Metabolic control in diabetic patients at the primary care level in México.

In México, several programs in the prevention, diagnosis, and treatment of diabetes mellitus (DM) have been implemented. However, there are no reported studies focusing on practice performed in the metabolic control of diabetics. The purpose of this study was to determine the practice performed by clinicians in the metabolic control of diabetic patients at the primary care level in the Instituto Mexicano del Seguro Social (IMSS) outpatients clinics in Tijuana, México, which has not been done hitherto in México; to detect fasting blood glucose (FBG), total cholesterol, glycosylated hemoglobin (HbA1C), and to analyze the relationship between FBG and selected clinical variables. A cross-sectional analysis was conducted from data obtained from the outpatient clinic files in Tijuana. Odds-ratio, in relation with levels of FBG were calculated. Results included FBG in 94.1%, cholesterol in 66.1%, with HbA1C in non and diet treatment in 4% of patients. FBG level greater than 120 mg/dl was seen in 82.6% of patients, subjects with body mass index (BMI) greater than 36 kg/m2 had higher levels of FBG, odds-ratio, 1.6, and those with hypertension had lower odds-ratio, 0.8. These results suggest a low level in the practice of monitoring indicators in DM, a lack of adequate life style counseling, and poor metabolic control. Basic guidelines should be designed at the local level, together with nutritional counseling and exercise programs for individuals and groups.