PRODIACOR: a treatment program for type 2 diabetes and associated cardiovascular risk factors in the city of Corrientes, Argentina: study design and baseline data

GAGLIARDINO JJ; LAPERTOSA S; VILLAGRA M; CAPORALE JE; OLIVER P; GONZÁLEZ C; SIRI F; CLARK CH

Florencia, Italia

Workshop; 3rd International Dawn Summit. From practice and research to large scale implementation; 2006

Aim: To improve clinical, metabolic, therapeutic and psychological indicators through the implementation of a management program for people with type 2 diabetes (T2DM). Methods: We randomly selected 4 groups of patients from the province of Corrientes, Argentina: 1) control, 2) education for patients, 3) education for providers and 4) education for patients and providers. Healthcare coverage was increased to 100%; all indicators were periodically assessed using data collected from multiple sources. Results: Baseline data showed a mean BMI of 29.8 kg/m2; most people had systolic/diastolic blood pressure, fasting blood glucose and total cholesterol levels above those recommended by international standards; 1% had microalbuminuria measurements; 57% had strips for glucose self-monitoring; 37% had an eye and 31% a foot examination the previous year. Despite most patients were above recommended targets, 27%, 26% and 73% of patients with hyperglycemia, hypertension and dislipemia respectively were untreated. Most patients treated with insulin (14%) or oral antidiabetic agents were on a monotherapy regimen as those treated for hypertension and dislipemia. According to WHO-5 questionnaire scores, 13% of the population needed psychological assistance, having these people the lowest degree of satisfaction. Conclusions: The available evidence indicates that our population will soon develop chronic complications, increasing the demand and costs of care and decreasing their quality and life expectation. Our educative intervention would switch from a poor and expensive to a preventive and cost-effective care of people with T2DM. PRODIACOR could thus be adopted by other Argentinean provinces and developing countries.