Application of recommendations for reducing mortality in patients with type 2 diabetes mellitus in a rural setting in Manabí, Ecuador: from theory to practice

Abstract

Objective: To evaluate the application of type 2 diabetes mellitus management guidelines that have shown a reduction in mortality in patients with this disease in patients treated in a rural establishment in Carmen, Manabí (Ecuador) during the period from May to August of 2016.

Methodology: A structured interview was designed and applied to patients who attended the outpatient clinic of El Carmen Basic Hospital from May to August 2016. The highlights of the survey were related to sociodemographic variables but mostly related to compliance of the treatment guidelines for the disease that have shown a reduction in the mortality of diabetes: quitting smoking, reducing blood pressure, using metformin, using statins and glycemic control.

Results: An average compliance of 47% of the total of the recommendations required to reduce mortality in patients with diabetes mellitus was observed. The recommendations that fulfilled most were no smoking (97.3), the use of metformin in addition to some other antidiabetic medication (82%) and the use of antihypertensive drugs (43.3%). The recommendations that obtained the lowest application were diet and physical activity (15.3%) and use of statins (28%).

Conclusions: It is necessary to develop efforts to promote the application of recommendations that benefit patients with diabetes mellitus. The application of the recommendations observed in this rural community is similar to that observed in other studies. There are recommendations whose usefulness is very clear in Anglo-Saxon countries, but its relevance must be analyzed for Latin American rural contexts. Larger studies are needed to identify the factors related to the application of these recommendations.