Implantación de la determinación de hemoglobina glucosilada capilar en un Área de Salud: estudio multicéntrico sobre evolución de pacientes con diabetes mellitus de tipo 2

Purpose

The aim of this study was to evaluate the efficiency of a joint intervention that included educational components, self-assessment, and information to optimise diabetes control through the introduction of instant capillary glycosylated haemoglobin (HbA1c) determination in Primary Care.

Materials and methods

A multicentre prospective descriptive study was carried out over 3 years in 10 Primary Care Centres of the Area VII Murcia East. At the end of the study there were 804 patients with type 2 diabetes (DM2). Patients were divided into 4 groups based on initial values of HbA1c, and if changes in their treatment were needed. HbA1c, body mass index, and blood pressure were monitored. A financial assessment was also performed on the impact of the implementation of a protocol to measure instant capillary

Results

A significant reduction was observed in HbA1c values. The initial HbA1c mean value was 7.4 ± 1.4%, which decreased to a final value of 6.9 ± 1.0% (P<.001). At the end of the study, 71.4% of patients included reached diabetic control objectives. In addition, the financial assessment demonstrated that the implementation of this diabetes control system led to a decrease of the 24.7% in spending on glucose strips after the first year of study in Area VII Murcia Health Service.

Conclusions

The introduction of capillary HbA1c determination in Primary Care has demonstrated to improve diabetes control and the efficiency of the health personnel. Furthermore, a reduction in the health costs of patients with DM2 was also shown.