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Fundamento y objetivo El buen control metabolico de los pacientes con diabetes mellitus tipo 2(DM2) disminuira su riesgo de enfermedad cardiovascular (ECV). El objetivo del estudio fue valorarel grado de control glucemico, lipidico y de presion arterial (PA) y describir la prevalenciade hipertension arterial (HTA) y dislipemia de los pacientes con DM2 asistidos en la consultamedica. Pacientes y metodo El TranSTAR es un estudio de casos y controles (emparejados segun sexo yedad), transversal, de ambito nacional realizado on-line. Se recogieron datos sobre glucemiabasal, hemoglobina glucosilada, perfil lipidico, PA y antecedentes personales de ECV y se determinoel valor de la glucemia capilar posprandial (GCPP), entre 1 y 3 h tras la ingesta. Parael estudio del grado de control glucemico, lipidico y de PA de los pacientes con DM2 se aplicaronlas recomendaciones de la Sociedad Espanola de Diabetes. Resultados Se estudiaron 371 parejas de pacientes. En los pacientes con DM2 se observo unmal control glucemico en el 82,1% (intervalo de confianza [IC] del 95%, 77,9–86,3) segun laglucemia basal, en el 88,4% (IC del 95%, 85,1–91,7) segun la GCPP o en el 18,8% (IC del95%, 14,3–23,3) segun la hemoglobina glucosilada. Presento un mal control lipidico el 63,3%(IC del 95%, 56,6–70,0) y un mal control de la PA el 69,5% (IC del 95%, 64,2–74,8). Un9,2% (IC del 95%, 0,9–17,5) y un 20,5% (IC del 95%, 12,8–28,2) presentaban una HTA yuna dislipemia desconocidas, respectivamente. Conclusion La proporcion de pacientes con DM2 que presentan un mal control metabolico esmuy elevada. La disponibilidad de datos obtenidos en nuestra propia poblacion deberia contribuiral mejor tratamiento de los pacientes.

Treatment of type 2 diabetes in the elderly represents a major challenge both in terms of clinical management and public health. Aging is causing a marked increase in the pandemic of diabetes in elderly people. However, scientific evidence to support the most appropriate treatment for diabetes in the elderly is scarce. Given the heterogeneity of the elderly population, which includes subjects with very different functional and cognitive capacities, co-morbidities, and life expectancy, it is critical to make a comprehensive assessment from a biopsychosocial perspective, to address the vascular risk factors integrally, and to establish individually tailored targets for glycemic control. In frail elderly or individuals with a short life expectancy, it may be reasonable to maintain HbA1c between 7.6%-8.5%. The therapeutic strategy for elderly patients with type 2 diabetes should be individualized and agreed with the patient and their caregivers, according to the objective. Improving quality of life, assuring patient safety and avoiding the adverse effects of antidiabetic treatment should be prioritized. Given the increased susceptibility of the elderly to severe hypoglycemia and its consequences, antidiabetic therapies that minimize the risk of hypoglycemic events should be selected.

A good metabolic control of patients with type 2 diabetes mellitus (DM2) will likely contribute to a decrease of their cardiovascular (CV) risk. Our aim was (1) to evaluate the degree of metabolic control with regard to glycemia, lipidemia and blood pressure (BP) and (2) to describe the prevalence of hypertension (HT) and hyperlipidemia in DM2 outpatients.TranSTAR is an on-line, case-control, cross-sectional study, which was performed in outpatient from all around Spain. Data on basal glycemia (BG), glycosilated hemoglobin (A1C), lipid profile, BP and personal history of CV diseases were obtained. The postprandial glycemia (PPG) was measured in a capillary sample at 1-3 hours post-meal. Standards of metabolic control of the Sociedad Española de Diabetes were applied to evaluate the degree of glycemic, lipidemic and BP control.371 pairs of patients were studied. In DM2 patients, a bad control was observed in 82.1% (CI 95%, 77.9-86.3) of them according to BG, in 88.4% (85.1-91.7) according to PPG and in 18.8% (14.3-23.3) according to A1C. An insufficient control in lipid profile was noticed in 63.3% (56.6-70.0) and in BP in 69.5% (64.2-74.8). 9.2% (0.9-17.5) and 20.5% (12.8-28.2) DM2 subjects had an unknown HT and hyperlipidemia, respectively.The rate of DM2 outpatients with a bad metabolic control is very high. The availability of data from our own population should contribute to a better clinical management of these patients.