[Educational program for doctors and nurses taking care for primary immunodeficiency patients treated with subcutaneous immunoglobulins]. / Propozycja programu edukacyjnego dla lekarzy i pielegniarek zajmujacych sie terapia substytucyjna podskórnymi preparatami immunoglobulin u pacjentów z pierwotnymi niedoborami odpornosci.

Primary immunodeficiency diseases (PIDs) are presenting the most common in childhood. PID are genetically determined disorders of the immune system resulting in greatly enhanced susceptibility to infectious disease. Therapy in these group of patients preventing infectious diseases is immunoglobulin (Ig) replacement therapy. Nowadays the quality of life is very important issue which doctors should consider treating their patients. The subcutaneous immunoglobulins appears to be the best solution for them. Treating patients with subcutaneous Ig require good educational programme not only for patients but also for doctors and nurses. We would like to provide practical guidelines for identifying patients who should be referred for assessment of possible immunodeficiency and give some practical instructions how to start and follow-up subcutaneous therapy in all centers of immunology in Poland who are engaged in this kind of treatment.

Perspectives of Patients with Insulin-Treated Type 1 and Type 2 Diabetes on Hypoglycemia: Results of the HAT Observational Study in Central and Eastern European Countries.

INTRODUCTION: The aim of this study was to determine the level of awareness of hypoglycemia, the level of fear for hypoglycemia, and the response to hypoglycemic events among insulin-treated diabetes patients from Central and Eastern Europe (CEE). The impact of hypoglycemia on the use of healthcare resources and patient productivity was also assessed. METHODS: This was a multicenter, non-interventional, two-part, patient self-reported questionnaire study that comprised both a retrospective cross-sectional evaluation and a prospective observational evaluation. Study participants were insulin-treated adult patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) from CEE. RESULTS: Most patients (85.4% T1DM and 83.6% T2DM) reported normal hypoglycemia awareness. The median hypoglycemia fear score was 5 out of 10 for T1DM and 4 out of 10 for T2DM patients. Patients increased glucose monitoring, consulted a doctor/nurse, and/or reduced the insulin dose in response to hypoglycemia. As a consequence of hypoglycemia, patients took leave from work/studies or arrived late and/or left early. Hospitalization was required for 31 (1.2%) patients with T1DM and 66 (2.1%) patients with T2DM. CONCLUSION: Hypoglycemia impacts patients' personal and social functioning, reduces productivity, and results in additional costs, both direct (related to increased use of healthcare resources) and indirect (related to absenteeism. FUNDING: Novo Nordisk.