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"en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Patients with treated diabetes with no HbA1c test in a year and patients controlled with step therapy in 2016</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">All control readings were calculated for patients for whom an HbA1c assessment was available.</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Controlled ADA1: in ≤75 years HbA1c <7% and in >75 years HbA1c <7.5%; controlled ADA2: in ≤75 years HbA1c <7% and in >75 years HbA1c <8.0%; controlled RedGDPS: in ≤75 years HbA1c <7% and in >75 years HbA1c <8.5%.</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: ADA: American Diabetes Association; RedGDPS: Network of Study Groups for Diabetes in Primary Health Care.</p>"
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"textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">It is well known that diabetes mellitus and its complications constitute a fundamental problem for the health of the Spanish population and that its increased incidence is mainly associated with the increased excess weight and obesity rates. In recent years, however, the evolution of its prevalence has indicated a different pattern, even showing negative interannual variation rates. A recent study examined the prevalence of diabetes mellitus in Spain by analyzing the various national health surveys on diabetes mellitus conducted in Spain between 1999 and 2014. The prevalence of diabetes mellitus in 2014 was 7.3% in men and 6.4% in women, showing that the exponential increase witnessed in previous decades showed a tendency to stabilize and, in some cases, diminish.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These results are similar to those encountered outside Spain; in 2015, the prevalence of diagnosed diabetes mellitus in the US was 7.2%.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">These results did not significantly differ when registries with data from electronic medical records were employed as sources. Thus, the recent Epichronic study conducted in Navarra and the Basque Country found a prevalence that ranged from 6.6% to 7% in the population older than 20 years.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Measuring drug consumption, through an analysis of large databases, is considered a valid method for determining the incidence and prevalence of diseases and is equally valid in the case of diabetes mellitus.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In a recent study that employed the consumption of antidiabetic drugs as the source showed a prevalence of diabetes mellitus of 8.3% in the population of Extremadura (Spain).<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Through an analysis of the consumption of antidiabetic agents, the interesting article published in this issue by Escribano et al. shows that the prevalence of diabetes in the province of Cadiz (Spain) between 2014 and 2016 varied between 8.65% and 8.83% of the population.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> These data provide reliable information on the state of affairs of a specific area of Spain (the province of Cadiz), with readings that are higher than the national average provided by surveys.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These results make it advisable to plan future studies to help establish the environmental and individual factors that explain this local increase in the prevalence of diabetes. As the authors themselves mentioned, this type of study based on drug consumption does not allow us to exactly establish the prevalence because the study does not take into account individuals with diabetes but with no drug treatment or the still undiagnosed patient population. Considering the population with diabetes who were not diagnosed before the health survey, the prevalence of diabetes in the US in 2015 rose to 9.4% of the population.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It is also relevant that in the study by Escribano et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> the blood glucose control objective was achieved in 69% of the patients with diabetes. It is also undoubtedly a highly significant fact that 78% of those older than 75 years showed glycated hemoglobin readings below 7.5%. This degree of control is greater than the 43.2% found by Formiga et al. in patients with diabetes older than 65 years.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> However, this excellent control of glycated hemoglobin in elderly patients can be a double-edged sword. We have no information on the number and severity of hypoglycemia in these patients, and without this information, we cannot determine with certainty the risks assumed with this high degree of blood glucose control. However, we can assure that, in the case of frail elderly patients, this approach would be inadvisable.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion, the studies on diabetes based on the consumption of antidiabetic drugs and conducted with large databases are an excellent source of reliable information on the prevalence of diabetes, control of the disease, drug consumption, compliance with the objectives and the degree of compliance with the recommendations of the clinical guidelines. These studies are undoubtedly the prelude to new advances in diabetes research, which will arrive with the possibility of obtaining information offered by the management of “big data” from electronic medical records.</p></span>"
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"nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cerezo JG. El consumo de antidiabéticos en grandes poblaciones: una nueva herramienta para el conocimiento de la diabetes mellitus . https://doi.org/10.1016/j.rce.2019.03.003, 10.1016/j.rceng.2019.01.002.</p>"
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