Diabetes and Blindness in Mexico: Quality of Care in Patients with Ophthalmic Complications.

Objective: Investigate the quality of diabetes care in patients treated for ophthalmologic complications in Mexico and its contribution. Patients and methods: Agreements were made to provide structured diabetes education to patients seeking specialized treatment at the 3 largest Ophtalmology hospitals, and at a public tertiary level hospital, in Mexico city. Patients were invited to attend group diabetes education sessions provided by certified diabetes educators, with the main objective to improve their self-care knowledge and abilities as a means to increase metabolic control and the outcomes of ophthalmologic therapy. As a requirement to attend the sessions, each patient received a survey in which history of diabetes, diagnostic methods, glycemic control, treatment, and chronic complications was investigated. Results: 300 patients were analyzed for this report: 171 females and 129 males. Despite that these hospitals are devoted to treat persons without social security, 43.6% of the patients had this type of care. Comparative percentages, odds ratios (OR) and statistical significance regarding glycemic control, treatment, and complications in patients with social security and without social security, in some of the variables investigated are shown in the table: Conclusions: The results of this survey clearly demonstrate that poor quality of diabetes care is a leading contributing factor in the pathogenesis of ophthalmologic complications. In Mexico, glycemic control is based on fasting and capillary casual measurements; A1c is rarely used. Albeit patients with social security have more access to drug therapy, differences with uninsured patients are not significant. Overall, quality of diabetes care is worse in recipients of social security in Mexico than in patients without access to these services; 40% of the patients should be receiving this type of specialized care at the institution that charges to provide health services. Rates of diabetic foot and current smokers are significantly higher in insured than in noninsured patients. [ABSTRACT FROM AUTHOR]