Abstract

LACLE, Adriana  and  PERALTA, Carmen. Tamizaje de Diabetes Mellitus tipo 2 en atención primaria. Acta méd. costarric [online]. 2006, vol.48, n.1, pp.17-23. ISSN 0001-6002.

Introduction: Type 2 Diabetes mellitus today must be considered a public health problem in Costa Rica, since it has a great impact in the quality of life of the patients and their families, due to its chronic complications and also in the Social Security System due to its costs. Early diagnosis and prompt treatment decrease the burden of its complications. Therefore, Diabetes screening in a high risk population should be considered beneficial. The purpose of this study was to evaluate the results of a screening intervention in primary care in high risk persons. Methodology: Screening was implemented along the year 2000 in the adult population with at least one risk factor of 6 Primary Health Centers, incorporated in the daily routine of the primary hea1th care attention. Four different strategies were used: the "opportunistic" during the regular medical consultation, a selective one during home visits, programmed, directed to captive groups or social organizations, and "Jornadas" during community or national health fairs. Results: During the year 2000, 173 new diabetic patients were registered by the health centers, either they were newly diagnosed or where known diabetics that lived in the area, but were not following control there. The predominant strategy was the "oportunístic", relaying the responsibility especially upon the physician. The programed strategy in "Jornadas" was undertaken during Health Fairs of the Primary care centers and during the World Diabetes Day, the 14 of November. The selective strategy was not perform systematically since there were no glucometers for the primary health care assistant that does home visits. The proper registration or "coverage" of the diabetic patients of the Health Center Area increased from 50% in 1999 to 70.2% in 2000, considering the former as the percentage of diabetic patients under control or registered divided by the number of diabetics accounted for each health center, considering a prevalence of 5% of the population 20 years and older. Conclusion: Costa Rica can accomplish an early detection and prompt treatment of Diabetes mellitus type 2 by screening intervention of high risk individuals. This is already being done with through the "opportunistic" strategy. This study shows that this strategy can be effectively implemented and that it can be operational with little effort. Our Health Care System, based in a primary health care setting, is in position to develop other screening strategies that could give higher coverage with lower costs: such as home visit screening by the primary health assistant. Logistically the conditions are given, however this intervention requires a community study to determine its real cost-benefit. If the results were favorable, such intervention could be implemented as part of diabetes care in the whole country, making Costa Rica a pioneer in the world in this kind of intervention.

Keywords : Diabetes Mellitus tipo 2; tamizaje; detección temprana; Diabetes Mellitus type 2; early detection; screening.