Vázquez Encalada Karla Stephanie, Vázquez Gamboa Carlos Esteban, Martínez Rivera José Iván, Uuh Narvaez Jonatan Jafet, Segura Campos Maira Rubi
Faculty of Chemical Engineering, Universidad Autónoma de Yucatán, Mérida, Yucatán, México.
Mexican Institute of Social Security, IMSS, Mérida, Yucatán, Mexico.
Ethn Dis. 2025 May 7;35(2):65-72. doi: 10.18865/EthnDis-2023-65. eCollection 2025 May.
Diabetes mellitus (DM) is a global health concern that has affected various populations worldwide. Among the various methods to monitor the progress and management of DM, glycosylated hemoglobin (HbA) serves as a key marker for understanding long-term glucose control. The Mayan populations of Yucatan represent a unique demographic in which the prevalence and management of DM can be distinctively analyzed.
In this study, HbA levels were monitored over 12 months in 1722 patients with DM from 17 medical units of the Mexican Institute of Social Security in the southern region of Yucatan. Based on initial HbA levels, patients were assigned to either standard or intensive treatment. Treatment efficacy was analyzed based on sex, age, and location.
HbA levels significantly decreased in patients receiving intensive treatment, from means (±SD) of 9.7±1.9% to 8.9±2.0% after 12 months (P=.001), with notable reductions in remote areas such as Akil and Huntochac (P<.05). Although slight reductions were observed among women and middle-aged individuals, these reductions were not statistically significant (P=.2 and P=.4, respectively). Despite the initial improvement, standard treatment was more effective for maintaining long-term glycemic stability, with lower variability and better adherence. However, a 10% increase in HbA was observed in this group by the end of the study.
Monitoring of DM in Mayan populations revealed significant HbA reductions with intensive treatment, especially in remote areas. Consequently, strategies to improve primary care and promote self-care in DM patients in the Mayan population must be implemented.
糖尿病是一个全球性的健康问题，已影响到世界各地的不同人群。在监测糖尿病进展和管理的各种方法中，糖化血红蛋白（HbA）是了解长期血糖控制的关键指标。尤卡坦半岛的玛雅人群是一个独特的人口群体，其中糖尿病的患病率和管理情况可以进行独特的分析。
在本研究中，对来自尤卡坦半岛南部墨西哥社会保障局17个医疗单位的1722例糖尿病患者进行了为期12个月的HbA水平监测。根据初始HbA水平，将患者分为标准治疗组或强化治疗组。基于性别、年龄和地点分析治疗效果。
接受强化治疗的患者HbA水平显著下降，12个月后平均水平（±标准差）从9.7±1.9%降至8.9±2.0%（P = 0.001），在阿基尔和洪托查克等偏远地区有显著降低（P < 0.05）。虽然在女性和中年个体中观察到轻微下降，但这些下降在统计学上不显著（分别为P = 0.2和P = 0.4）。尽管最初有所改善，但标准治疗在维持长期血糖稳定性方面更有效，变异性更低，依从性更好。然而，在研究结束时，该组患者的HbA水平增加了10%。
对玛雅人群糖尿病的监测显示，强化治疗可显著降低HbA水平，尤其是在偏远地区。因此，必须实施改善玛雅人群糖尿病患者初级保健和促进自我保健的策略。
