Situación de control metabólico y pautas de tratamiento en pacientes con diabetes tipo 1 en Castilla-La Mancha: estudio de diabetes tipo 1 en Castilla-La Mancha

Sastre, Julia; Pinés, Pedro; Moreno, Jesús Rodríguez; Aguirre, Miguel; Blanco, Benito; Calderón, Dulce; Herránz, Sandra; Roa, Carlos; López, José López

doi:10.1016/j.endonu.2012.07.003

Cited by 27 publications

(11 citation statements)

References 27 publications

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“…All 8 studies reporting on SES and risk factors for cardiovascular disease (CVD) or CVD events found an increased risk associated with low SES [16;18;19;21;31;43;47;50]. An association between low SES and increased rates of complications arising from diabetes was observed in 5 studies [21;31;39;43;44].…”

Section: Resultsmentioning

confidence: 99%

“…An association between low SES (as measured by education, social class or income) and poorer glycaemic control was found in nine of the twelve studies [10;16;19;21;31;36;40;43;51]. Two studies found no SES association with glycaemic control [17;35].…”

Section: Resultsmentioning

confidence: 99%

“…For example, only 2 of 12 studies investigating glycaemic control utilised adjusted analysis [19;40], however, both studies found that SES was independently associated with glycaemic control. In one of these studies conducted in the USA, multiple regression demonstrated that level of education was an independent predictor of glycaemic control (p = 0.0008) [40].…”

Section: Resultsmentioning

confidence: 99%

“…In one of these studies conducted in the USA, multiple regression demonstrated that level of education was an independent predictor of glycaemic control (p = 0.0008) [40]. In Spain, a study using adjusted (logistic regression) analysis found that better glycaemic control was also independently associated with higher levels of education (p <0.05) [19]. Only 1 of 3 studies investigating SMBG used adjusted analysis.…”

Section: Resultsmentioning

confidence: 99%

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Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review

et al. 2017

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AimsTo systematically review the evidence of socioeconomic inequalities for adults with type 1 diabetes in relation to mortality, morbidity and diabetes management.MethodsWe carried out a systematic search across six relevant databases and included all studies reporting associations between socioeconomic indicators and mortality, morbidity, or diabetes management for adults with type 1 diabetes. Data extraction and quality assessment was undertaken for all included studies. A narrative synthesis was conducted.ResultsA total of 33 studies were identified. Twelve cohort, 19 cross sectional and 2 case control studies met the inclusion criteria. Regardless of healthcare system, low socioeconomic status was associated with poorer outcomes. Following adjustments for other risk factors, socioeconomic status was a statistically significant independent predictor of mortality in 9/10 studies and morbidity in 8/10 studies for adults with type 1 diabetes. There appeared to be an association between low socioeconomic status and some aspects of diabetes management. Although only 3 of 16 studies made adjustments for confounders and other risk factors, poor diabetes management was associated with lower socioeconomic status in 3/3 of these studies.ConclusionsLow socioeconomic status is associated with higher levels of mortality and morbidity for adults with type 1 diabetes even amongst those with access to a universal healthcare system. The association between low socioeconomic status and diabetes management requires further research given the paucity of evidence and the potential for diabetes management to mitigate the adverse effects of low socioeconomic status.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review

et al. 2017

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“… 4 However, most patients with DM1 have HbA1c values above the international recommendation of <7.0%. 5 Inadequate glycaemic control (HbA1c levels >7.0%) in patients with DM1 was observed in 77% of the participants of a study in the USA in 2016, 6 in 74% of the study patients in the region of Castilla-La Mancha, Spain in 2012, 7 in 87% of patients surveyed in Venezuela 8 and in 84%–90% of the participants of national multicentre studies conducted in Brazil in 2010 and 2015. 9 10 …”

Section: Introductionmentioning

confidence: 99%

Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil

et al. 2017

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ObjectiveLong-term complications of type 1 diabetes mellitus (DM1) can be prevented with adequate glycaemic control. However, high levels of glycated haemoglobin (HbA1c) occur in 60%–90% of the patients with DM1. Thus, we aimed to investigate the role of sociodemographic, behavioural and clinical factors on the HbA1c levels of patients with DM1 in Brazil.Design, setting and participantsA cross-sectional study was conducted in ambulatory patients with DM1 aged ≥18 years from 10 Brazilian cities. Sociodemographic, behavioural and clinical data were obtained through interviews.Main outcome measuresHbA1c level was measured by liquid chromatography. Hierarchical multiple variable linear regression models were used to identify factors correlated with high levels of HbA1c.ResultsOf 979 patients with DM1, 63.8% were women, and the mean age was 40 (SD 14.6) years. The mean HbA1c level was 9.4% (SD 2.2%), and 89.6% of the patients had HbA1c ≥7.0%. Factors independently correlated with increased HbA1c levels included: lower education, non-participation in diabetes classes/lecture during the year before, having a self-perception of poor adherence to diet and insulin, not having private medical care and not measuring the HbA1c levels in the prior year. Of note, poor adherence to diet and insulin were the independent factors most strongly associated with high levels of HbA1c (mean increment in HbA1c levels of 0.88% and 1.25%, respectively).ConclusionPoor glycaemic control, which is common among Brazilian patients with DM1, is associated with lower education, self-perception of insufficient adherence to diet and insulin and inadequate monitoring of HbA1c levels. Specific actions, particularly those targeting improving adherence to diet and insulin, may contribute to successful management of patients with DM1.

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Psychometric properties of a questionnaire to measure adherence to treatment in patients with type 1 diabetes mellitus

et al. 2022

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Aim To validate the psychometric properties of a questionnaire to measure adherence to treatment among people with type 1 diabetes mellitus and to evaluate its relationship with metabolic control. Design A cross‐sectional study of 167 adult people with type 1 diabetes mellitus recruited from the Endocrinology Service of University Hospital Doctor Peset (Spain). Methods The validity of the content, construct and reliability of the instrument were evaluated and the results correlated with levels of glycosylated haemoglobin. Results The questionnaire was composed of 25 items and 5 dimensions, with a score of 25–150 points and an internal consistency of 0.92, according to Cronbach's coefficient α. The content of validity ratio and the construct (exploratory functional analysis, Kaiser–Meyer–Olkin index and Barlett's spherical test) were adequate. We observed a significant correlation between glycosylated haemoglobin levels and treatment adherence. Conclusion The questionnaire to measure adherence to treatment in type 1 diabetes mellitus is consistent, reliable and valid, showing an excellent association with degree of metabolic control.

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Situación de control metabólico y pautas de tratamiento en pacientes con diabetes tipo 1 en Castilla-La Mancha: estudio de diabetes tipo 1 en Castilla-La Mancha

Cited by 27 publications

References 27 publications

Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review

Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review

Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil

Psychometric properties of a questionnaire to measure adherence to treatment in patients with type 1 diabetes mellitus

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