Mejoría del control de la diabetes en atención primaria tras implantar un programa de atención con la determinación instantánea en sangre capilar de hemoglobina glucosilada

Abstract

Objective

The aim of this study was to evaluate the effectiveness of a joint intervention, with educational, self-evaluation and feedback components, in order to optimize diabetes control by measuring HbA1c in capillary blood.

Material and methods

A prospective, pilot study, of one year duration was carried out in the Primary Care Health Centre «El Carmen» (VII Area Murcia East). A total of 266 patients over 16 years old were included in the study. Instant capillary HbA1c (DCA VANTAGE de SIEMENS) was measured on patients who attended the clinics. The patients were divided into 4 different groups, depending on HbA1c values and the requirement of intensifying treatment (Group A: patients with good control of their diabetes (HbA1c < 7%, or 8% in patients over 70 years old) and no changes in the treatment; B: patients with good control of their diabetes and required changes in the treatment; C: patients with poor control and no changes in treatment (non-optimization criteria); and D: patients with poor control and treatment intensification).

Results

The mean age was 66.36 ± 12.56 years, and the body mass index (BMI) was 29.72 ± 4.92 kg/m². The initial HbA1c mean value was 7.79 ± 1.57%, which decreased to a final HbA1c mean value of 6.91 ± 1.07% (P < .001). A change in the therapeutic inertia was searched by the healthcare personnel, who found that the 74.81% of the diabetic patients reached the control objectives. BMI decreased by –0.34 ± 1.04 kg/m² (P < .001).

Conclusions

Instant capillary HbA1c is a simple, rapid and efficient method to improve diabetes control. It is necessary to sensitize the healthcare personnel in Primary Care to assume this kind of intervention, both educational and pharmacological, to improve values in type 2 diabetes patients.