Aims/hypothesis. The aim of this study was to determine the incidence, prevalence and coronary heart disease risk in patients with known Type 2 (non-insulindependent) diabetes mellitus in a Basque Country sentinel practice network study. Methods. During the year 2000 we did a survey among sentinel practitioners who registered information about previously and newly diagnosed Type 2 diabetic patients older than 24 years of age. We studied 65,651 people attending a primary care service in the Basque Country Health Service-Osakidetza. We collected information about diabetic complications and cardiovascular risk factors and measured the coronary heart disease risk in these patients. Results. In the year 2000, the standardized cumulative incidence and prevalence of known Type 2 diabetes were 5.0 per 1000 (CI 95%: 4.9-5.1) and 4.6% (CI 95%: 4.5-4.7) respectively. Macroangiopathy was the most frequent complication both in the newly diagnosed (21.6%) and previously known Type 2 diabetic patients (33%). Total cholesterol ≥5.17 mmol/l and LDL cholesterol ≥2.58 mmol/l were found in 75% and 90% of newly diagnosed and 65% and 85% of previously diagnosed Type 2 diabetic patients respectively. Of the Type 2 diabetic patients 42% were obese and 80% had high blood pressure. More than 55% of the men compared with 44% of the women with Type 2 diabetes had high or very high risk of coronary heart disease (p<0.05). Conclusion/interpretation. We report new epidemiological data on known Type 2 diabetes in the Basque Country. These patients have a high frequency of cardiovascular risk factors causing a high coronary heart disease risk. [Diabetologia (2003) 46:899-909]

Mental health problems are common in childhood and tend to be more frequent in populations at risk of poverty or social exclusion (AROPE). The family environment can play a role in reducing the impact of economic hardship on these problems. The aim of this study was to assess the effect of multidimensional poverty on the mental health of children aged 7–11 years and the role of the family environment in two areas of Spain. Participants were 395 and 382 children aged 7 and 11 from Gipuzkoa and Valencia, respectively. Internalizing and externalizing problem scales of the child behaviour checklist (CBCL) were used. AROPE indicators were obtained by questionnaire, and three dimensions of the family context (Organization of the Physical Environment and Social Context, Parental Stress and Conflict, and Parental Profile Fostering Development) were measured through subscales 3, 4 and 5 of the Haezi-Etxadi family assessment scale (7–11) (HEFAS 7–11), respectively. Data were analysed using negative binomial regression and Structural Equation Modelling. AROPE prevalence was 7.1 and 34.5% in Gipuzkoa and Valencia, respectively. In both cohorts, there was a significant increase in internalizing and externalizing problems among participants with a higher AROPE score. However, AROPE did not affect internalizing problems in children from families living in a better physical environment and with social support (Subscale 3). The AROPE effect was jointly mediated by subscales 4 and 5 in 42 and 62% of internalizing and externalizing problems, respectively. Preventing economic inequities by economic compensation policies, improving the neighbourhood and immediate environment around the school, and promoting positive parenting programmes can improve mental health in childhood.