suggest a low level in the practice of monitoring indicators in DM, a lack of adequate life style counseling, and poor metabolic c ontrol. Basic guidelines should be designed at the local level, togeth er with nutritional counseling and exercise programs for individuals a nd groups. (C) 1997 Elsevier Science Ireland Ltd.