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Control of type 2 diabetes mellitus among general practitioners in private practice in nine countries of Latin America.

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Title: Control of type 2 diabetes mellitus among general practitioners in private practice in nine countries of Latin America.
Alternate Title: Control de la diabetes mellitus tipo 2 por médicos generales del sector privado en nueve países de América Latina.
Authors: Stewart, Gloria Lopez1 glopezstewart@mi.cl, Tambascia, Marcos2, Guzmán, Juan Rosas3, Etchegoyen, Federico4, Carrion, Jorge Ortega5, Artemenko, Sofia6
Source: Pan American Journal of Public Health / Revista Panamericana de Salud Pública. Jul2007, Vol. 22 Issue 1, p12-20. 9p.
Subjects: DIABETES, GENERAL practitioners, MEDICAL care, EPIDEMIOLOGY, DRUG utilization
Geographic Terms: LATIN America
Abstract (English): Objectives. To better understand how diabetes care and control are being administered by general practitioners/nonspecialists in private practice in nine countries of Latin America, and to identify the most significant patient- and physician-related barriers to care. Methods. A multicenter, cross-sectional, epidemiological survey was conducted in nine countries in Latin America: Argentina, Brazil, Chile, Costa Rica, Ecuador, Guatemala, Mexico, Peru, and Venezuela. General practitioners in private practice were asked to provide care and control data for patients 18 to 75 years of age with type 2 diabetes mellitus (T2DM), including demographics, medical and medication history, laboratory exams, and information on the challenges of patient management. Results. Of the 3 592 patient questionnaires returned by 377 physicians, 60% of the patients had a family history of diabetes, 58%followed a poor diet, 71% were sedentary, and 79% were obese or overweight. Poor glycemic control (fasting blood glucose ≥ 110 mg/dL) was observed in 78% of patients. The number of patients with HbA1c < 7.0% was 43.2%. Glycemic control decreased significantly with increased duration of T2DM. Comorbid conditions associated with T2DM were observed in 86% of patients; insulin use and comorbid conditions, especially those associated with microvascular complications, increased significantly disease duration. Ensuring compliance with recommended diet and exercise plans was the most-cited patient management challenge. Conclusions. Blood glucose levels are undercontrolled in T2DM patients in the private health care system in Latin America, particularly among those who have had the disease the longest (>15 years). Considering the differences between private and public health care in Latin America, especially regarding the quality of care and access to medication, further studies are called for in the public setting. Overall, a more efficient and intensive program of T2DM control is required, including effective patient education programs, adjusted to the realities of Latin America. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivos. Comprender mejor cómo los médicos generales/no especialistas del sector privado atienden y controlan la diabetes en nueve paises de América Latina e identificar los principales problemas retacionados con el paciente y el médico, que obstaculizan la atención. Métodos. Se realizó un estudio epidemiológico, multicéntrico, transversal, en nueve palses de América Latina: Argentina, Brasil, Chile, Costa Rica, Ecuador, Guatemala, Móxico, Perú y Venezuela. Se pidió a los médicos generales del sector privado la información sobre la atención y el control de sus pacientes de 18 a 75 años de edad con diabetes mellitus tipo 2 (DMT2), así como los datos demográficos, la historia clínica y de medicación, las pruebas de laboratorio e información sobre los retos relacionados con la atención del paciente. Resultados. De los 3 592 cuestionarios de pacientes entregados pot 377 módicos, 60% de los pacientes tenian antecedentes familiares de diabetes, 58% segufan una dieta inadecuada, 71% eran sedentarios y 79% presentaban obesidad o sobrepeso. Se observó un inadecuado control glucémico (glucemia en ayunas ≥ 110 mg/dL) en 78% de los pacientes. La proporción de pacientes con HbA1c < 7,0% fue de 43,2%. El control glucémico se redujo significativamente al aumentar la duración de la DMT2. En 86% de los pacientes se encontraron enfermedades concurrentes asociadas con la DMT2; el uso de insulina y las enfermedades concurrentes —especialmente las asociadas con complicaciones microvasculares— incrementaron significativamente la duración de la diabetes. En cuanto al tratamiento de los pacientes, el reto más frecuentemente citado fue garantizar la adhesión a la dieta y al plan de ejercicios recomendados. Conclusiones. Los niveles de glucemia no están suficientemente controlados en los pacientes con DMT2 que se atienden en el sistema privado de salud de América Latina, particularmente en los pacientes que han tenido la enfermedad por más tiempo (> 15 años). Tornado en cuenta las diferencias entre la atención sanitaria privada y la pública en América Latina, especialmente en lo concerniente a la calidad de la atención y el acceso a los medicamentos, se requieren estudios adicionales en el sector público. En general, se necesita un programa más eficiente e intensivo de control de la DMT2 y programas eficaces de educación de los pacientes, ajustados alas realidades de América Latina. [ABSTRACT FROM AUTHOR]
Copyright of Pan American Journal of Public Health / Revista Panamericana de Salud Pública is the property of Pan American Health Organization and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
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  Data: Control of type 2 diabetes mellitus among general practitioners in private practice in nine countries of Latin America.
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  Data: Control de la diabetes mellitus tipo 2 por m&#233;dicos generales del sector privado en nueve pa&#237;ses de Am&#233;rica Latina.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Stewart%2C+Gloria+Lopez%22&quot;&gt;Stewart, Gloria Lopez&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; glopezstewart@mi.cl&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tambascia%2C+Marcos%22&quot;&gt;Tambascia, Marcos&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Guzm&#225;n%2C+Juan+Rosas%22&quot;&gt;Guzm&#225;n, Juan Rosas&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Etchegoyen%2C+Federico%22&quot;&gt;Etchegoyen, Federico&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Carrion%2C+Jorge+Ortega%22&quot;&gt;Carrion, Jorge Ortega&lt;/searchLink&gt;&lt;relatesTo&gt;5&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Artemenko%2C+Sofia%22&quot;&gt;Artemenko, Sofia&lt;/searchLink&gt;&lt;relatesTo&gt;6&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22LATIN+America%22&quot;&gt;LATIN America&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Objectives. To better understand how diabetes care and control are being administered by general practitioners/nonspecialists in private practice in nine countries of Latin America, and to identify the most significant patient- and physician-related barriers to care. Methods. A multicenter, cross-sectional, epidemiological survey was conducted in nine countries in Latin America: Argentina, Brazil, Chile, Costa Rica, Ecuador, Guatemala, Mexico, Peru, and Venezuela. General practitioners in private practice were asked to provide care and control data for patients 18 to 75 years of age with type 2 diabetes mellitus (T2DM), including demographics, medical and medication history, laboratory exams, and information on the challenges of patient management. Results. Of the 3 592 patient questionnaires returned by 377 physicians, 60% of the patients had a family history of diabetes, 58%followed a poor diet, 71% were sedentary, and 79% were obese or overweight. Poor glycemic control (fasting blood glucose ≥ 110 mg/dL) was observed in 78% of patients. The number of patients with HbA1c &lt; 7.0% was 43.2%. Glycemic control decreased significantly with increased duration of T2DM. Comorbid conditions associated with T2DM were observed in 86% of patients; insulin use and comorbid conditions, especially those associated with microvascular complications, increased significantly disease duration. Ensuring compliance with recommended diet and exercise plans was the most-cited patient management challenge. Conclusions. Blood glucose levels are undercontrolled in T2DM patients in the private health care system in Latin America, particularly among those who have had the disease the longest (&gt;15 years). Considering the differences between private and public health care in Latin America, especially regarding the quality of care and access to medication, further studies are called for in the public setting. Overall, a more efficient and intensive program of T2DM control is required, including effective patient education programs, adjusted to the realities of Latin America. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Objetivos. Comprender mejor c&#243;mo los m&#233;dicos generales/no especialistas del sector privado atienden y controlan la diabetes en nueve paises de Am&#233;rica Latina e identificar los principales problemas retacionados con el paciente y el m&#233;dico, que obstaculizan la atenci&#243;n. M&#233;todos. Se realiz&#243; un estudio epidemiol&#243;gico, multic&#233;ntrico, transversal, en nueve palses de Am&#233;rica Latina: Argentina, Brasil, Chile, Costa Rica, Ecuador, Guatemala, M&#243;xico, Per&#250; y Venezuela. Se pidi&#243; a los m&#233;dicos generales del sector privado la informaci&#243;n sobre la atenci&#243;n y el control de sus pacientes de 18 a 75 a&#241;os de edad con diabetes mellitus tipo 2 (DMT2), as&#237; como los datos demogr&#225;ficos, la historia cl&#237;nica y de medicaci&#243;n, las pruebas de laboratorio e informaci&#243;n sobre los retos relacionados con la atenci&#243;n del paciente. Resultados. De los 3 592 cuestionarios de pacientes entregados pot 377 m&#243;dicos, 60% de los pacientes tenian antecedentes familiares de diabetes, 58% segufan una dieta inadecuada, 71% eran sedentarios y 79% presentaban obesidad o sobrepeso. Se observ&#243; un inadecuado control gluc&#233;mico (glucemia en ayunas ≥ 110 mg/dL) en 78% de los pacientes. La proporci&#243;n de pacientes con HbA1c &lt; 7,0% fue de 43,2%. El control gluc&#233;mico se redujo significativamente al aumentar la duraci&#243;n de la DMT2. En 86% de los pacientes se encontraron enfermedades concurrentes asociadas con la DMT2; el uso de insulina y las enfermedades concurrentes —especialmente las asociadas con complicaciones microvasculares— incrementaron significativamente la duraci&#243;n de la diabetes. En cuanto al tratamiento de los pacientes, el reto m&#225;s frecuentemente citado fue garantizar la adhesi&#243;n a la dieta y al plan de ejercicios recomendados. Conclusiones. Los niveles de glucemia no est&#225;n suficientemente controlados en los pacientes con DMT2 que se atienden en el sistema privado de salud de Am&#233;rica Latina, particularmente en los pacientes que han tenido la enfermedad por m&#225;s tiempo (&gt; 15 a&#241;os). Tornado en cuenta las diferencias entre la atenci&#243;n sanitaria privada y la p&#250;blica en Am&#233;rica Latina, especialmente en lo concerniente a la calidad de la atenci&#243;n y el acceso a los medicamentos, se requieren estudios adicionales en el sector p&#250;blico. En general, se necesita un programa m&#225;s eficiente e intensivo de control de la DMT2 y programas eficaces de educaci&#243;n de los pacientes, ajustados alas realidades de Am&#233;rica Latina. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Pan American Journal of Public Health / Revista Panamericana de Salud P&#250;blica is the property of Pan American Health Organization and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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