Evolution of the Prevalence of Obesity in the Workers of a General Hospital in Mexico

OBJECTIVE -To assess and compare the technical accuracy of portable glucose meters during the last decade.RESEARCH DESIGN AND METHODS -One-thousand preprandial (pre) and postprandial (post) capillary whole-blood glucose values measured with meters owned mainly by diabetic patients were compared with a single laboratory method yearly from 1989 to 1999. A total of 21,950 capillary measurements and their corresponding laboratory reference values were analyzed at our clinic.RESULTS -The lowest mean absolute difference was found in 1989 (pre: 2 Ϯ 22 mg/dl, post: 9 Ϯ 31 mg/dl) (mean Ϯ SD). The highest mean absolute difference was observed in 1993 (pre: 31 Ϯ 33 mg/dl) and 1996 (post: 50 Ϯ 35 mg/dl). The highest mean relative deviation was observed in 1990 (pre: 16.4%) and 1996 (post: 20.6%). The highest percentage of readings that were within a 5% deviation limit were observed in 1998 (pre: 44.5%) and in 1997 (post: 36.7%). Based on blood glucose levels within Ϯ5 and Ϯ10% of laboratory values, the technical accuracy of meters was similar for 1989 and 1999 (P ϭ 0.27 and 0.52, respectively). The percentage of pre values in zone A of Clarke's error grid analysis was Ͼ90% in 1989, 1997, 1998, and 1999.CONCLUSIONS -The analytical performance of glucose meters decreased between 1990 and 1996 but was restored between 1997 and 1999. Nevertheless, our data suggest that the technical accuracy of glucose meters has not significantly improved during the last decade. Complementary studies taking into account the preanalytical improvements of the recent meters, as well as their calibration method, appear necessary. Diabetes Care 26:1170 -1175, 2003S elf-monitoring of blood glucose is now considered to be an important tool in the management of insulintreated diabetes (1). Its importance has increased since Diabetes Control and Complications Trial results have shown that proper control of glucose levels is associated with a reduced risk of microvascular disease in type 1 diabetes (2). Portable glucose meters are widely used in type 2 diabetes, although their contribution to blood glucose improvement has not been established (3). In the last two decades, results obtained with glucose meters appear to have become more reproducible and accurate. The meters have also become smaller, faster for blood glucose analysis, and easier to use (4,5). Although there are some studies concerning user error (6,7), information relating to the evolution of analytical error appears limited (8). To determine whether the analytical accuracy has changed in relation to the global improvement of meter performances, we have prospectively compared, at our clinic and under medical control, 1,000 preprandial and postprandial capillary blood glucose measures using various portable meters on a yearly basis between 1989 and 1999 in comparison to a single reference method (RM). RESEARCH DESIGN AND METHODS -In our Department ofDiabetes, most of the diabetic patients (mainly type 1 and type 2 diabetes) benefit from an annual check-up during which each patient's device ...

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“…This was not surprising and remains consistent with the most recent studies analyzing the performance of glucose meters (5,17,25,28).…”

Section: Methodssupporting

confidence: 76%

“…All the studies relating to accuracy and precision of home blood glucose meters were performed in a crosssectional manner (4,8,(15)(16)(17)(18). Our results suggest that the older glucose meters from the late 1980s have similar accuracy to the newer ones.…”

Section: Methodsmentioning

confidence: 69%

Evolution of Analytical Performance in Portable Glucose Meters in the Last Decade

et al. 2003

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“…18,19 The included population may be consider as representative of middle class urban population in Mexico City; so the obtained results may not be readily applied to the rest of the Mexican population, for instance countryside populations, or populations from other regions of the country.…”

Section: Discussionmentioning

confidence: 99%

Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dyslipidaemia in a Mexican population

et al. 2001

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OBJECTIVE:To determine values of simple anthropometric measurements which are associated with the presence of type 2 diabetes mellitus, hypertension and dyslipidaemia and to assess anthropometric cut-off values for predicting the likelihood of these chronic conditions in a Mexican population. DESIGN AND SETTING: The data were obtained from PRIT (Prevalence of Cardiovascular Risk Factors in General Hospital Workers) surveys from 1994 to 2000 adjusted to the structure of the overall Mexican population. SUBJECTS: A total of 2426 men and 5939 women aged 38.99 AE 7.11 and 39.11 AE 14.25 y, respectively. MEASUREMENTS: The optimal sensitivity and specificity of using various cut-off values of BMI (body mass index), WHR (waistto-hip ratio), WC (waist circumference) and WTH (waist-to-height ratio) to predict type 2 diabetes mellitus (DM), hypertension (HT), or dyslipidaemia were examined by receiver operating characteristic curve (ROC) analysis. The likelihood ratios for having diabetes, hypertension and dyslipidaemia in subjects with various cut-off values of BMI, WHR, WC and WTH were calculated. Multiple step-wise logistic regression analysis was used to examine the independent relationship between the anthropometric indexes, age and smoking, and the odds ratio of having chronic conditions. RESULTS: The BMI cut-off to predict DM, HT, or dyslipidaemia varied from 25.2 to 26.6 kg=m 2 in both men and women. The optimal WC cut-offs were 90 cm in men and 85 cm in women. The WHR cut-off was about 0.90 in men and 0.85 in women, and the optimal WTH cut-off was 52.5 in men and varied from 53 to 53.5 in women. The cut-off levels for WC, WHR and WTH corresponded to the inflexion points in the likelihood ratio graphs. In the case of BMI likelihood ratio graphs, we found a significant increase in the risk for chronic conditions from 22 to 23 BMI levels in both genders. Logistic regression analyses disclosed that only BMI and age were included in all the models as well as the influence of smoking in DM and dyslipidaemia in men. CONCLUSION: Although these results may not be readily applied to the rest of the Mexican population or to other Hispanic populations, they point to the necessity of similar studies with large randomized samples to find the cut-off levels for chronic conditions in different populations.

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“…In Mexico, for example, both adults (43)(44)(45) and children (17,44,45) are struggling with overweight. Investigators reported that the rates of overweight in young Mexican children (under 5 years old) are 19% (45).…”

mentioning

confidence: 99%

Overweight and aerobic fitness in children in the United States/Mexico border region

Coleman¹,

Heath²,

Alcalá³

2004

Rev Panam Salud Publica

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Objective. To study overweight and aerobic fitness among children in the third and fourth grades of elementary schools in a city in the United States of America (El Paso, Texas) and a city in Mexico (Chihuahua, Chihuahua) Child, anthropometry, obesity, physical fitness, Mexico, Mexican Americans. ABSTRACTWhile the impact that a healthy lifestyle has on coronary artery disease, obesity, and type 2 diabetes is well documented, that knowledge has not led to substantial changes in diet and physical activity in the United

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Evolution of the Prevalence of Obesity in the Workers of a General Hospital in Mexico

Cited by 11 publications

References 15 publications

Evolution of Analytical Performance in Portable Glucose Meters in the Last Decade

Evolution of Analytical Performance in Portable Glucose Meters in the Last Decade

Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dyslipidaemia in a Mexican population

Overweight and aerobic fitness in children in the United States/Mexico border region

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