Minister of Health and Consumer Affairs, catalina garciais highlighted l“Clinical effectiveness” of implantable flash glucose monitoring systems in adults with type 1 diabetes. The benefits offered by the Andalusian Health Service (SAS) as well as in the diabetes education process designed by the Comprehensive Diabetes Plan of Andalusia (PIDMA) at the inauguration of the Andalusian Diabetes Congress. During the meeting organized by the Federation of Diabetes Associations of Andalusia (FADA) at the Juan Ramon Jiménez University Hospital of Huelva, the consultant concluded that the quality of life of approximately 50,000 Andalusian patients has improved thanks to technologies applied to diabetes.
Thus, Garcia detailed that follow-up of 13,846 adult patients with type 1 diabetes with flash glucose monitoring showed a 27.2% incidence rate reduction of severe hypoglycemia episodes, accounting for 061% of the total study population. Immediate health care is required. Going from 3.5 emergent hypoglycemia per 100 person-years to 2.5 emergent hypoglycemia per 100 person-years, The reduction is particularly notable in older people (59% reduction in those between 61–75 years of age and 48% reduction in those over 75 years of age) and in those whose metabolism is controlled by glycated hemoglobin before surgery. is considered optimal. In monitoring that reduction is 35%.
“In addition to improving patients’ quality of life, this improvement results in reduced clinical, health impacts and costs.”The consultant has evaluated.
This is a success, Garcia said, which justifies the “effort” by the Ministry of Health and Consumer Affairs to incorporate the technology applicable to diabetes with insulin pumps, pump-sensor systems and continuous sensors and flash monitoring of glucose. Technologies that already benefit more than 26,000 patients with type 1 diabetes in the Autonomous Community. Thus, he points out that Andalusia’s service portfolio is one of the most comprehensive in incorporating technologies applied to diabetes in the entire national health system.
Consolidation of functional units of diabetes, Which started in 2020, has supported the implementation of these technologies in selected regional hospitals and high-resolution hospitals by improving access to endocrinological care, and “this has been made possible due to the provision of human resources specific to endocrinological care and diabetes education,” it reported.
Along these lines, specific actions have been developed that guarantee Full access to sensors by the end of 2021 for all patients with type 1 diabetes and other forms of insulin-deficient diabetes for whom they are authorizedIncluding a continuous glucose monitoring system in patients under 4 years of age, financed exclusively in the Andalusian community. “The experience in the implementation of the flash-type sensor has been successful, as it allows optimization of patient control, effective telecare and ultimately a better quality of life,” he said.
With this experience, and following the recommendations of technology assessment agencies, “in Andalusia we have opted to expand flash monitoring to patients with type 2 diabetes being treated with multiple doses of insulin. “Our community is leading the way in funding this group.”, the head of health and consumer affairs explained. In fact, from April 2022, following a progressive implementation program based on clinical priority, flash monitoring has been expanded to people with type 2 diabetes on intensive insulin therapy in a basal bolus regimen, and Spain Primary care has been included in a leading manner. Teams.
Currently, a total of 14,855 people with type 2 diabetes benefit from this technology. It is used in certain priority groups, such as those due to dependence or functional disability (5,035), severe hypoglycemia (1,542) or pregnancy (173).
In recent months, an intensive training program for primary care professionals has been developed, which will be continuously maintained to ensure that the patient educational process and its follow-up are developed not only by hospital teams but primarily by health care teams. Be done. ,
Prevalence and early detection
The estimated prevalence of diabetes in the population over 18 years of age in Andalusia is 15.3%, the second highest rate in Europe. However, Garcia pointed out, “only about 780,000 diagnosed cases are known.” Of this population, 90–95% belong to patients with type 2 diabetes mellitus (DM2). A form of diabetes that is closely linked to obesity and a sedentary lifestyle, Therefore, the counselor stressed the importance of “education to safeguard the future”.
In this sense, García described as “indispensable” the actions aimed at the prevention of diabetes and many other chronic diseases that share risk factors with diabetes and he recalled, “We “Specified in the strategy to promote Andalusia”.
However, One in three people with diabetes in Andalusia do not know they have the disease, Which represents, he stressed, “a huge risk”, because “untreated diabetes can lead to serious and life-threatening complications, such as myocardial infarction, stroke, kidney failure, blindness or amputation of the lower limbs.” Complications that reduce quality of life and increase health costs associated with the disease.”
For this reason, the advisory encourages that, “at the slightest symptom, it is best to consult your primary care team and be screened for diabetes periodically for those who have a family history of diabetes or Have a personal history of gestational diabetes or any other.” Other factors.” Such as age over 45, obesity, high blood pressure or dyslipidemia.
Comprehensive Diabetes Plan of Andalusia
Along with disease prevention and early detection, PIDMA includes organization of care, prevention and early detection of complications, clinical education in diabetes, and development of technologies applicable to diabetes.
One of the most successful programs of the scheme is Early detection of diabetic retinopathy, in which the primary care centers and endocrinology and nutrition services of the Andalusian public health system actively participate, and which includes 570,000 patients. In 2022, 166,180 patients were reviewed and 167,457 retinographs were performed within the framework of this program, which is the highest figure in the entire historical series since 2005. As of the end of August 2023, 94,015 patients have been reviewed and 94,262 retinography scans have been performed.
“As well as the record, it is the result of the efforts of professionals; most importantly, in more than 67,000 trials, diabetic retinopathy lesions have been detected in more than 56,000 patients, of whom approximately 3,000 were vision-threatening forms of retinopathy. “, highlighted the consultant, who stressed that, “Thanks to this early detection, these patients have been able to be treated early in ophthalmology services, with which we have significantly reduced the risk of visual disability due to diabetes. “Autonomous Community”.
Similarly, Network for Prevention and Care of the Diabetic Foot of Andalusia (RePAP) Its aim is to ensure comprehensive, personalized and quality care that responds to the specific needs of the person with high-risk foot and diabetic foot and their family, guaranteeing continuity of care. 36 Advanced Practice Nurses in Chronic Wound and Diabetic Foot play a fundamental role in this network, strengthening prevention work in primary care and communicating with multidisciplinary hospital care teams for early and coordinated care. “Once this professional category joins the SAS, podiatrists will soon join these teams,” said Catalina García.
Felipe Arias, First Deputy Mayor of the Huelva City Council, also attended the inauguration; President of FADA, Ana María Álvarez, and President of the Huelva Diabetes Association, Diego Gómez. In addition, García is accompanied by Manuel Caro, Regional Representative for Health and Consumer Affairs in Huelva; Huelva City Council’s representative for infrastructure and public services, María Dolores Ponce; Alejandra Álvarez, acting manager of the Juan Ramón Jiménez University Hospital; and PIDMA Director, María Asuncion Martínez.
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