Cristóbal Morales , Guillermo Rodríguez-Munzenmaier , Dunia Marrero , José M. Baeza , Juan M. Martínez-Jiménez , Gloria Barberá , en nombre de los investigadores del estudio DIAPASAT
José A. Piniés , Fernando Gonzalez-Carril , José M. Arteagoitia
{"title":"Escalas de cálculo del riesgo cardiovascular para pacientes con diabetes. ¿Qué son y de qué nos sirven?","authors":"José A. Piniés , Fernando Gonzalez-Carril , José M. Arteagoitia","doi":"10.1016/j.avdiab.2015.02.001","DOIUrl":"https://doi.org/10.1016/j.avdiab.2015.02.001","url":null,"abstract":"<div><p>Cardiovascular disease (CVD) remains the first cause of death in patients with diabetes mellitus. Cardiovascular mortality is between 2 and 4 times as high as the risk of matched controls in the general population. Although practice guidelines recommend calculating CVD risk in diabetes, few models for estimating cardiovascular risk have been developed specifically for diabetic patients. The first ones, taking into account HbA1c and diabetes duration plus classical risk factors, is not contemporary and perform sub-optimally in different populations with diabetes. Constructing updated population-derived and externally validated cardiovascular risk models will yield more aggressive patient-centered preventive interventions to curb the ongoing epidemic of CVD in patients with diabetes.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"31 3","pages":"Pages 102-112"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2015.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Vázquez, R. Barrio, M. Goñi, Gonzalo Díaz-Soto, Inmaculada Simón Muela, C. G. Blanco
{"title":"Documento de consenso sobre el tratamiento con infusión subcutánea continua de insulina en el medio hospitalario","authors":"F. Vázquez, R. Barrio, M. Goñi, Gonzalo Díaz-Soto, Inmaculada Simón Muela, C. G. Blanco","doi":"10.1016/J.AVDIAB.2015.02.005","DOIUrl":"https://doi.org/10.1016/J.AVDIAB.2015.02.005","url":null,"abstract":"","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"21 1","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87139987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramón Ferrer-Penadés , Manuel Aguilar-Diosdado , Joan Carles March-Cerdá , Domingo Orozco-Beltrán , Antonio Picó-Alfonso , el Grupo Paciente Activo y Diabetes (PAyDInet)
{"title":"Claves para avanzar hacia un rol más activo por parte del paciente con diabetes mellitus tipo 2 en España","authors":"Ramón Ferrer-Penadés , Manuel Aguilar-Diosdado , Joan Carles March-Cerdá , Domingo Orozco-Beltrán , Antonio Picó-Alfonso , el Grupo Paciente Activo y Diabetes (PAyDInet)","doi":"10.1016/j.avdiab.2015.02.004","DOIUrl":"10.1016/j.avdiab.2015.02.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Diabetes mellitus type<!--> <!-->2 (DM2) is a public health problem of the first order of concern to managers, health professionals and society as a whole. Having a more active and responsible patient with DM2 is emerging as one of the solutions. Hence the importance of promoting a multidisciplinary discussion that provides ideas and solutions that contribute to an active and involved patient with DM2. In this article some consensual recommendations are provided by the working group called <em>Active Patient and Diabetes</em> (PAyDInet by its Spanish initials).</p></div><div><h3>Methods</h3><p>PAyDInet team was established by gathering agents from different fields of the system. Following the nominal group technique, barriers, facilitators and specific initiatives to promote a preventive attitude and self-care in patients with DM2, were identified and prioritized.</p></div><div><h3>Results</h3><p>The team reached a final consensus on 3 key barriers, 3 enablers and 3 key initiatives to achieve patients with DM2 more active in managing their disease. The configuration of the healthcare system, the need to improve interprofessional coordination, and development of structured diabetes education, are the key points identified by the group.</p></div><div><h3>Conclusion</h3><p>It is an inescapable need to move forward to put the patient at the centre of the system. Training and informing a patient on DM2 is a complex task that can only be achieved with new partnerships and collaboration of all stakeholders. In any case, the discussion and recommendations of the group PAyDInet give us a good approach to the subject and an excellent starting point.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"31 3","pages":"Pages 128-135"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2015.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89407580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manel Mata-Cases, Sara Artola, Javier Escalada, Patxi Ezkurra-Loyola, Juan Carlos Ferrer-García, José Antonio Fornos, Juan Girbés, Itxaso Rica, en nombre del Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes
{"title":"Consenso sobre la detección y el manejo de la prediabetes. Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes","authors":"Manel Mata-Cases, Sara Artola, Javier Escalada, Patxi Ezkurra-Loyola, Juan Carlos Ferrer-García, José Antonio Fornos, Juan Girbés, Itxaso Rica, en nombre del Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes","doi":"10.1016/j.avdiab.2014.10.007","DOIUrl":"https://doi.org/10.1016/j.avdiab.2014.10.007","url":null,"abstract":"<div><p>In Spain, according to the <span><span>[email protected]</span></span><svg><path></path></svg> study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality.</p><p>The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"31 3","pages":"Pages 89-101"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.10.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Federico Vázquez , Raquel Barrio , Maria Jose Goñi , Gonzalo Díaz-Soto , Inmaculada Simón Muela , Cintia González Blanco , en representación del Grupo de Nuevas Tecnologías de la Sociedad Española de Diabetes (SED)
{"title":"Documento de consenso sobre el tratamiento con infusión subcutánea continua de insulina en el medio hospitalario","authors":"Federico Vázquez , Raquel Barrio , Maria Jose Goñi , Gonzalo Díaz-Soto , Inmaculada Simón Muela , Cintia González Blanco , en representación del Grupo de Nuevas Tecnologías de la Sociedad Española de Diabetes (SED)","doi":"10.1016/j.avdiab.2015.02.005","DOIUrl":"https://doi.org/10.1016/j.avdiab.2015.02.005","url":null,"abstract":"<div><p>There is an increasing number of people with type<!--> <!-->1 diabetes treated with continuous subcutaneous insulin infusion therapy (CSII) in Spain, but there are no national guidelines on how to manage insulin pump therapy in the hospital setting. The Group on New Technologies in Diabetes of the Spanish Diabetes Society has reviewed the literature and several international guidelines, and proposes a consensus document on the management of insulin pump therapy for inpatients. The document contains recommendations on indications, contraindications and the requirements needed to maintaining CSII therapy. This review provides a guide for the management of CSII patients in special settings such as the emergency room, surgery, delivery, and for pediatric patients. Finally, the group proposes a set of documents needed to establish a CSII policy in the hospital. In conclusion, CSII therapy can safely be used in the hospital in selected patients after the implementation of a standardized protocol.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"31 3","pages":"Pages 81-88"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2015.02.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reunión anual del grupo de trabajo «islotes pancreáticos» de la Sociedad Española de Diabetes","authors":"","doi":"10.1016/j.avdiab.2014.12.005","DOIUrl":"10.1016/j.avdiab.2014.12.005","url":null,"abstract":"","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"31 3","pages":"Pages 136-146"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.12.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83768824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Colom , Ana Chico , Gemma Carreras , Anna Aulinas , Isabel Pujol , Antonio Pérez
{"title":"Control glucémico y complicaciones crónicas a 20 años del comienzo de la diabetes tipo 1. Resultados de una unidad especializada","authors":"Cristina Colom , Ana Chico , Gemma Carreras , Anna Aulinas , Isabel Pujol , Antonio Pérez","doi":"10.1016/j.avdiab.2015.02.002","DOIUrl":"10.1016/j.avdiab.2015.02.002","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine the prevalence of chronic complications in a group of patients with long duration type 1 diabetes (DM1), and their relationship with glycemic control since diagnosis of disease, as well as control and prevalence of cardiovascular risk factors (CVRF).</p></div><div><h3>Material and methods</h3><p>The study included patients diagnosed in our center between 1985 and 1994 and followed-up until the present. Anthropometric data, glycemic control, chronic complications, and CVRF were collected from medical records at baseline and annually. A visit was made that included a physical examination and complete blood analysis.</p></div><div><h3>Results</h3><p>A total of 77 patients were studied (46 males, and mean age 47<!--> <!-->±<!--> <!-->8.5 years, duration of follow-up, 22.4<!--> <!-->±<!--> <!-->2.2 years). Sixteen patients (20.4%) developed retinopathy, 8 (10.4%) nephropathy, 12 (15.6%) polyneuropathy, and 3 (3.9%) macroangiopathy. Hypertension, dyslipidemia and obesity were found in 28.6%, 46.8% and 20.8%, respectively, and 22.1% were sedentary, and 35.1% were smokers. Mean glycosylated hemoglobin (HbA1c) during the entire follow-up was 7.2<!--> <!-->±<!--> <!-->0.8%. In the first five years it was 6.4<!--> <!-->±<!--> <!-->1.2% and at the study visit, it was 7.6<!--> <!-->±<!--> <!-->1.1%. More than two-thirds (70%) of patients remained on target in the first five years, with 45% in the next five years, and about 25% from years 10 to 22. Patients with no complications showed better glycemic control during the entire follow-up (HbA1c 7.0<!--> <!-->±<!--> <!-->0.7% vs. 7.6<!--> <!-->±<!--> <!-->0.9%; <em>P</em>=.003), and also in the first five years (HbA1c 6.1<!--> <!-->±<!--> <!-->0.9 vs. 7.0<!--> <!-->±<!--> <!-->1.4%; <em>P</em>=.001).</p></div><div><h3>Conclusion</h3><p>Prevalence of complications after 20 years of follow-up in well controlled DM1 since diagnosis is low, and is related to the overall glycemic control during follow-up and in the early years of the disease. The prevalence of smoking is high.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"31 3","pages":"Pages 113-119"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2015.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90754850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. A. Piniés, Fernando González-Carril, J. M. Arteagoitia
{"title":"Escalas de cálculo del riesgo cardiovascular para pacientes con diabetes. ¿Qué son y de qué nos sirven?","authors":"J. A. Piniés, Fernando González-Carril, J. M. Arteagoitia","doi":"10.1016/J.AVDIAB.2015.02.001","DOIUrl":"https://doi.org/10.1016/J.AVDIAB.2015.02.001","url":null,"abstract":"","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"1 1","pages":"102-112"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82785145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edurne Alonso-Morán , Juan F. Orueta , Jose Ignacio Fraile Esteban , Jose Mª Arteagoitia Axpe , Mari Luz Marqués González , Nuria Toro Polanco , Patxi Ezkurra Loiola , Sonia Gaztambide , Roberto Nuño-Solinis
{"title":"Prevalence and quality of care indicators of type 2 diabetes in the population of the Basque Country (Spain)","authors":"Edurne Alonso-Morán , Juan F. Orueta , Jose Ignacio Fraile Esteban , Jose Mª Arteagoitia Axpe , Mari Luz Marqués González , Nuria Toro Polanco , Patxi Ezkurra Loiola , Sonia Gaztambide , Roberto Nuño-Solinis","doi":"10.1016/j.avdiab.2015.01.002","DOIUrl":"10.1016/j.avdiab.2015.01.002","url":null,"abstract":"<div><h3>Objective</h3><p>The global prevalence of diabetes mellitus has reached epidemic proportions, and consequently the prevention and management of the disease is now a major public health challenge. This study aims to determine the prevalence of type 2 diabetes mellitus (T2DM) in the Basque Country, and identify new cases and the management of the disease based on data sourced from administrative databases.</p></div><div><h3>Methods</h3><p>Records of all citizens living in the Basque Country aged ≥35 were reviewed and an algorithm was established to detect the presence of T2DM from registered diagnoses and prescriptions. Information from a four-year period was extracted detailing the demographic variables, requirements recommended by clinical practice guidelines, the level of management of the disease in accordance with local guidelines and the presence of ischemic heart disease.</p></div><div><h3>Results</h3><p>In 2011, there were 134,421 diagnosed cases of T2DM, representing a known prevalence of 9.12%. There were 8,896 new cases. The three main control criteria, glycosylated haemoglobin (HbA<sub>1c</sub>), LDL-cholesterol (LDLc) and blood pressure (BP), were met in 23.2% of people diagnosed with ischemic heart disease diagnosis and in 24.5% of people without a diagnosis of ischemic heart disease.</p></div><div><h3>Conclusions</h3><p>The prevalence observed in the Basque Country is lower than that observed in Spain, and the achievement of targets for HbA<sub>1c</sub>, BP, and LDLc was slightly better, except the BP values, which were similar. The data recorded in this study could lead to the development of strategies to improve clinical care for patients with type 2 diabetes.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":"31 2","pages":"Pages 72-79"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2015.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89599408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}