Diabetes mellitus. La crónica de la historia

24 12 2012

Throughout the 20th century non-communicable chronic diseases have passed progressively to occupy the top spots in terms of health and social importance. Diabetes Mellitus, which attaches his name to the Greeks Apolunio and Demetrius of the II century b.c. a.d.. (1) It is the endocrine disorder most commonly found in these moments between the first 10 causes of death in the country with a tendency to the increase in its prevalence, proportion to the aging of the population. (2)


Is considered that even we have not really reached the expected prevalence of diabetics who according to previous studies could reach between a 30 a 40 by 100 inhabitants when the active pursuit of the disease reaches its maximum efficiency. (3)


Recognition of diabetes as a chronic disease that affects millions of people worldwide has motivated the search for various areas of health care, mainly in relation to the knowledge, perceptions, attitudes and fears of patients in the family and community context. (4)


It is important to place emphasis on education to the patient in the doctor's Office, implying teach basic aspects of diabetes, promote the modification of knowledge and solve immediate problems with changes in the psychological frame of reference to help the patient to accept his illness. (5)


The influence of the doctor on the behaviour of the patient against the disease is a cardinal point, many health professionals are therefore limited to the diagnosis and the prescription, leaving aside the valuable education tool (6) which must be stressed in the doctor's family, implying teach basic aspects of diabetes, promote the modification of knowledge and solve immediate problems with changes in the psychological frame of reference to help the patient to accept his illness. (5)


Because it is as old as humanity suffering diabetes, the educational aspect often has been relegated. The treatment of diabetic must include in order of importance: education, power, exercises and medication. Commonly inverted order. The primary objective is to improve the control, avoid or reduce acute or chronic complications and improve quality of life. (7)


Guide of health personnel is needed for these, changing attitudes in patients and relatives family, before the disease (8) educate will allow addressing therapeutic demands with autonomy and responsibility but without undermining the general welfare .(9)


The dynamics of relationship to be established between the individual and family is one of the determining factors in the metabolic control as she will report Karisson (10) When writes that diabetic with a favorable family model, It significantly increases its control before the disease. Within the role of the family physician, extendable to all members of the health care system, is as an essential work recognize the influence of family factors on health and take them into account for the same care, also recognizing the influence of the patient in his family's problems. People with diabetes have symptoms and also have families. The road between diabetic patients and their families runs in both directions. (11)


Some of the essential functions of the family is providing support to its members. In the case of occurrence of a chronic disease this feature acquired singular importance, both from the physical point of view as emotional and thanks to her can resolve conflict situations which include to turn in the proper disease control. On the other hand allows you to protect the family of dysfunctional situations that may be triggered by the emergence of the disease or its complications. (12)


Previous programs on educational principles for diabetic patients as conclusions highlights the enormous importance of having family collaboration to achieve favorable results. (13)


The World Health Organization, says: education is a vital and angular in the treatment of diabetic stone for the integration of the diabetic society. (14)


Is also known that the cost of a diabetic patient in the treatment of both acute and chronic complications is high worldwide. In addition to the deterioration of his mental and organic State, his relationship with society is impoverished to the extent that this deterioration increases. Knowing the advantages offered by this educational method have been motivated to make our work to promote the educational work both as relatives of the diabetic patients. In these moments it is known that the prevalence of the disease in the country, is up to the year 2001 of a 25,3 by each 1000 inhabitants. (15)


In our province the prevalence during the year 2001 was of a 22.7 por cada 1000 population figure that has been on the rise until the value in the 2004 of 30.5 por cada 1000 habitantes. In our municipality, the prevalence of diabetes in the year 2002, behaved, para una población total de 55 280 in 1370, para un índice de 24,78 by 1000/ h; in the 2003 the population was of 55 282, the prevalence increased up to 14for an index of de 26,39; and in the 20for a total population of de 55 569 the prevalence has increased up to 1540, with an index of 27,71 porby each00 hinhabitants According to previous studies of the 50 to the 80% acute complications can be prevented through proper education, so the diabetes education is of vital importance in the current treatment of diabetes. (16).


Currently few jobs about the influence of the education of the family are collected jointly with the diabetic patient in disease control. In our opinion, primary health care in function by the improvement of the health status of the population in this group of patients, debe crear estrategias encaminadas a la educación no solo del enfermo sino de la familia y la comunidad, siempre marcando un destino final en el diabético; prevenir o retrasar los daños ya establecidos propios de la enfermedad.


Referencias Bibliográficas:


Montoro P. La diabetes y su control. Murcia: University of Murcia; 1991. 
Declaration of the Americas on Diabetes. PanAm Health Org Bull. 1996; 30 (3):261-5. 
Harrison IM, Foster DW. Diabetes mellitus. In: Issel Bacher KJ ed. Harrison´s main completo of Internal Medicine. 13 Ed. New York: MC Graww Hill; 2000. 
Arauz AG, G Sanchez, Padilla G, Fernandez M, Rosillo M, Gosman S. Community educational intervention on diabetes, in the field of primary health care. Rev. PanAm health Pub. 2001; 9(3):30-4. 
Garito LL, Wheel a.. Course of diabetes educators. USA: Lilly laboratories diabetes unit. S.A; 1999. 
Lennon GM, Taylor KG, Debney, C J barley. Knowledge, attitudes, technical competence and blood glucose control of type I diabetic patients during an education program after. Diabetic Med. 1997;7:825-32. 
Zuniga S, S Islands. Education of the diabetic patient. Rev Med IMSS. 2000; (3):187-191. 
Hiss R. The activates patients: a foce for change in diabetes health care and education. Diabetes Educ 1986; 12 (suppl): 225–23. 
García R. A dibetes education programme based on and interventive patients centred aproach: the cuban experience. West Indian Med. 1999;4(Bsupplpl 1):1. 
Karlsson J.A. Psycosocial aspect of diseases duration and control in young adults with type I diabetes. Clin Epidemiol. 1988;41(5):435–40. 
Rodriguez Moran M, Gerrero J.F. Importance of family support in the control of glicemia. Salud Pública Méx. 1997;39:44–7. 
De la Revilla L. Conceptos, instrucciones e instrumentos de la atención familiar. Barcelona: DOYMA; 2000. 
Junta de Andalucía. Guía de atención a la salud del anciano. Andalusia: Consejería de salud; 1997. 
Moncada E. Educar en Diabetes. BBarcelona Editorial Científico Médica; 1998. 
Programa Nacional de Prevención y control de la Diabetes Mellitus. La Habana: [s.l.]; May 2002. 
Tame L. A community survey of diabetes in the elderly. Diabetes Med. 1992 Nov;9 (9):860-5.




DRA. Mayelin Fundora Gallardo, 1

DRA. Madelyn Jimenez Garcia 2

DRA. Isdeky Milian Espinosa 3

DRA. Mabel Quintana Sosa. 4


¹ Dra. in medicine. Specialist in 1st grade in General comprehensive medicine. Work center polyclinic Juan Martí Pi Area Jicotea.

Dra m². in medicine. Specialist in 1st grade in General comprehensive medicine. Work center: Polic. Juan Martí Pi Jicotea Area.

3 DRA. in medicine. Specialist in 1st grade in General comprehensive medicine. Work center polyclinic Juan Martí Pi Area Jicotea.

4 DRA. in medicine. Specialist in 1st grade in General comprehensive medicine. Specialist in 1st grade in internal medicine. Professor Instructor ISCM VC. Work center polyclinic Juan Martí Pi Area Jicotea.



Portalesmedicos.com [en línea]Cadiz (ESP): portalesmedicos.com, 24 in December of 2012 [REF. 12 in June of 2007] Available on Internet: http://www.portalesmedicos.com/publicaciones/articles/553/1/Diabetes-mellitus-La-cronica-de-la-historia.html