(Des)control diabético: Controversias en las prácticas terapéuticas de la DM2

(Un)controlled diabetic: Controversies in the therapeutic practices of type 2 diabetes mellitus

Abstract

Despite the health care focus on diabetes in Spain, numerous studies show that there is an elevated percentage of the proportion of the population diagnosed with type 2 diabetes mellitus (DM2) who do not achieve the established criteria of therapeutic control, even while they are under medical observation and receiving pharmacological treatment. This paper is based on a research process which began with a descriptive cross-sectional study carried out with pharmacists, in the field of community pharmacy. In this initial phase, a high rate of "glycemic uncontrolled" was found (40% of the participants), while most of the participants claimed to have total or partial control of the disease. The controversy led to a second research phase: exploring explanatory hypotheses for the so-called "(un)controlled diabetes issue". This time the study was designed and carried out by the paper’s author, from an anthropological perspective and through ethnographic methodology. Nine of the participants from the first study were interviewed and the main Clinical Practice and Pharmaceutical Guidelines of the same geographical area were reviewed. The work allowed for the verification of the abysmal distance between both perspectives regarding control, goals, evaluation and therapy for DM2; as well as the detection of both the descriptive and explanatory limitations of the hegemonic biomedical-pharmaceutical standpoint and epistemology. This article collects the main results as they were emerging during the study process which are presented along with the discoveries and epistemological "battles" that the research itself entailed.