Development of the professional role of diabetes nurses in specialised diabetes and primary care in Catalonia.

Objectives: The aim of this study was to describe therapeutic education programmes in diabetes in Catalonia and the differences according to the healthcare setting in which the patients are attended (primary care [PC] and specialised diabetes care [SDC]).

Method: We performed a descriptive, cross-sectional, comparative study of diabetes nurses (DN) in SDC and PC in Catalonia. The sample was obtained from all the DN in SDC and a randomised cluster sample of DN in PC.

Methodological guidelines for preparing a structured therapeutic education program: From design to evaluation.

Background And Objective: Therapeutic patient education (TPE) is effective and essential in the context of the growing prevalence of chronic diseases, in which tools are needed for planning structured programs. The objective of this project was to develop guidelines for designing and assessing a TPE program.

Methods: 1) We assembled a multidisciplinary group of 8 leaders in TPE, chronicity, quality and safety from the hospital and the university.

Mobile Health Projects in a High-Complexity Reference Hospital: Case Study.

Background: The widespread adoption of mobile and wearable devices and apps makes it essential to assess their possible impact on the management of health and diseases. Health care providers (HCPs) find themselves faced with a new situation in their setting with the proliferation of mobile health (mHealth) intervention tests. Few studies have addressed the development of mHealth and the methodologies to manage these apps in a tertiary hospital.

Hypoglycaemia unawareness in young people with type 1 diabetes transferred to an adult center.

Objective: To evaluate frequency of hypoglycaemia unawareness (HU) in patients with type 1 diabetes (T1D) transferred from Paediatrics following a specific therapeutic education programme (TEP) in an adult hospital.

Patients And Methods: Young patients transferred from 2009-2011 were evaluated. The TEP included a coordinated transfer process, individual appointments and a group course.

Frequency and awareness of hypoglycemia in patients with Type 2 Diabetes treated with two or more insulin injections in primary care outpatient clinics.

Aims: To assess the frequency of hypoglycemia events, patient characteristics and the prevalence of impaired awareness of hypoglycemia (IAH) in patients with Type 2 Diabetes (T2D) using two or more insulin injections in primary care.

Methods: Cross-sectional study performed at 9 Primary Care Centers including review of electronic medical records and an on-site visit to patients using >2 insulin injections with suboptimal control. Episodes of severe hypoglycemia (SH) in the last 12months were recorded.

Analysis of the quality of patient therapeutic education and information in a high complexity reference hospital.

Background And Objectives: The application and monitoring of quality criteria in information and therapeutic patient education can identify areas to improve care. The objectives of this study were: (1) To analyze the characteristics of patient information materials, educational activities, and self-management programs, and (2) to determine health care provider (HCP) proposals on therapeutic patient education.

Materials And Methods: Using a cross-sectional study, an online questionnaire was sent to hospital departments in a high complexity reference hospital from September to December 2013 to record: (a) information materials, (b) patient educational activities, and self-management program characteristics, (c) HCP proposals.

Health care and therapeutic education program for newly diagnosed type 2 diabetes: A new approach in primary care.

Introduction: Despite the favorable evidence available, our public health care system has no specific programs including therapeutic education for patients newly diagnosed with type 2 diabetes (T2DM), which would be crucial for the subsequent course of the disease.

Objectives: To assess the effectiveness of a "Health care and Therapeutic Education Program for newly diagnosed type 2 diabetes (PAET-Debut DM2)" agreed by the primary care centers and the reference hospital in a given geographical area.

Methods: A prospective pilot study in patients over 18 years of age diagnosed with T2DM between February 2012 and 2013.

Experiences and real life management of insulin pump therapy in adults with type 1 diabetes.

Objective: There is scarce information regarding the performance of a specific, structured education program addressed to patients with type 1 diabetes (T1D) using continuous subcutaneous insulin infusion (CSII) including both routine use of the therapy and patient experience evaluation. We aimed to assess the routine use of CSII and patient's experience and satisfaction regarding a specific structured patient self-management education and care program.

Methods: A retrospective, observational, cross-sectional study collecting CSII routine use downloaded data.

Impact of hypoglycemic episodes on health-related quality of life of type-2 diabetes mellitus patients: development and validation of a specific QoLHYPO questionnaire.

Background: Hypoglycemia is a limiting factor to achieving optimal glycemic control in patients with type-2 diabetes mellitus (T2DM), increasing risk of death and complications, reducing health-related quality of life (HRQoL) and work productivity and increasing healthcare costs. The study's primary objective was to develop and validate a specific questionnaire to assess the impact of hypoglycemia on the HRQoL of T2DM patients (QoLHYPO questionnaire).

Methods: A two-phase multicenter prospective, longitudinal, observational, epidemiologic study of consecutively enrolled patients, not involving any drug, was conducted: In phase 1 (questionnaire development), patients who had given their written informed consent, who were at least 30 years of age, had been diagnosed with T2DM at least 5 years prior, had an HbA1c test in the previous 3 months, and a hypoglycemic episode in the previous 6 months were included.

Detailed description of a prepregnancy care program and its impact on maternal glucose control, weight gain, and dropouts.

Background: The aim of this study was to analyze the clinical and metabolic changes observed during a prepregnancy care (PPC) program.

Methods: We performed a retrospective, observational, cohort study of 104 women with type 1 diabetes initiating a PPC program from 2011 to 2014. The outcomes measured were changes in HbA levels, weight and hypoglycemic events during PPC.

Assessment of use of specific features of subcutaneous insulin infusion systems and their relationship to metabolic control in patients with type 1 diabetes.

Background And Objective: Patients with type 1 diabetes (T1DM) treated with continuous subcutaneous insulin infusion (CSII) have available several specific features of these devices. The aim of this study was to evaluate the relationship between real use of them and the degree of glycemic control in patients using this therapy.

Patients And Methods: Forty-four T1DM patients on CSII therapy with or without real-time continuous glucose monitoring (CGM) were included.

[Psychometric analysis of the Spanish and Catalan versions of a questionnaire for hypoglycemia awareness].

Background And Objective: Intensive insulin therapy with multiple insulin doses in subjects with type 1 diabetes mellitus (T1D) is associated with a higher risk of hypoglycaemic episodes. Repeated hypoglycemia results in a reduced ability/failure to recognize hypoglycemia symptoms and predisposes to severe episodes. In this context is crucial to work with specific questionnaires to diagnose and address this burden.

The efficiency of telemedicine to optimize metabolic control in patients with type 1 diabetes mellitus: Telemed study.

Objective: This study evaluated the impact of an Internet-based telematic system on the economic and clinical management of patients with type 1 diabetes mellitus.

Research Design And Methods: This 6-month prospective, randomized, comparative, open, multicenter study included patients with type 1 diabetes >18 years old treated with multiple insulin doses and with a glycated hemoglobin (HbA1c) level of >8%. We compared an intervention group (IG) (two face-to-face and five telematic appointments) with a control group (CG) (seven face-to-face appointments).

Psychometric analysis of the Spanish and Catalan versions of the Diabetes Self-Care inventory-revised version questionnaire.

Background: The purpose of this study was to validate the Spanish and Catalan versions of the Diabetes Self-Care Inventory-Revised Version (SCI-R) questionnaire to assess the degree of adherence to self-care among adults with diabetes.

Methods: We validated the Spanish and Catalan translation from, and back translation to, English and cultural adaptation of the SCI-R in type 1 diabetes patients on multiple insulin doses or continuous subcutaneous insulin infusion and in type 2 diabetes patients on oral agents and/or insulin. Internal reliability, structural validity, and external validity (correlation with glycated hemoglobin) were evaluated.

[Continuous monitoring systems of glucose].

The possibility of obtaining a continuous reading of glucose may represent a breakthrough and a useful tool for the management of diabetes. Technological advances can improve the quality of life and people with diabetes metabolic control, even if this means having to learn and incorporate new technical concepts, new algorithms for pattern modification and new challenges in Therapeutic Education.

[Therapeutic education didactic techniques].

This article includes an introduction to the role of Therapeutic Education for Diabetes treatment according to the recommendations of the American Diabetes Association (ADA), the Diabetes Education Study Group (DESG) of the "European Association for Study of Diabetes (EASD) and the clinical Practice Guidelines (CPG) of the Spanish Ministry of Health. We analyze theoretical models and the differences between teaching vs. learning as well as current trends (including Internet), that can facilitate meaningful learning of people with diabetes and their families and relatives.

[Administration of insulin. New recommendations].

Covered by the new recommendations on the technique of administration of insulin released by a group of experts from different countries (Consensus TITAN) and different types of insulin and incretin GLP1 mimetics marketed in the Spanish market and devices for administration. The purpose is to keep health professionals, especially nurses, on the proper technique for administering insulin, due to the continuous changes of insulin therapy has been introduced in recent decades in their kinetics of action and route of administration. In reference to the technique in the administration of insulin, taking into account the different areas recommended for subcutaneous injection, the needle length and local secondary problems that may arise related to the administration of insulin.

[Medical nutritional therapy and therapeutic patient education in diabetes].

This article includes an introduction to the current approach to dietary treatment of diabetes. Are provided the nutritional recommendations to primary secondary and tertiary prevention of diabetes, as recommended by the American Diabetes Association (ADA) adapted to different types of diabetes, treatments and special situations. Secondly, it introduces the concept of Therapeutic Education, especially education and nutritional diet for persons with diabetes and their families, the educational objectives in food according to type of diabetes type 1 or type 2 in different treatment modalities and educational strategies recommended by the Diabetes Education Study Group (wear) of the European Association for the Study of Diabetes (EASD) to facilitate better adherence to dietary treatment.

[Quality standards of educational activities for patients and families in a university hospital].

Objective: To identify groups of patients receiving hospital-based educational programs, to determine whether the education was structured or ad hoc, and to analyse information on the structure, process and results of the programs.

Material And Methods: We performed a cross-sectional study using a translated and adapted version of the National Standards for Diabetes Self-Management Education. Information was collected on structure (resources, availability of a written program and professional training), the process followed by the patient (baseline assessment, methodology, training courses, support materials and record of activities), patient outcomes (post-intervention assessment, tools, record of evaluation and results) and program results (number of patients/relatives included, regular assessment).

Multidimensional analysis of treatment adherence in patients with multiple chronic conditions. A cross-sectional study in a tertiary hospital.

Objective: Determine treatment adherence in patients with multiple chronic conditions (MCC).

Methods: A random patient sample ≥ 15 years, discharged from hospital with ≥1 chronic conditions (CC) was interviewed after 6-12 months. Analysis included variables in 5 dimensions (WHO): socio-demographics, disease, treatment, patient and health system characteristics.

Role of musculoskeletal disorders as concurrent chronic conditions: are they underestimated in the discharge?

Background: Differences in recording concurrent chronic conditions (CCs) could change the weight of the influence of the different CCs on health status.

Objectives: To determine the role of musculoskeletal disorders as concurrent CCs.

Methods: Cross-sectional study.

The burden of chronic disorders on hospital admissions prompts the need for new modalities of care: a cross-sectional analysis in a tertiary hospital.

Background: Chronic disorders constitute a primary concern because of their burden on healthcare systems worldwide. Integrated care strategies enhancing the interface between tertiary care and primary care are pivotal to improve chronic care.

Aim: To asses the prevalence of chronic disorders on hospital discharges and their impact on unplanned admissions and mortality.

[Therapeutic education regarding type 1 diabetes (DM1)].

This article presents an introduction to diabetes and the problems associated with diabetes as well as scientific evidence on how to prevent or retard chronic complications diabetes causes by means of optimizing a diabetes sufferer's metabolic control. The authors make reference to one of the most important studies by The Diabetes Control and Complications Trial-DCCT which has signified a before and an after in the treatment of type 1 diabetes mellitus (DM1). Focusing on the treatment of diabetes with continuous subcutaneous insulin injection (CSII), the authors describe 1) Patients who are candidates for this treatment according to scientific associations; 2) Characteristics and functioning methods for insulin delivery systems as well as the different models of insulin delivery systems, catheters, needles and commercial inserting mechanisms presently available in Spain.