Journal Information
Vol. 20. Issue 2.
Pages 124-131 (March - April 2006)
Vol. 20. Issue 2.
Pages 124-131 (March - April 2006)
Originales
Open Access
Incidencia de diabetes tipo 2 y análisis del proceso diagnóstico en un centro de atención primaria durante la década de los noventa
Incidence of type 2 diabetes and its diagnosis process in the decade 1991-2000 in a primary health care centre
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Manuel Mata-Cases
Corresponding author
mmata@medynet.com

Correspondencia: Dr. Manel Mata Cases. CAP La Mina. Mar, s/n. 08930 Sant Adrià de Besòs. Barcelona. España.
, Esther Fernández-Bertolín, Xavier Cos-Claramunt, Manuel García-Durán, Teresa Mateu-Gelabert, Clara Pareja-Rossell, Enriqueta Pujol-Ribera
Centro de Atención Primaria La Mina, Unidad Docente de Medicina Familiar y Comunitaria de Barcelona. Institut Català de la Salut, Sant Adrià de Besòs, Barcelona, España
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Article information
Resumen
Fundamento y objetivo

Conocer la incidencia anual y los motivos de diagnóstico de la diabetes mellitus tipo 2 (DM2) en el período 1991-2000.

Pacientes y método

Estudio longitudinal retrospectivo. Revisión de las historias clínicas de todos los nuevos casos de DM2 registrados en un centro de salud urbano durante 10 años. Cálculo de la prevalencia e incidencia anuales en la población mayor de 14 años. Análisis de las tendencias temporales y periodicidad en la incidencia de DM2 (mensual, estacional y anual) mediante modelos ARIMA (Box-Jenkins), modelo paramétrico de regresión de Poisson y modelos semiparamétricos (GAM).

Resultados

Se identificaron 598 nuevos casos de DM2 (edad media [DE], 59,7 [11,4] años; 51,3% mujeres). Los factores de riesgo cardiovascular más frecuentes fueron la obesidad (58,5%) y la hipertensión arterial (68,2%). Los principales motives de diagnóstico fueron: hiperglucemias previas (64,7%) y la aplicación de protocolos de otros factores de riesgo cardiovascular (12,4%).

La incidencia anual fue de 37,9 por 10.000 personas (intervalo de confianza [IC] del 95%, 34,9-40,9), sin diferencias significativas entre ambos sexos. La prevalencia de DM2 al principio y al final del estudio fue del 4,4% (IC del 95%, 2,0-4,8) y el 5,5% (IC del 95%, 5,2-5,9) (un 25% de incremento relativo), sin que el análisis de tendencias mostrara un incremento progresivo de la incidencia.

Conclusiones

La incidencia observada es superior a la descrita en otros estudios. El incremento de la prevalencia no se relaciona con un incremento progresivo de la incidencia. Los motivos de diagnóstico más frecuentes fueron el seguimiento de hiperglucemias previas y la aplicación de protocolos de otros factores de riesgo cardiovascular. Este hecho parece indicar un diagnóstico precoz que podría beneficiar a estos pacientes.

Palabras clave:
Diabetes tipo 2
Incidencia
Prevalencia
Diagnóstico
Atención primaria
Abstract
Background and objective

To determine the annual incidence and reasons for diagnosing type 2 diabetes mellitus (T2DM) from 1991 to 2000.

Patients and method

We performed a retrospective, longitudinal study. The clinical records of all new cases of T2DM registered in an urban primary care center over a 10-year period were reviewed. The annual incidence and prevalence in the population aged more than 14 years old were calculated. Statistical analyses of temporal trends and periodicity (monthly, seasonal and annual) were performed with ARIMA models (Box-Jenkins), Poisson parametrical regression and semiparametrical (GAM) models.

Results

There were 598 true new cases of T2DM (mean age [SD]: 59.7 [11.4] years; 51.3% women). The most frequent associated cardiovascular risk factors were obesity (58.5%) and hypertension (68.2%). The main reasons for diagnosing T2DM were the presence of previous hyperglycemia (64.7%) and the application of protocols for other cardiovascular risk factors (12.4%).The annual incidence was 37.9 per 10,000 persons (95% CI, 34.9-40.9) with no differences between sexes. The prevalence of T2DM at the beginning and end of the study period was 4.4 (95% CI, 2.0-4.8) and 5.5% (95% CI, 5.2-5.9) (25% relative increase). There was no significant temporal trend in the incidence of T2DM over the years.

Conclusions

The observed incidence of T2DM is high compared with that reported in other studies. The increase in prevalence was not related to a progressive increase in the incidence. The most frequent reasons for diagnosing T2DM were previous hyperglycemia and the application of protocols for other cardiovascular risk factors. This finding seems to be related to an early diagnosis and could benefit these patients.

Key words:
Type 2 diabetes mellitus
Incidence
Prevalence
Diagnosis
Primary health care
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