Ramos-Valle David, García-Cortés Luis Rey, Dichi-Romero María de Los Ángeles
Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 64, Coordinación Clínica de Educación e Investigación en Salud. Tlalnepantla de Baz, Estado de México, México.
Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada Regional Estado de México Oriente, Coordinación Auxiliar Médica de Investigación en Salud. Naucalpan de Juárez, Estado de México, México.
Rev Med Inst Mex Seguro Soc. 2023 May 2;61(3):258-264.
The pathogenic model guides the study of risk factors for the disease; the salutogenic model guides the study of health assets, focused on problem solving, the ability of people to use their available resources and perceive their lives as coherent, structured and understandable. Its central element is the sense of coherence (SOC). The relationship of SOC with different phases of diabetes has been demonstrated, but not in diabetic debutants.
To evaluate the magnitude of the association of SOC between type 2 diabetes mellitus (T2DM) debutants and absentees in people detected in the PREVENIMSS module.
case-control design. Cases were T2DM debutants with fasting plasma glucose ≥ 126 mg/dL; controls, people with plasma glucose < 100 mg/dL. Sample size was estimated for independent groups (101 cases and 202 controls) in which the SOC-29 questionnaire was administered; socio-demographic data was recorded and their file was reviewed. Reliability of SOC-29 was analyzed; univariate analysis, chi-squared and binary logistic regression were used to estimate association and odds ratio (OR).
T2DM debutants were 5 times more likely to achieve a low SOC score than patients without T2DM (p = 0.002; OR: 5.31, 95% confidence interval: 1.81-15.53).
High sense of coherence is an asset for the health of T2DM debutants; it is proposed to incorporate this topic into the DIABETIMSS program.
致病模型指导疾病危险因素的研究；健康促进模型指导健康资产的研究，侧重于解决问题、人们利用现有资源的能力以及将自己的生活视为连贯、有序和可理解的能力。其核心要素是连贯感（SOC）。SOC与糖尿病不同阶段的关系已得到证实，但在糖尿病初发患者中尚未得到证实。
评估PREVENIMSS模块中检测出的2型糖尿病（T2DM）初发患者和未患糖尿病者之间SOC的关联程度。
病例对照设计。病例为空腹血糖≥126mg/dL的T2DM初发患者；对照为血糖<100mg/dL的人群。对独立组（101例病例和202例对照）进行样本量估计，对其进行SOC-29问卷调查；记录社会人口学数据并查阅其档案。分析SOC-29的信度；采用单因素分析、卡方检验和二元逻辑回归估计关联度和比值比（OR）。
T2DM初发患者获得低SOC评分的可能性是未患T2DM患者的5倍（p = 0.002；OR：5.31，95%置信区间：1.81 - 15.53）。
高连贯感是T2DM初发患者健康的一项资产；建议将该主题纳入DIABETIMSS项目。
