Costa B, Utgés P, Monclús J F, Gomis T, Ciurana M R, Julve P
Programa de Formación Médica Continuada en Diabetes, Colegio Oficial de Médicos, Tarragona.
Med Clin (Barc). 1992 Sep 19;99(8):294-9.
This study was carried out to estimate the treatment characteristics and prevalence of diabetes mellitus (DM) diagnosed in the counties of Tarragona (548,900 inhabitants) from the consumption of hypoglycemic medication.
A stratified aleatory sample was made of the prescription of oral hypoglycemic agents (OHA) and insulin (INS) in 14 centers of primary health care. Calculation of pharmacy dispensing and prescriptions (computer network of the Institut Català de la Salut) was carried out with a relation of the mean doses of the survey and the estimate of the consumer population being made. A contrast was made of the system with the daily doses defined (DDD/1,000 inhabitants/day) of the different OHA and INS preparations.
Following aleatorization a representative sample of 550 diabetics, 64 (11.6%) type I and 486 (88.4%) type II was obtained. In total, 61 were treated with diet alone (IC 95%; 8-13%, p less than 0.05); 249 (41-49%) with OHA (51% of type II) and 240 (39-47%) received insulin, all the type I and 176 (36%) type II. In 23 cases (2-5%) multiple therapy with different drugs was confirmed and 72 (10-15%) were treated with the maximal doses of OHA recommended. The rate of OHA/INS was 2.02-2.05. The prevalence of pharmaco-treated DM was 1.9% (prescriptions of public health) and 2.1-2.3% (total consumption). The method for DDD was evaluated as between 1.8% (prescriptions) and 2.0% (total consumption). Globally, during 1990 the prevalence of DM diagnosed in Tarragona was estimated as between 2.1-2.5%.
The estimation of the prevalence of diabetes mellitus indicated higher numbers than those obtained in other studies providing a first line indicator for the planning of care for diabetics in this demarcation. The study also identified the real therapeutic tendencies permitting the extraction of lines of action for the education of diabetics and the formation of professionals attending these patients.
本研究旨在通过降糖药物的消费情况来估计塔拉戈纳县（548,900名居民）诊断出的糖尿病（DM）的治疗特征和患病率。
在14个初级卫生保健中心对口服降糖药（OHA）和胰岛素（INS）的处方进行分层随机抽样。利用加泰罗尼亚卫生研究所的计算机网络计算药房配药和处方，并将调查的平均剂量与消费人群估计数相关联。将该系统与不同OHA和INS制剂的规定日剂量（DDD/1000居民/天）进行对比。
随机抽样后获得了550名糖尿病患者的代表性样本，其中64名（11.6%）为I型，486名（88.4%）为II型。总共有61名患者仅接受饮食治疗（95%置信区间；8 - 13%，p小于0.05）；249名（41 - 49%）使用OHA治疗（II型患者的51%），240名（39 - 47%）接受胰岛素治疗，所有I型患者以及176名（36%）II型患者。在23例（2 - 5%）患者中确认采用了不同药物的联合治疗，72例（10 - 15%）患者接受了推荐的最大剂量OHA治疗。OHA/INS比率为2.02 - 2.05。药物治疗的DM患病率为1.9%（公共卫生处方）和2.1 - 2.3%（总消费量）。DDD方法的评估结果为处方占1.8%，总消费量占2.0%。总体而言，1990年塔拉戈纳诊断出的DM患病率估计在2.1 - 2.5%之间。
糖尿病患病率的估计结果显示人数高于其他研究所得，为该地区糖尿病护理规划提供了首要指标。该研究还确定了实际的治疗趋势，可为糖尿病患者教育及照料这些患者的专业人员培训提供行动方向。
