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. 2008 Nov 24;40(2):69–74. [Article in Spanish] doi: 10.1157/13116152

Determinación ambulatoria de glucohemoglobina en el seguimiento y el control de la diabetes mellitus: revisión sistemática de la literatura

Out-patient determination of glycosylated haemoglobin in the monitoring and control of diabetes mellitus: systematic review of the literature

Jesús Ruiz-Aragón 1,⁎, Román Villegas Portero 1, Sandra Flores Moreno 1
PMCID: PMC7659817  PMID: 18358159

Abstract

Objetivo

Evaluar la determinación ambulatoria de glucohemoglobina (HbA1c) comparada con la de laboratorio, midiendo control metabólico, calidad de vida y episodios de hipoglucemia, en adultos con diabetes mellitus tipo 1 o 2.

Diseño

Revisión sistemática.

Fuente de datos

MEDLINE (1966-agosto 2006), EMBASE (2000-agosto 2006), bases mantenidas por el Center for Reviews and Dissemination (DARE, INAHTA, NHSEED), Cochrane Library (número 3, 2006), Agencia Europea del Medicamento, Food and Drug Administration y Red Europea de Tecnologías Emergentes. Se realizó una búsqueda manual en Point of Care y en el registro de ensayos ClinicalTrials.gov.

Métodos

Los criterios de inclusión fueron estudios con adultos diabéticos de tipo 1 o 2, que utilizaran dispositivos ambulatorios portátiles y se compararan con referencias de laboratorio. Se excluyeron aquellos con menores de edad, con otro tipo de diabetes, sin dispositivo portátil o si el comparador no incluía métodos de referencia. Se recuperaron completos los que, a priori, cumplían los criterios. Se realizó análisis de la calidad según los criterios del programa CASPe y se extrajeron los datos con un formulario específico. Se realizó una síntesis cualitativa al no poder realizar un metaanálisis.

Resultados

Se seleccionaron 20 publicaciones. La mayoría de los dispositivos mostraron buena correlación entre valores (R2 = 0,85 y R2 = 0,059, p < 0,001). Algunos estudios describían que aumentaba el control glucémico, con descenso de HbA1c de 0,1-1,5% (p < 0,01); se intensificaba el control terapéutico (intervalo de confianza del 95% de la odds ratio, 0,95-1,52) y disminuían las visitas médicas.

Conclusiones

Son técnicas rápidas y cómodas, que aumentan el control metabólico de los pacientes, pero poseen ciertas limitaciones.

Palabras clave: Diabetes mellitus, Glucohemoglobina, Diagnóstico, Cabecera del paciente, Evaluación de tecnología sanitaria

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