Objective: To evaluate the degree of control of metabolic goals in a group of very selected type 1 and 2 diabetic patients.
Methods: A cross-sectional and descriptive study was done. Patients were enrolled consecutively in the Diabetes Clinic in a tertiary-care hospital in México City during the period between april and july 2005. The population at this clinic is very selected as demonstrated by the fact that all type 2 diabetic patients were treated with drugs for diabetic control, including insulin in 43% of them. We used the goals recommended by the American Diabetes Association (ADA) as parameters to analyze and additionally included non-HDL cholesterol and the atherogenic index.
Results: A total of 530 patients were included; 468 (58.8% female) had type 2 diabetes, with an average age of 58.5 years; 62 (65% female) patients had type 1 diabetes, with an average age of 31.2 years. The mean HbA1c values were 10.2 +/- 2.8 and 9.0 +/- 2.4 in type 1 and type 2 diabetic patients, respectively. The proportion of diabetic type 1 and 2 patients reaching treatment goals were 12.9% and 23.7% for HbA1c (p=0.02), 82.2% and 57.2% for both systolic and diastolic blood pressure (p=0.0001), 75.8% and 49.3% for triglycerides (p=0.0001), 45.1% and 35.6% for LDL-c (p=0.16), 51.6% and 53.4% for HDL-c (p=0.79), 56.4% and 43.3% for non-HDL cholesterol (p=0.03) and 58.0% and 55.1% for atherogenic index (p=0.66), respectively. The proportion of patients reaching all the optimal treatment goals (non-HDL cholesterol, HbA1c, arterial blood pressure and triglycerides) was 6.4% for type 1 diabetic patients and 4.4% for type 2 patients (p=0.6). Factors associated with achieving goal values in a multiple regression analysis were drug treatment for high blood pressure, use of lipid lowering drugs, insulin use and a history of stroke.
Conclusions: Our results are not comparable with other publications of series evaluating the same parameters in open populations. The results show that the degree of control of evaluated risk factors is not good, principally in the case of glucemic control; it is necessary to plan strategies that help to reach these goals in diabetic patients.