Family Dysfunction as a Limiting Factor in Achieving Adequate Glycemic Control in Type 2 Diabetic Patients at the Pedro Vicente Maldonado Rural Hospital from January 2010 to January 2012
Abstract
OBJECTIVE: To identify the association between family dysfunction and adequate glycemic control in type 2 diabetic patients at the Pedro Vicente Maldonado Rural Hospital between 2010 and 2012
SPECIFIC OBJECTIVES: To determine the prevalence of family dysfunction in patients with DM 2. To correlate glycemic control with the presence of family dysfunction. Determine demographic factors related to family functionality (APGAR) in patients with DM 2.
METHODS: We conducted a cross-sectional descriptive study in the town of Pedro Vicente Maldonado, located in the northwest Province of Pichincha in a rural hospital. We studied 104 medical records and family records of patients with DM 2 who attended the hospital in a period of two years, 2010 to 2012. The degree of glycemic control was established through HbA1C and family functionality using the family APGAR. The analysis was carried out with the EPI INFO 7 program, to obtain a univariate and bivariate analysis. Percentages of the quantitative variables were obtained, and the search for a relation was made using Fisher's exact test.
RESULTS: The sample size was 104 patients diagnosed with DM2, of which 52% (n = 54) were female; the average age of the studied population was 62 years +/- SD 13.08 years. The age distribution with the highest prevalence was in the population over 50 years old (84.5%). From the demographic data we found that 66% (n = 69) of the population has less than 6 years of schooling. Regarding work activity, we found a prevalence of 75% (n = 78) that work in agriculture.
When observing the type of care according to the provision of health service, we find that 88% (n = 92) is free. In addition, 92.3% (n = 85) have inadequate glycemic control despite receiving medication at no cost.
When analyzing the metabolic behavior through the adequate control of HBA1c (<7%), 92% (n = 96) presented figures higher than those established. In our study it was proven that 94% (n = 98) of patients presented some degree of family dysfunction, of which 53% (n = 52) corresponded to the female sex. That correlates with the prevalence worldwide of 50%. 85% (n = 83) with family dysfunction are in ages ranging from 50 to 65 and above, which is statistically significant in relation to the urban area. (27)
It was proven that 96% (n = 92) of patients who presented family dysfunction had an inadequate glycemic control.
CONCLUSION: The family dysfunction variable is not statistically significant in our study as in other studies performed, due to the limitation of the sample that may bias the result. However, we observed a tendency for family dysfunction in patients with inadequate HbA1c control.
Downloads
References
2. De EYE, Obligatoria N, Vigilancia SA, De DPC, Provincias MPOR. Epidemiologia / epi-2. ministerio de salud publica Ecuador. 2007.
3. Mc Daniel S, Campbell T. Orientación Familiar en Atención Primaria. Barcelona: España: Springer-Verlag Iberica; 1998.
4. Hautecoeur M, Com MS, Zunzunegui MV, Epidemiol D, Vissandjee B. Las barreras de acceso a los servicios de salud en la población indígena de Rabinal en Guatemala. salud publica de mexico. 2007;49(2).
5. Gonz A, Avil P. Artículo original Cohesión y adaptabilidad familiar y su relación con la hemoglobina glucosilada de los pacientes diabéticos. revista de especialidades medico quirurgicas. 2011;16(2):82-88.
6. Victor R, Dilelby S. ESTUDIO DE NECESIDADES PARA LA CREACION DE UN PROGRAMA EDUCATIVO PARA DIABÉTICOS. MEDICO DE FAMILIA. 2004;12(1):23-26.
7. Pineda MS, Nadal JF, Ellacuria MP, et al. Estadísticas y causas de mortalidad en la diabetes tipo 2. atencion primaria. 2009;27:654-657.
8. Garcia S. La exploración de la familia, Aspectos medicos, psicológicos y sociales. revista medica del IMSS. 1981;19(2):155-163.
9. Harris M, Klein R, Welborn T. Onset of NIDDM occurs at least 4-7 years before clinical diagnosis. Diabetes Care. 1992;15(7):815.
10. María D, López M, Manuel V, et al. Disfuncion familiar y control del paciente diabetico tipo2. revista medica del IMSS. 2004;42.
11. Pablo A. Guias ALAD de diagnostico,control y tratamiento de la Diabetes Mellitus tipo 2. 2006.
12. Santacruz VJ. La Familia como unidad de análisis. revista medica del IMSS. 1983;21(4):348-357.
13. Carmen CTM del. funcionalidad familiar en pacientes diabeticos e hipertensos compensados y descompensados. theoria. 2010;19(1).
14. Manga UBA, Eps DC, Ariza E, et al. Factores asociados a control metabólico en pacientes diabéticos tipo 2. salud Uninorte Barranquilla. 2005;21:28-40.
15. Vijan S, Hofer TP, Hayward RA. Estimated Benefits of Glycemic Control in Microvascular Complications in Type 2 Diabetes. Annals of Internal Medicine. 1997;127(9):837-839.
16. Dis- V, Modified D, Box PO. Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes. The New England Journal of Medicine. 2008:2560-72.
17. Khaw K-tee, Wareham N, Bingham S, et al. Association of Hemoglobin A 1c with Cardiovascular Disease and Mortality in Adults : The European Prospective Investigation into Cancer in Norfolk. Annals of Internal Medicine. 2004;(12).
18. Hba E. Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes. American Medical Association. 2005;165.
19. Sciences HH, Miller ME, Byington RP, et al. Effects of Intensive Glucose lowering in Type 2 Diabetes. The New England Journal of Medicine. 2008;358(24):2545-2559.
20. Sereday M, Lapertosa YS. Complicaciones crónicas en personas con diabetes mellitus tipo 2 de reciente diagnostico. endocrinol nutri. 2008;55(1014):64-68
21. Menéndez A. Optimización del tratamiento de la diabetes tipo 2 : ajustar el tratamiento al paciente y a la enfermedad. Atención Primaria. 2009;31(2):93,97.
22. Arroyo J, Badía X, De H, et al. Tratamiento de los pacientes con diabetes mellitus tipo 2 en atención primaria en España. Med Clin (Barc). 2005;125(5):166- 172.
23. Herrera D. Como se piensan las familias. :1-20.
24. American Diabetes Association. Standars of medical care in diabetes. diabetes care. 2011;34:1-7.
25. Kasper DL, Braunwald E, Fauci AS, et al. Principios de Medicina Interna Harrison.
26. Nathan DM, Kuenen J, Group (ADAG) S. Translating the A1C Assay Into Estimated Average Glucose Values. Diabetes Care. 2008;31(8):1-6.
27. Evelyn Ariza1, et col. Factores asociados a control metabólico en pacientes diabéticos tipo 2 UBA Manga de Coomeva EPS en Cartagena (Colombia). 2006.
28. Martinez et al. Conocimiento sobre diabetes mellitus en pacientes diabeticos tipo 2, tanto urbanos como rurales del occidente de Mexico . Archivos de Medicina Familiar , vol 9 (3), 147-159 , 2007.
29. Guerrero J et al, Prevalencia de diabetes mellitus no insulinodependiente en la poblacion rural de Durango, Mexico. Revista Panamericana de Salud Publica . vol 2 (6). 386-391 . 1997.
30. Cabezas C et al. Revista Medica Vozandes . Disfunción familiar y su correlación con el estado metabólico en el club de pacientes tipo 2 . vol 22 .PAG 4 2011
31. Armas, N.; Entre voces y silencios: Las Familias por dentro, 2007, Quito
Copyright (c) 2017 Rural Family Practice
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
