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En Estados Unidos&#44; en 2014&#44; entre los residentes de 65 o m&#225;s a&#241;os la prevalencia de prediabetes fue del 51&#37; y la de DM2 del 25&#44;9&#37;&#44; lo que representa para esta &#250;ltima una poblaci&#243;n de 11&#44;2 millones de personas<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a>&#46; Respecto al abordaje terap&#233;utico de la DM2 en los pacientes<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os&#44; los <span class="elsevierStyleItalic">Standards of Medical Care in Diabetes</span> publicados recientemente por la <span class="elsevierStyleItalic">American Diabetes Association</span> &#40;ADA&#41; consideran prioritario individualizar el tratamiento para cumplir con los objetivos de control de la hemoglobina glucosilada &#40;HbA1c&#41; y proponen 3 niveles de control &#40;&#60;<span class="elsevierStyleHsp" style=""></span>7&#44;5&#37;&#44; &#60;<span class="elsevierStyleHsp" style=""></span>8&#37; y &#60;<span class="elsevierStyleHsp" style=""></span>8&#44;5&#37;&#41; en funci&#243;n de los diferentes grados de discapacidad&#44; comorbilidad y deterioro cognitivo<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Por otra parte&#44; se ha objetivado que los pacientes ancianos con DM2 tienen una elevada prevalencia de discapacidad y de comorbilidades asociadas&#44; como la hipertensi&#243;n arterial&#44; enfermedad coronaria&#44; enfermedad cerebrovascular&#44; e incluso un porcentaje elevado de s&#237;ndromes geri&#225;tricos como deterioro cognitivo&#44; ca&#237;das&#44; dolor cr&#243;nico y polifarmacia<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&#46; Hasta la fecha desconocemos la verdadera situaci&#243;n de los pacientes ancianos con DM2 en Espa&#241;a&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El <span class="elsevierStyleItalic">Estudio de las caracter&#237;sticas de los pacientes ancianos con diabetes en Espa&#241;a</span> &#40;ESCADIANE&#41;&#44; cuyos resultados se presentan en este art&#237;culo&#44; fue dise&#241;ado por el Grupo de Atenci&#243;n Primaria de la Sociedad Espa&#241;ola de Diabetes&#44; con el fin de conocer las caracter&#237;sticas de los pacientes ancianos con DM2 en nuestro pa&#237;s y poder as&#237; mejorar las estrategias de atenci&#243;n sociosanitaria en este grupo de poblaci&#243;n&#46; El objetivo principal de este estudio fue conocer el estado del control gluc&#233;mico de los pacientes ancianos con DM2 en Espa&#241;a y su relaci&#243;n con la capacidad funcional y la comorbilidad&#46; Los objetivos secundarios fueron conocer la prevalencia de los factores de riesgo cardiovascular y el grado de control de los mismos&#44; la prevalencia de complicaciones macro y microvasculares&#44; describir los tratamientos empleados para el control gluc&#233;mico&#44; analizar el porcentaje de pacientes con hipoglucemias registradas en la historia cl&#237;nica y describir las caracter&#237;sticas de las mismas durante el a&#241;o previo al estudio&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Material y m&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se trata de un estudio epidemiol&#243;gico&#44; observacional&#44; transversal&#44; multic&#233;ntrico&#44; de &#225;mbito nacional&#44; que se desarroll&#243; entre octubre de 2014 y abril de 2015&#46; Participaron 82 investigadores&#44; m&#233;dicos de atenci&#243;n primaria de las diferentes comunidades aut&#243;nomas&#44; cuya distribuci&#243;n fue proporcional a la poblaci&#243;n de cada comunidad aut&#243;noma de Espa&#241;a&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La poblaci&#243;n de estudio comprendi&#243; todos los pacientes &#8805;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os con DM2 conocida o de nuevo diagn&#243;stico seg&#250;n criterios de la ADA 2011<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> &#40;s&#237;ntomas cardinales de diabetes y glucemia al azar &#8805;<span class="elsevierStyleHsp" style=""></span>200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en una sola ocasi&#243;n&#59; glucemia en ayunas &#8805;<span class="elsevierStyleHsp" style=""></span>126<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; HbA1c<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>6&#44;5&#37; o glucemia &#8805;<span class="elsevierStyleHsp" style=""></span>200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl a las 2<span class="elsevierStyleHsp" style=""></span>horas de una sobrecarga oral con 75<span class="elsevierStyleHsp" style=""></span>g de glucosa&#41;&#46; Si no exist&#237;a hiperglucemia inequ&#237;voca los resultados se deb&#237;an confirmar repitiendo los an&#225;lisis&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Los pacientes deb&#237;an firmar el consentimiento informado &#40;ellos o su representante legal&#41; y no ten&#237;an que estar participando en ning&#250;n otro tipo de estudio epidemiol&#243;gico&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se excluyeron personas &#60;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os que no cumpl&#237;an los criterios diagn&#243;sticos de DM2 de la ADA 2011&#44; pacientes en situaci&#243;n terminal y aquellos cuya historia cl&#237;nica no aportaba los datos necesarios y suficientes para el estudio&#44; a juicio del comit&#233; evaluador&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A cada m&#233;dico investigador se le propuso seleccionar 12 pacientes con DM2 que cumplieran los criterios de inclusi&#243;n&#46; Para ello se proporcion&#243; una secuencia de n&#250;meros aleatorios mediante la que se deb&#237;an elegir dichos pacientes de un listado en el que figuraban todos los DM2<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os de la consulta del m&#233;dico investigador&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Variables del estudio</span><p id="par0060" class="elsevierStylePara elsevierViewall">Se estudiaron las siguientes variables demogr&#225;ficas y antropom&#233;tricas&#58; edad&#44; sexo&#44; peso&#44; talla&#44; &#237;ndice de masa corporal&#44; per&#237;metro abdominal&#44; h&#225;bito tab&#225;quico &#40;fumador&#44; ex-fumador&#44; no fumador&#41;&#44; consumo de alcohol &#40;bebedor&#44; ex-bebedor&#44; no bebedor&#41;&#44; presi&#243;n arterial sist&#243;lica y diast&#243;lica&#44; a&#241;os de evoluci&#243;n y fecha de diagn&#243;stico de la diabetes mellitus&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Se recogieron los antecedentes de enfermedades y la aparici&#243;n de complicaciones macro y microvasculares de la DM2 con un diagn&#243;stico confirmado y datado en la historia cl&#237;nica&#44; como cardiopat&#237;a isqu&#233;mica &#40;<span class="elsevierStyleItalic">angor pectoris</span> o infarto de miocardio&#41;&#44; insuficiencia cardiaca&#44; enfermedad vascular cerebral&#44; arteriopat&#237;a perif&#233;rica sintom&#225;tica&#44; enfermedad renal &#40;filtrado glomerular estimado<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> y&#47;o presencia de albuminuria &#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>mg&#47;24<span class="elsevierStyleHsp" style=""></span>h y&#47;o &#237;ndice alb&#250;mina&#47;creatinina en muestra aislada de orina &#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>mg&#47;g&#41;&#44; neuropat&#237;a&#44; retinopat&#237;a&#44; dislipidemia&#44; hipertensi&#243;n arterial&#44; hipertrofia ventricular izquierda y arritmia card&#237;aca&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Se registr&#243; el tratamiento farmacol&#243;gico utilizado de forma habitual por los pacientes &#40;antidiab&#233;ticos&#44; antihipertensivos&#44; hipolipidemiantes&#44; antiagregantes o anticoagulantes&#41; y se investigaron los antecedentes de hipoglucemias que aparec&#237;an en la historia cl&#237;nica y si precisaron de ayuda externa&#44; es decir&#44; de otra persona para su recuperaci&#243;n&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Entre las variables anal&#237;ticas se recogieron la HbA1c &#40;&#37;&#41;&#44; glucemia basal &#40;mg&#47;dl&#41;&#44; perfil lip&#237;dico &#40;colesterol total&#44; colesterol HDL&#44; colesterol LDL&#44; triglic&#233;ridos&#41;&#44; perfil hep&#225;tico&#44; creatinina plasm&#225;tica&#44; filtrado glomerular estimado seg&#250;n la f&#243;rmula <span class="elsevierStyleItalic">Modification of diet in renal disease</span> &#40;ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; e &#237;ndice de alb&#250;mina&#47;creatinina en orina&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Para estudiar el nivel de dependencia se emple&#243; el &#237;ndice de Barthel<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> y se clasific&#243; a los pacientes seg&#250;n su puntuaci&#243;n en&#58; independientes &#40;100 puntos&#41;&#44; o con dependencia leve &#40;91-99 puntos&#41;&#44; moderada &#40;61-90 puntos&#41;&#44; grave &#40;21-60 puntos&#41; o total &#40;0-20 puntos&#41;&#46; La comorbilidad&#44; basada en el &#237;ndice de Charlson<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a>&#44; permiti&#243; clasificar a los pacientes en&#58; comorbilidad baja &#40;0 puntos&#41;&#44; media &#40;1-2 puntos&#41;&#44; alta &#40;3-4 puntos&#41; y muy alta &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>5 puntos&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">El estudio fue calificado como un &#171;Estudio post-autorizaci&#243;n observacional-otros dise&#241;os&#187; por la Agencia Espa&#241;ola del Medicamento &#40;c&#243;digo FJS-DIA-2013-01&#41; y aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica de Arag&#243;n&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lisis estad&#237;stico</span><p id="par0095" class="elsevierStylePara elsevierViewall">Para un nivel de confianza del 95&#37; se calcul&#243; que con una muestra de 939 pacientes se conseguir&#237;a una precisi&#243;n del 2-3&#37;&#46; Se realiz&#243; un an&#225;lisis descriptivo de las variables demogr&#225;ficas&#44; sociales&#44; antropom&#233;tricas&#44; anal&#237;ticas y de las comorbilidades&#46; Las variables continuas se han descrito mediante medidas de tendencia central &#40;media o mediana&#41;&#44; no central &#40;cuartiles&#41; o de dispersi&#243;n &#40;desviaci&#243;n est&#225;ndar&#41; y las variables cualitativas mediante distribuciones de frecuencias absolutas y relativas &#40;porcentajes&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Para la comparaci&#243;n entre variables cuantitativas y cualitativas se comprob&#243;&#44; mediante prueba de Kolmogorov-Smirnov&#44; si las primeras segu&#237;an una distribuci&#243;n normal&#46; Se utilizaron pruebas param&#233;tricas &#40;&#171;t&#187; de Student o ANOVA&#41; o no param&#233;tricas &#40;U de Mann Whitney o Kruskal Wallis&#41; seg&#250;n se cumpliera o no la normalidad&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Las diferencias entre proporciones se calcularon mediante prueba la prueba de Chi-cuadrado&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Cuando se ha precisado se ha utilizado la correcci&#243;n de Yates&#46; En caso de realizar comparaciones m&#250;ltiples se aplic&#243; el m&#233;todo de Bonferroni&#46; Se tom&#243; como nivel de significaci&#243;n p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 y se realiz&#243; el estudio mediante el Sofware IBM SPSS Statistics v&#46;23&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0115" class="elsevierStylePara elsevierViewall">Se incluyeron 939 pacientes&#44; cuya edad media fue de 76&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;7 a&#241;os&#46; Los valores de las variables antropom&#233;tricas&#44; capacidad funcional y comorbilidad distribuidos por grupos etarios se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; Los resultados del grado de control gluc&#233;mico&#44; glucemia basal en ayunas y el porcentaje de hipoglucemias seg&#250;n el grado de dependencia y comorbilidad se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; El nivel de HbA1c present&#243; diferencias estad&#237;sticamente significativas seg&#250;n el grado de discapacidad entre los ancianos con DM2 y dependencia grave y los que eran independientes &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; o ten&#237;an dependencia leve &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#46; Los pacientes con dependencia grave ten&#237;an la HbA1c m&#225;s elevada &#40;7&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;1&#37;&#41;&#46; Tambi&#233;n fue significativa la diferencia entre la media de HbA1c de los ancianos diab&#233;ticos con dependencia moderada&#44; frente a los independientes &#40;7&#44;43&#37; vs&#46; 7&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41;&#46; Un porcentaje elevado de los pacientes con dependencia total &#40;62&#44;5&#37;&#41; recib&#237;an tratamiento con insulina&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Seg&#250;n el &#237;ndice de Charlson el 57&#44;2&#37; de los ancianos con DM2 ten&#237;an un grado de comorbilidad media &#40;puntuaci&#243;n 1-2&#41;&#44; el 28&#44;4&#37; de comorbilidad alta &#40;3-4&#41; y el 14&#44;4&#37; de comorbilidad muy alta &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>5&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">A medida que la comorbilidad era mayor&#44; tambi&#233;n lo era el nivel de HbA1c&#44; con diferencias estad&#237;sticamente significativas entre las cifras de HbA1c de los DM2 ancianos con comorbilidad media frente a los de comorbilidad muy alta &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Conforme aumentaba la comorbilidad&#44; tambi&#233;n lo hac&#237;a el porcentaje de pacientes tratados con insulina sola o asociada a secretagogos&#44; y disminu&#237;a el porcentaje de pacientes tratados con antidiab&#233;ticos orales&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran los datos de control gluc&#233;mico y la prevalencia de los factores de riesgo cardiovascular&#46; El 40&#37; de los pacientes ten&#237;a un &#237;ndice de masa corporal<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30&#44; el 43&#44;7&#37; presentaban cifras de presi&#243;n arterial sist&#243;lica<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>140<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg y&#47;o de diast&#243;lica &#62;<span class="elsevierStyleHsp" style=""></span>90<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>Hg&#46; Solo el 3&#44;2&#37; ten&#237;a cifras de colesterol total<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>250<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; En el 84&#44;3&#37; de los pacientes sin enfermedad cardiovascular el colesterol LDL fue<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>130<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; y en un 69&#44;1&#37; de los que ten&#237;a enfermedad cardiovascular previa se situ&#243; por debajo de 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; Las concentraciones de colesterol HDL fueron adecuadas en el 60&#44;7&#37; &#40;HDL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en mujeres y &#62;<span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en hombres&#41; y el 66&#44;6&#37; de los pacientes manten&#237;a unos triglic&#233;ridos por debajo de 150<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; El colesterol LDL fue inferior a 70<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en el 34&#37; de los pacientes con enfermedad macrovascular y en el 24&#44;1&#37; de los pacientes con insuficiencia renal avanzada&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">El 58&#44;4&#37; de la poblaci&#243;n tuvo complicaciones macrovasculares y&#47;o microvasculares &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">El 28&#44;6&#37; padec&#237;a al menos una enfermedad macrovascular y el 45&#44;7&#37; alguna complicaci&#243;n microvascular&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">El 91&#37; de los pacientes segu&#237;a tratamiento farmacol&#243;gico&#58; el 25&#44;5&#37; insulina y el 82&#37; tratamiento no insul&#237;nico&#46; El 17&#37; utilizaba insulina junto a antidiab&#233;ticos orales&#46; El 16&#37; de los pacientes tomaban sulfonilureas &#40;SU&#41;&#44; siendo la m&#225;s usada la gliclazida &#40;54&#37; de las SU&#41;&#46; El 28&#37; recib&#237;a inhibidores de la enzima dipeptidil peptidasa 4 &#40;iDPP-4&#41;&#46; Dentro de este grupo destacaban la sitagliptina &#40;46&#44;5&#37;&#41;&#44; la vildagliptina &#40;30&#37;&#41; y la linagliptina &#40;19&#37;&#41;&#46; Los antidiab&#233;ticos orales &#40;o combinaciones&#41; m&#225;s utilizados fueron&#58; metformina &#40;47&#37;&#41;&#44; metformina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>IDPP4 &#40;19&#37;&#41;&#44; metformina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>sulfonilureas &#40;9&#37;&#41;&#44; IDPP4 &#40;6&#37;&#41; e IDPP4<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>metformina<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>sulfonilureas &#40;5&#37;&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">El 12&#44;5&#37; de los pacientes ten&#237;a registrados episodios de hipoglucemia en la historia cl&#237;nica&#46; El 18&#37; de estos episodios fueron considerados graves&#44; ya que precisaron la asistencia de otra persona&#46; El 86&#37; de las hipoglucemias graves ocurrieron en pacientes tratados con insulina&#44; frente al 14&#37; ocurrido en sujetos tratados con secretagogos &#40;sulfonilureas o repaglinida&#41;&#46; La utilizaci&#243;n de insulina y secretagogos fue porcentualmente mayor en los pacientes que ten&#237;an una mayor comorbilidad y dependencia y&#44; adem&#225;s&#44; estos f&#225;rmacos fueron m&#225;s empleados en los pacientes con peor control metab&#243;lico &#40;un 67&#37; de los pacientes con una HbA1c<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7&#37; estaban siendo tratados con insulina y&#47;o secretagogos&#44; frente al 25&#37;</p><p id="par0155" class="elsevierStylePara elsevierViewall">de los pacientes con una HbA1c<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>7&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discusi&#243;n</span><p id="par0160" class="elsevierStylePara elsevierViewall">El manejo de los pacientes con DM2 precisa de una adecuada valoraci&#243;n individual con el fin de establecer los objetivos de control y la mejor estrategia terap&#233;utica&#46; La edad&#44; la esperanza de vida&#44; la capacidad funcional&#44; la comorbilidad&#44; los a&#241;os de evoluci&#243;n de la enfermedad y la colaboraci&#243;n del paciente son los pilares sobre los que se deben basar las decisiones cl&#237;nicas y establecer los objetivos de control gluc&#233;mico<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">En el caso de los pacientes ancianos con DM2 es de especial importancia evitar los episodios hipogluc&#233;micos y los efectos adversos farmacol&#243;gicos&#44; que pueden empeorar su calidad de vida y provocar ca&#237;das&#44; accidentes o deterioro cognitivo&#46; El control estricto de los par&#225;metros metab&#243;licos en estos pacientes es menos probable que aporte beneficios a largo plazo<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6&#44;8</span></a>&#44; especialmente en los m&#225;s ancianos&#46; En nuestro estudio llama la atenci&#243;n la baja concentraci&#243;n de HbA1c de los ancianos con DM2&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">La media de HbA1c fue del 7&#37;&#44; a pesar de que eran pacientes con un tiempo medio de evoluci&#243;n de la enfermedad de m&#225;s de 10 a&#241;os &#40;11&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;9&#41;&#46; Un 75&#37; de los pacientes ten&#237;a una HbA1c<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>7&#44;5&#37;&#46; Estas cifras son orientativas de la intensidad terap&#233;utica y podr&#237;an explicar el porqu&#233; de las hipoglucemias registradas en la historia cl&#237;nica &#40;uno de cada 8 pacientes experiment&#243; al menos un episodio de hipoglucemia&#41;&#46; De estas&#44; el 18&#37; precisaron de ayuda externa para la recuperaci&#243;n del paciente&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Los datos de control gluc&#233;mico de este estudio son similares a los de otros realizados en nuestro entorno<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">20&#8211;22</span></a> u otros pa&#237;ses&#46; En concreto&#44; un an&#225;lisis de 1&#46;288 pacientes mayores de 65 a&#241;os<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> de una encuesta de salud de Estados Unidos &#40;NHANES&#41;&#44; apunt&#243; hacia el posible sobretratamiento de los pacientes ancianos&#44; ya que el 61&#44;5&#37; de la muestra estudiada ten&#237;a una HbA1c<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>7&#37; y un 41&#44;9&#37; menor al 6&#44;5&#37;&#46; En otra encuesta de salud llevada a cabo en Alemania&#44; el 65&#37; de los diab&#233;ticos ten&#237;a una HbA1c<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>7&#37;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a>&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Los resultados mostraron un peor control gluc&#233;mico cuando el anciano diab&#233;tico ten&#237;a un mayor grado de comorbilidad&#44; aunque la diferencia de HbA1c entre los grupos con mayor y menor comorbilidad fue solamente de 0&#44;36&#37;&#44; diferencia de escasa relevancia cl&#237;nica&#46; Tambi&#233;n se observ&#243; un peor control gluc&#233;mico conforme aumentaba el grado de dependencia&#44; excepto en el caso de los ancianos con dependencia total&#44; que presentaron niveles medios similares a los ancianos sin ning&#250;n grado de dependencia&#46; Este control gluc&#233;mico estricto en ancianos diab&#233;ticos totalmente dependientes podr&#237;a estar asociado a la intensificaci&#243;n del tratamiento con insulina&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">En Francia<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> se realiz&#243; un estudio en pacientes diab&#233;ticos mayores de 70 a&#241;os para investigar la relaci&#243;n entre el control metab&#243;lico y la morbimortalidad&#46; Se investigaron 3 cohortes seg&#250;n el tratamiento empleado&#58; solo insulina&#44; insulina m&#225;s antidiab&#233;ticos orales y solo antidiab&#233;ticos orales y&#47;o an&#225;logos de <span class="elsevierStyleItalic">glucagon like peptide-1</span>&#46; Se observ&#243; un alto porcentaje de hipoglucemias &#40;53&#37;&#41; en el primer grupo&#44; siendo&#44; adem&#225;s&#44; su control gluc&#233;mico peor y mayor la proporci&#243;n de retinopat&#237;a&#44; enfermedad renal&#44; afectaci&#243;n cardiovascular y complicaciones geri&#225;tricas&#46; Los pacientes tratados exclusivamente con antidiab&#233;ticos orales o an&#225;logos de <span class="elsevierStyleItalic">glucagon like peptide-1</span>tuvieron una evoluci&#243;n de su enfermedad y unas caracter&#237;sticas y comorbilidades muy parecidas a las de nuestra muestra y presentaron niveles de HbA1c media semejantes &#40;7&#44;1&#37;&#41;&#44; con un 75&#37; de pacientes con HbA1c<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>7&#44;5&#37;&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">En los ancianos de nuestra muestra&#44; como era de esperar&#44; los factores de riesgo cardiovascular y las complicaciones vasculares fueron elevadas&#46; La hipertensi&#243;n arterial&#44; presente en un 78&#37; de pacientes&#44; sigue siendo el factor m&#225;s dif&#237;cil de controlar&#46; Aproximadamente un tercio de los ancianos con DM2 padec&#237;a enfermedad macrovascular y&#44; de manera semejante a otros estudios espa&#241;oles<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">20&#44;21&#44;26</span></a>&#44; la principal complicaci&#243;n fue la cardiopat&#237;a isqu&#233;mica &#40;13&#44;9&#37;&#41;&#44; seguida de la enfermedad cerebro-vascular &#40;11&#44;9&#37;&#41; y de la enfermedad arterial perif&#233;rica &#40;9&#37;&#41;&#46; Sin embargo&#44; la prevalencia de enfermedad macrovascular fue muy inferior en comparaci&#243;n con la de otros pa&#237;ses occidentales como Estados Unidos<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">23&#44;27</span></a>&#44; Alemania<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#44;29</span></a>&#44; Escocia<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> o Francia<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a>&#44; incluso en cohortes con edades m&#225;s j&#243;venes&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Las complicaciones microvasculares afectaron al 45&#44;7&#37; de los pacientes&#44; siendo la m&#225;s prevalente la enfermedad renal cr&#243;nica&#46; La alta prevalencia de la enfermedad renal cr&#243;nica deber&#237;a tener influencia en los tratamientos farmacol&#243;gicos empleados y ser objetivo de m&#225;s estudios&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">En referencia al tratamiento farmacol&#243;gico la metformina fue el f&#225;rmaco m&#225;s frecuentemente utilizado&#44; seguida de los IDPP-4&#46; La utilizaci&#243;n de insulina no fue residual&#44; ya que se emple&#243; en un 25&#37; de los casos&#44; por lo que el conocimiento de su manejo es importante&#46; Insulina y secretagogos fueron los f&#225;rmacos con una relaci&#243;n m&#225;s intensa con las hipoglucemias&#44; y su uso era m&#225;s frecuente en los pacientes con peor control metab&#243;lico&#46; Tambi&#233;n resulta llamativo que la glibenclamida supusiera todav&#237;a el 7&#37; de las SU empleadas&#44; a pesar de su vida media prolongada y de la capacidad para provocar hipoglucemias&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">El presente trabajo tiene las limitaciones propias de los estudios transversales&#46; Los datos fueron extra&#237;dos de la historia cl&#237;nica y probablemente algunos resultados&#44; como la prevalencia de las hipoglucemias o de los s&#237;ndromes geri&#225;tricos&#44; est&#233;n infraestimados&#46; Sin embargo&#44; el tama&#241;o de la muestra estudiada y el m&#233;todo de elecci&#243;n de la misma&#44; con investigadores distribuidos por toda Espa&#241;a y con el empleo de series de n&#250;meros aleatorios para la selecci&#243;n de los pacientes&#44; nos hacen pensar que los resultados obtenidos son representativos de la situaci&#243;n actual en nuestro pa&#237;s&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusi&#243;n</span><p id="par0210" class="elsevierStylePara elsevierViewall">Los valores medios de HbA1c en los pacientes ancianos con DM2 analizados en Espa&#241;a son inferiores a los recomendados por las principales gu&#237;as de pr&#225;ctica cl&#237;nica&#46; Estos valores resultaron m&#225;s elevados en los pacientes con un nivel m&#225;s alto de comorbilidad y se vieron influidos por el grado de discapacidad del paciente&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Financiaci&#243;n</span><p id="par0215" class="elsevierStylePara elsevierViewall">Este trabajo ha sido desarrollado gracias al soporte financiero de Boehringer-Ingelgeim&#46; Las fuentes financieras no han tenido ning&#250;n papel en el dise&#241;o del estudio&#44; recogida de datos o interpretaci&#243;n de los mismos&#46; Tampoco han participado en la preparaci&#243;n&#44; revisi&#243;n o aprobaci&#243;n del manuscrito&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0225" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Conocer el estado del control gluc&#233;mico de los pacientes ancianos con diabetes mellitus tipo 2 en Espa&#241;a y su relaci&#243;n con la capacidad funcional y la comorbilidad&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal&#44; observacional&#44; multic&#233;ntrico&#44; de &#225;mbito nacional&#44; en pacientes con diabetes mellitus<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os&#46; Se estudiaron variables sociodemogr&#225;ficas&#44; antropom&#233;tricas&#44; factores de riesgo cardiovascular&#44; datos de exploraci&#243;n cl&#237;nica y anal&#237;ticos&#44; comorbilidad asociada y tratamientos utilizados&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se analiz&#243; la capacidad funcional mediante el &#237;ndice de Barthel y la comorbilidad con el de Charlson&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 939 pacientes&#46; La edad media fue 76&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;7 a&#241;os&#46; La hemoglobina glucosilada &#40;HbA1c&#41; media fue 7&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;2&#37; y la glucemia basal media 137<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>39&#44;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; El nivel de HbA1c present&#243; diferencias estad&#237;sticamente significativas seg&#250;n el grado de discapacidad&#46; En los pacientes con dependencia total&#44; grave&#44; moderada&#44; leve o independientes las concentraciones de HbA1c media fueron de 7&#44;0&#37;&#44; 7&#44;9&#37;&#44; 7&#44;4&#37; y 7&#44;0&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;028&#41; respectivamente&#46; Los niveles de HbA1c fueron de 7&#44;3&#37;&#44; 7&#44;1&#37; y 6&#44;9&#37; en los pacientes con comorbilidad muy alta&#44; alta y media&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los valores medios de HbA1c en los pacientes ancianos con diabetes tipo 2 analizados en Espa&#241;a son inferiores a los recomendados por las principales gu&#237;as de pr&#225;ctica cl&#237;nica&#46; Son m&#225;s elevados en los pacientes que presentan mayor grado de discapacidad funcional y un nivel m&#225;s alto de comorbilidad&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objectives</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To understand the state of glycaemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional&#44; observational&#44; multicentre national study on patients with diabetes mellitus aged 65 years or older&#46; The study analysed demographic and anthropometric variables&#44; cardiovascular risk factors&#44; clinical and laboratory data&#44; associated comorbidity and treatments&#46;</p><p id="spar0155" class="elsevierStyleSimplePara elsevierViewall">We analysed the functional capacity using the Barthel index and the comorbidity with Charlson index&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The study included 939 patients with a mean age of 76&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;7 years&#46; The mean glycated haemoglobin &#40;HbA1c&#41; level was 7&#46;0&#37;<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&#37;&#44; and the mean basal blood glucose level was 137<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>39&#46;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#46; The HbA1c level showed statistically significant differences depending on the degree of disability&#46; In the patients who were totally&#44; severely&#44; moderately or slightly dependent or who were independent&#44; the mean HbA1c levels were 7&#46;0&#37;&#44; 7&#46;9&#37;&#44; 7&#46;4&#37; and 7&#46;0&#37;&#44; respectively &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;028&#41;&#46; HbA1c levels were 7&#46;3&#37;&#44; 7&#46;1&#37; and 6&#46;9&#37; in the patients with very high&#44; high and medium comorbidity&#44; respectively &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Mean HbA1c levels in elderly patients with type 2 diabetes analysed in Spain are below those recommended by the main clinical practice guidelines&#46; The levels are higher in patients who have more functional disability and a higher level of comorbidity&#46;</p></span>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Los datos se expresan como media &#40;DE&#41;&#44; mediana &#40;RI&#41; o n&#250;mero &#40;&#37;&#41; seg&#250;n corresponda&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Para variables cualitativas &#40;n &#91;&#37;&#93;&#41;&#58; p-valor test Chi cuadrado&#46; Para variables cuantitativas&#58; test param&#233;trico &#40;&#171;t&#187; de Student o ANOVA 1 factor&#41; si siguen distribuci&#243;n normal&#44; test no param&#233;trico &#40;U-Mann Whitney&#44; K Kruskal Wallis&#41; si no siguen distribuci&#243;n normal&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; IMC&#58; &#237;ndice de masa corporal&#59; ns&#58; no significativo&#59; RI&#58; rango intercuart&#237;lico&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a&#44;b&#44;c</span> Las letras en super&#237;ndice denotan un subconjunto de grupos de edad&#59; categor&#237;as cuyas proporciones de columna no difieren de forma significativa entre s&#237; en el nivel 0&#44;05&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Poblaci&#243;n total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">65-74 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">75-84 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#8805;<span class="elsevierStyleHsp" style=""></span>85 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hombre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">442 &#40;47&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">196 &#40;49&#44;6&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">203 &#40;49&#44;8&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;31&#44;6&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mujer</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">497 &#40;52&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">199 &#40;50&#44;4&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">205 &#40;50&#44;2&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93 &#40;68&#44;4&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad&#44; a&#241;os</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 &#40;5&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;4&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87 &#40;3&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peso&#44; kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#44;5 &#40;18&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#44;0 &#40;17&#44;9&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;6 &#40;17&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#44;0 &#40;17&#44;5&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Talla&#44; cm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160&#44;0 &#40;13&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161&#44;0 &#40;12&#44;5&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">159&#44;0&#40;13&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">156&#44;0 &#40;11&#44;0&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Per&#237;metro cintura&#44; cm</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hombres&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104&#44;1 &#40;11&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104&#44;6 &#40;10&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104&#44;2 &#40;11&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#44;6 &#40;11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mujeres&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&#44;7 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99&#44;8 &#40;12&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&#44;2 &#40;11&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#44;4 &#40;14&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">RA&#47;E&#44; relaci&#243;n per&#237;metro abdomen&#47;estatura</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hombres&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;625 &#40;0&#44;070&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;622&#40;0&#44;066&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;630 &#40;0&#44;070&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;614 &#40;0&#44;080&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mujeres&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;641 &#40;0&#44;086&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;641 &#40;0&#44;082&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;641 &#40;0&#44;085&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;639 &#40;0&#44;101&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IMC&#44; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;9 &#40;6&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;4 &#40;6&#44;5&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;7 &#40;5&#44;7&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;0 &#40;5&#44;9&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de Barthel</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Independientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">671 &#40;71&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">348 &#40;88&#44;1&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">276 &#40;67&#44;6&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47 &#40;34&#44;6&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dependencia leve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">204 &#40;21&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;9&#44;9&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104 &#40;25&#44;5&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;44&#44;9<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dependencia moderada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#44;3&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;4&#44;2&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;14&#44;0<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dependencia grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;5&#41;<span class="elsevierStyleSup">a&#44;b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;2&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;2&#44;9&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dependencia total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;3&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;2&#44;5&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;3&#44;7&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Institucionalizados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;5&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;2&#44;2&#41;<span class="elsevierStyleSup">a&#44;b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;5&#44;9&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de Charlson</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Comorbilidad baja &#40;1-2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">532 &#40;57&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">247 &#40;63&#44;0&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">217 &#40;53&#44;7&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;51&#44;1&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">0&#44;003</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Comorbilidad media &#40;3-4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">263 &#40;28&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 &#40;24&#44;7&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131 &#40;32&#44;4&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;26&#44;3&#41;<span class="elsevierStyleSup">a&#44;b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Comorbilidad alta<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134 &#40;14&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;12&#44;2&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;13&#44;9&#41;<span class="elsevierStyleSup">a&#44;b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;22&#44;6&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Medidas antropom&#233;tricas&#46; Capacidad funcional y comorbilidad de la poblaci&#243;n estudiada</p>"
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        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ADO&#58; antidiab&#233;ticos orales&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; SU&#58; sulfonilureas&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a&#44;b</span> Cada letra en super&#237;ndice denota un subconjunto de grupos de edad&#59; categor&#237;as cuyas proporciones de columna no difieren de forma significativa entre s&#237; en el nivel 0&#44;05&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Discapacidad &#205;ndice de Barthel</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HbA1C&#44; &#37; Media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Glucemia&#44; mg&#47;dl Media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hipoglucemias n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento insulina n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento con ADO n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento ADO<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>insulina n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tatamiento insulina y&#47;o secretagogos &#40;SU o repaglinida&#41; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dependencia total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;99 &#40;1&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134&#44;9 &#40;52&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;25&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;62&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;43&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;18&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;68&#44;85&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dependencia grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;93 &#40;1&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125&#44;3 &#40;47&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;42&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;57&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;14&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;71&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dependencia moderada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;43 &#40;1&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">135&#44;9 &#40;41&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;29&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;48&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;80&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;34&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;61&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dependencia leve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">202 &#40;21&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;05 &#40;1&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">135&#44;5 &#40;42&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;16&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;32&#44;3&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">152 &#40;75&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;17&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96 &#40;47&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Independiente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">672 &#40;71&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;00 &#40;1&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137&#44;8 &#40;35&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66 &#40;9&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">141 &#40;21&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">576 &#40;85&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">107 &#40;15&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">263 &#40;39&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            1 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Comorbilidad &#205;ndice de Charlson</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HbA1c&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Glucemia&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hipoglucemias n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento Insulina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento ADO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento ADO<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Insulina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiemto insulina y&#47;osecretagogos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Comorbilidad media&#58; 1-2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">535 &#40;57&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;95 &#40;1&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">136&#44;34 &#40;36&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;41&#44;0&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;16&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">473 &#40;88&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 &#40;13&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">194 &#40;36&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Comorbilidad alta&#58; 3-4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">265 &#40;28&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;06 &#40;1&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">136&#44;90 &#40;40&#44;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;27&#44;4&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;31&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">210 &#40;79&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;23&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120 &#40;45&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Comorbilidad muy alta<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134 &#40;14&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;31 &#40;1&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140&#44;99 &#40;48&#44;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;31&#44;6&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;50&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87 &#40;64&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;22&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85 &#40;63&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;5 &#40;8&#44;6&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;2 &#40;8&#44;4&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;6 &#40;9&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">0&#44;003</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>5 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">168 &#40;17&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;17&#44;3&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77 &#40;18&#44;9&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;16&#44;9&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5-10 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">159 &#40;40&#44;4&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">124 &#40;30&#44;4&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;25&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">453 &#40;48&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">167 &#40;42&#44;4&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">207 &#40;50&#44;7&#41;<span class="elsevierStyleSup">a&#44;b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79 &#40;58&#44;1&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">171&#44;5 &#40;49&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">171&#44;0 &#40;52&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;0 &#40;19&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;0 &#40;18&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;0 &#40;16&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93&#44;6 &#40;43&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93&#44;6 &#40;40&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;4 &#40;30&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#44;1 &#40;30&#44;6&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#44;8 &#40;32&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#44;4 &#40;29&#44;8&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">261 &#40;29&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;18&#44;8&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">121 &#40;31&#44;4&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72 &#40;55&#44;4&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fumador</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fumador habitual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62 &#40;6&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;8&#44;1&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;5&#44;7&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;5&#44;2&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ex fumador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">214 &#40;23&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;28&#44;2&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;21&#44;7&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;11&#44;2&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No fumador&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">656 &#40;70&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250 &#40;63&#44;6&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">294 &#40;72&#44;6&#41; <span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112 &#40;83&#44;6&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hipertensi&#243;n arterial</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">731 &#40;78&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">303 &#40;77&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">320 &#40;79&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108 &#40;80&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hipercolesterolemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">545 &#40;58&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">254 &#40;64&#44;6&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">229 &#40;56&#44;5&#41;<span class="elsevierStyleSup">a&#44;b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62 &#40;46&#44;3&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hipertrigliceridemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">224 &#40;24&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">122 &#40;31&#44;0&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77 &#40;19&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;18&#44;7&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Control gluc&#233;mico y factores de riesgo cardiovascular en la poblaci&#243;n de estudio</p>"
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          "leyenda" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Los datos se expresan como n&#250;mero &#40;&#37;&#41;&#46; Para variables cualitativas&#58; c&#225;lculo del valor p mediante el test Chi cuadrado&#46; Para variables cuantitativas&#58; test param&#233;trico &#40;&#171;t&#187; de Student o ANOVA un factor&#41; si siguen distribuci&#243;n normal&#44; test no param&#233;trico &#40;U-Mann Whitney&#44; K Kruskal Wallis&#41; si no siguen distribuci&#243;n normal&#46;</p><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">ACVA&#58; accidente cerebrovascular agudo&#59; ns&#58; no significativo&#46;</p><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a&#44;b&#44;c</span> Cada letra en super&#237;ndice denota un subconjunto de grupos de edad&#59; categor&#237;as cuyas proporciones de columna no difieren de forma significativa entre s&#237; en el nivel 0&#44;05&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Poblaci&#243;n total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">75-84 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#8805;<span class="elsevierStyleHsp" style=""></span>85 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Complicaciones macrovasculares</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">267 &#40;28&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108 &#40;27&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">119 &#40;29&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;29&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130 &#40;13&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;12&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62 &#40;15&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;13&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">111 &#40;11&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;11&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#40;11&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;15&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad arterial perif&#233;rica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84 &#40;9&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;10&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Complicaciones microvasculares</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">422 &#40;45&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">143 &#40;36&#44;9&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">197 &#40;49&#44;0&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;61&#44;7&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">339 &#40;36&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101 &#40;25&#44;9&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161 &#40;39&#44;9&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77 &#40;57&#44;5&#41;<span class="elsevierStyleSup">c</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neuropat&#237;a diab&#233;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;6&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;6&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;6&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Retinopat&#237;a<br>&#40;retinopat&#237;a diab&#233;tica no proliferativa y&#47;o proliferativa&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">111 &#40;11&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;12&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53 &#40;13&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Complicaciones microvasculares y&#47;o macrovasculares</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">541 &#40;58&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">194 &#40;50&#44;0&#41;<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">251 &#40;62&#44;4&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94 &#40;70&#44;7&#41;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">Tratamientos utilizados y control metab&#243;lico en la poblaci&#243;n total y en los diferentes grupos etarios</p>"
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          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:30 [
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              "identificador" => "bib0155"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; Dept&#46; of Noncommunicable Disease Surveillance&#46; Definition&#44; diagnosis&#46;and classification of diabetes mellitus and its complications&#58; Report of WHO consultation&#46; Part 1&#46; Diagnosis and classification of diabetes mellitus&#46; 1999&#46; Ed&#46; Geneva&#58; World Health Organization&#59; p&#46; 60&#46;"
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            1 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Estrategia en diabetes del Sistema Nacional de Salud&#46; Prevalencia e incidencia de la DM y sus complicaciones&#46; Madrid&#58; Ministerio de Sanidad y Consumo&#59; 2007&#46; p&#46; 85&#46;"
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            2 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Ministerio de Sanidad y Pol&#237;tica Social&#46; Encuesta Nacional de Salud &#91;consultado 23 May 2016&#93;&#46; Disponible en&#58; <a href="http://pestadistico.msc.es/PEMSC25/ArbolNodos.aspx">http&#58;&#47;&#47;pestadistico&#46;msc&#46;es&#47;PEMSC25&#47;ArbolNodos&#46;aspx</a>"
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            3 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Centers for Disease Control and Prevention&#46; National diabetes fact sheet&#58; National estimates and general information on diabetes and prediabetes in the United States&#59; 2011&#46; Atlanta&#44; GA&#58; U&#46;S&#46; Department of Health and Human Services&#44; Centers for Disease Control and Prevention&#44; 2011 &#91;consultado 23 May 2016&#93; 13 pp&#46; Disponible en&#58; <a href="http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf">http&#58;&#47;&#47;www&#46;cdc&#46;gov&#47;diabetes&#47;pubs&#47;pdf&#47;ndfs&#95;2011&#46;pdf</a>"
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              "identificador" => "bib0175"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diabetes mellitus in older people"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Position statement on behalf of the International Association of Gerontology and Geriatrics &#40;IAGG&#41;&#44; the European Diabetes Working Party for Older People &#40;EDWPOP&#41;&#44; and the International Task Force of Experts in Diabetes"
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                          "autores" => array:6 [
                            0 => "A&#46; Sinclair"
                            1 => "J&#46; Morley"
                            2 => "L&#46; Rodriguez-Ma&#241;as"
                            3 => "G&#46; Paolisso"
                            4 => "T&#46; Bayer"
                            5 => "A&#46; Zeyfang"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jamda.2012.04.012"
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                        "tituloSerie" => "J Am Med Dir Assoc"
                        "fecha" => "2012"
                        "volumen" => "13"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22748719"
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              "identificador" => "bib0180"
              "etiqueta" => "6"
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                  "referenciaCompleta" => "Sinclair A&#44; Dunning T&#44; Colagiuri S&#46; IDF Global guideline for managing older people with type 2 diabetes&#46; 2013 &#91;consultado 21 May 2016&#93;&#46; p&#46; 94&#46; Disponible en&#58; hppt&#46;&#47;&#47;www&#46;idf&#46;org&#47;sites&#47;default&#47;files7IDFGuideline- for-older-people-T2D&#46;pdf"
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                      "titulo" => "Clinical practice guidelines diabetes in the elderly Canadian Diabetes Association clinical practice guidelines expert committee"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;S&#46; Meneilly"
                            1 => "A&#46; Knip"
                            2 => "D&#46; Daniel Tessier"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcjd.2013.01.045"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Diabetes"
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                        "volumen" => "37"
                        "paginaInicial" => "S184"
                        "paginaFinal" => "S190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24070944"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Conferencia de consenso&#58; tratamiento de la diabetes tipo 2 en el paciente anciano"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; G&#243;mez Huelgas"
                            1 => "J&#46; D&#237;ez-Espino"
                            2 => "F&#46; Formiga"
                            3 => "J&#46; Lafita"
                            4 => "L&#46; Rodr&#237;guez- Ma&#241;as"
                            5 => "E&#46; Gonz&#225;lez-Sarmiento"
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                        ]
                      ]
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                  ]
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                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
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              "identificador" => "bib0195"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of diabetes mellitus and impaired glucose regulation in Spain&#58; The Di&#64;bet&#46;es Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Soriguer"
                            1 => "A&#46; Goday"
                            2 => "A&#46; Bosch-Comas"
                            3 => "E&#46; Bordi&#250;"
                            4 => "A&#46; Calle"
                            5 => "R&#46; Carmena"
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                      ]
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                  ]
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                    0 => array:2 [
                      "doi" => "10.1007/s00125-011-2336-9"
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                        "tituloSerie" => "Diabetologia"
                        "fecha" => "2012"
                        "volumen" => "55"
                        "paginaInicial" => "88"
                        "paginaFinal" => "93"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21987347"
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              "identificador" => "bib0200"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "en representaci&#243;n de la Red de Grupos de Estudio de la Diabetes en Atenci&#243;n Primaria de la Salud&#46; Evoluci&#243;n de los indicadores de calidad asistencial al diab&#233;tico tipo 2 en atenci&#243;n primaria &#40;1996-2007&#41;&#46; Programa de mejora continua de calidad de la Red de Grupos de Estudio de la Diabetes en Atenci&#243;n Primaria de la Salud"
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "S&#46; Artola"
                            2 => "J&#46; Diez-Espino"
                            3 => "M&#46; Mata"
                          ]
                        ]
                      ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
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                        "volumen" => "135"
                        "paginaInicial" => "600"
                        "paginaFinal" => "607"
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Vol. 217. Núm. 9.
Páginas 495-503 (diciembre 2017)
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Vol. 217. Núm. 9.
Páginas 495-503 (diciembre 2017)
Original
Control glucémico de los pacientes ancianos con diabetes mellitus tipo 2 en España (2015) y su relación con la capacidad funcional y la comorbilidad. Estudio Escadiane
Glycaemic control of elderly patients with type 2 diabetes mellitus in Spain (2015) and its relationship with functional capacity and comorbidity. The Escadiane study
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F.J. Sangrós-Gonzáleza,
Autor para correspondencia
sangrosconte@telefonica.net

Autor para correspondencia.
, J. Martínez-Candelab, L. Avila-Lachicac, J. Díez-Espinod, J.M. Millaruelo-Trilloa, J. García-Soidáne, L. Carrillo Fernándezf, P. Ezkurra Loiolag
a Centro de Salud Torrero-La Paz, Zaragoza, España
b Centro de Salud Mariano Yago, Yecla, Murcia, España
c UGC Vélez Norte, Málaga, España
d Centro de Salud de Tafalla, Tafalla, Navarra, España
e Centro de Salud de Porriño, Porriño, Pontevedra, España
f CS La Victoria de Acentejo, Santa Cruz de Tenerife, España
g Centro de Salud de Zumaia, Zumaia, Guipúzcoa, España
Contenido relacionado
Rev Clin Esp. 2017;217:518-910.1016/j.rce.2017.10.003
R. Gómez-Huelgas, M.D. López-Carmona
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Estadísticas
Tablas (5)
Tabla 1. Medidas antropométricas. Capacidad funcional y comorbilidad de la población estudiada
Tabla 2. Relación entre el grado de discapacidad y comorbilidad y el control glucémico
Tabla 3. Control glucémico y factores de riesgo cardiovascular en la población de estudio
Tabla 4. Complicaciones macro y microvasculares en la población de estudio y en los diferentes grupos de edad
Tabla 5. Tratamientos utilizados y control metabólico en la población total y en los diferentes grupos etarios
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Resumen
Objetivos

Conocer el estado del control glucémico de los pacientes ancianos con diabetes mellitus tipo 2 en España y su relación con la capacidad funcional y la comorbilidad.

Métodos

Estudio transversal, observacional, multicéntrico, de ámbito nacional, en pacientes con diabetes mellitus65 años. Se estudiaron variables sociodemográficas, antropométricas, factores de riesgo cardiovascular, datos de exploración clínica y analíticos, comorbilidad asociada y tratamientos utilizados.

Se analizó la capacidad funcional mediante el índice de Barthel y la comorbilidad con el de Charlson.

Resultados

Se incluyeron 939 pacientes. La edad media fue 76,4±6,7 años. La hemoglobina glucosilada (HbA1c) media fue 7,0±1,2% y la glucemia basal media 137±39,6mg/dl. El nivel de HbA1c presentó diferencias estadísticamente significativas según el grado de discapacidad. En los pacientes con dependencia total, grave, moderada, leve o independientes las concentraciones de HbA1c media fueron de 7,0%, 7,9%, 7,4% y 7,0% (p<0,028) respectivamente. Los niveles de HbA1c fueron de 7,3%, 7,1% y 6,9% en los pacientes con comorbilidad muy alta, alta y media, respectivamente (p<0,001).

Conclusiones

Los valores medios de HbA1c en los pacientes ancianos con diabetes tipo 2 analizados en España son inferiores a los recomendados por las principales guías de práctica clínica. Son más elevados en los pacientes que presentan mayor grado de discapacidad funcional y un nivel más alto de comorbilidad.

Palabras clave:
Diabetes
Ancianos
Control glucémico
Comorbilidad
Capacidad funcional
Abstract
Objectives

To understand the state of glycaemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity.

Methods

Cross-sectional, observational, multicentre national study on patients with diabetes mellitus aged 65 years or older. The study analysed demographic and anthropometric variables, cardiovascular risk factors, clinical and laboratory data, associated comorbidity and treatments.

We analysed the functional capacity using the Barthel index and the comorbidity with Charlson index.

Results

The study included 939 patients with a mean age of 76.4±6.7 years. The mean glycated haemoglobin (HbA1c) level was 7.0%±1.2%, and the mean basal blood glucose level was 137±39.6mg/dL. The HbA1c level showed statistically significant differences depending on the degree of disability. In the patients who were totally, severely, moderately or slightly dependent or who were independent, the mean HbA1c levels were 7.0%, 7.9%, 7.4% and 7.0%, respectively (P<.028). HbA1c levels were 7.3%, 7.1% and 6.9% in the patients with very high, high and medium comorbidity, respectively (P<.001).

Conclusions

Mean HbA1c levels in elderly patients with type 2 diabetes analysed in Spain are below those recommended by the main clinical practice guidelines. The levels are higher in patients who have more functional disability and a higher level of comorbidity.

Keywords:
Diabetes
Elderly
Glycaemic control
Comorbidity
Functional capacity

Artículo

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