TYPE 2 DIABETES. PREVALENCE OF HYPOGLYCEMIA IN PUBLIC VERSUS PRIVATE HEALTH CARE SYSTEM.

Social vulnerability has proved to be an independent risk factor for hypoglycemia in patients with diabetes. In some countries, patients who are in a vulnerable situation are assisted in the public health system which provides free medical care. This study compares the prevalence of hypoglycemia amo...

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Publicado en:Medicina (Buenos Aires) Vol. 80; no. 3; pp. 203 - 211
Autores principales: CAEIRO, GABRIELA, ROMERO, SILVANA A., SOLIS, SILVANA E., POZZI, JOSÉ M., LOZANO, MARÍA E., WAITMAN, JORGE N.
Formato: Artículo
Publicado: Medicina (Buenos Aires) may/jun2020
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: may/jun2020
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          CAEIRO, GABRIELA
          ROMERO, SILVANA A.
          SOLIS, SILVANA E.
          POZZI, JOSÉ M.
          LOZANO, MARÍA E.
          WAITMAN, JORGE N.
        affil: Departamento de Medicina Interna, Servicio de Diabetes, Hospital Córdoba, Córdoba, Argentina
      su:
        Hypoglycemia
        Type 2 diabetes
        Public health
        Disease prevalence
        Psychological vulnerability
      sug:
        subj:
          Hypoglycemia
          Type 2 diabetes
          Public health
          Disease prevalence
          Psychological vulnerability
      keyword:
        diabetes
        diabetes tipo 2
        hipoglucemia
        hypoglycemia
        poblaciones vulnerables
        type 2 diabetes
        vulnerable populations
        diabetes tipo 2
        hipoglucemia
        poblaciones vulnerables
      ab:
        Social vulnerability has proved to be an independent risk factor for hypoglycemia in patients with diabetes. In some countries, patients who are in a vulnerable situation are assisted in the public health system which provides free medical care. This study compares the prevalence of hypoglycemia among patients with type 2 diabetes (T2D), in public versus private sector and its relationship with social vulnerability. This multicentric descriptive study included 600 patients with T2D from public and private care institutions of Argentina. Socioeconomic level (SEL) was evaluated through the Marketing Argentinean Association survey. Number of severe, documented symptomatic and asymptomatic hypoglycemias were registered. Among the patients included, 66% were assisted in the public sector. The 41% of patients (n = 246) registered at least 1 episode of any hypoglycemia event being more prevalent in the public sector compared to the private sector (50% vs. 22%). In the adjusted analysis it was observed a greater risk of hypoglycemia in public sector (OR 4, 95% CI 2.65-6.04) and in patients that did not have diabetological education (OR 2.28 95% CI 1.35-3.84). Similarly, unemployment (OR 5.04 95% CI 2.69-9.46), and marginal SEL (OR 60.79 95% CI 14.89-248.13) increased the risk of hypoglycemia. Several factors related to social vulnerability as unemployment, marginal SEL and poor sanitary education showed a significant increase in the hypoglycemia risk. Professionals working with people with diabetes must take into account these factors for a safe treatment of the disease.
        La vulnerabilidad social ha demostrado ser un factor de riesgo independiente de hipoglucemia en pacientes con diabetes. Los pacientes que se encuentran en situación de vulnerabilidad social reciben asistencia en el sistema de salud pública que brinda atención médica gratuita. Este estudio compara la prevalencia de hipoglucemia en pacientes con diabetes tipo 2 en el sector público frente al privado y su relación con la vulnerabilidad social. Se realizó un estudio multicéntrico descriptivo que incluyó 600 pacientes con diabetes tipo 2 de instituciones de atención pública y privada de Córdoba. El nivel socioeconómico se evaluó a través de la encuesta de la Asociación Argentina de Marketing que evalúa la dimensión social, educativa y económica para estratificar el nivel socioeconómico. Se registró el número de hipoglucemias graves, documentadas sintomáticas y asintomáticas. El 66% de los pacientes pertenecían al sector público. El 41% de los pacientes (n = 246) registró al menos 1 episodio de cualquier evento de hipoglucemia. En el análisis ajustado, se observó un mayor riesgo de hipoglucemia en el sector público (OR 4, 95% CI 2.65-6.04), en pacientes que no tenían educación diabetológica previa (OR 2.28, 95% CI 1.35-3.84), en desempleados (OR 5.04, 95% CI 2.69-9.46) y en aquellos con nivel socioeconómico marginal (OR 60.79 95% CI 14.89-248.13). Factores relacionados con la vulnerabilidad social como el desempleo, el nivel socioeconómico marginal y educación sanitaria deficiente mostraron un aumento en el riesgo de hipoglucemia. Los profesionales que trabajan con personas con diabetes deben tener en cuenta estos factores para un tratamiento seguro de la enfermedad.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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