Insulin doses requirements in patients with type 1 diabetes using glargine U300 or degludec in routine clinical practice.

There are not many real-world studies evaluating daily insulin doses requirements (DIDR) in patients with type 1 diabetes (T1D) using second-generation basal insulin analogs, and such comparison is necessary. The aim of this study was to compare DIDR in individuals with T1D using glargine 300 UI/mL (IGlar-300) or degludec (IDeg) in real clinical practice. An observational, retrospective study was designed in 412 patients with T1D (males: 52%; median age 37.0±13.4 years, diabetes duration: 18.7±12.3 years) using IDeg and IGla-300 ≥6 months to compare DIDR between groups. Patients using IGla-300 (n=187) were more frequently males (59% vs 45.8%; p=0.004) and had lower glycosylated hemoglobin (HbA1c) (7.6±1.2 vs 8.1%±1.5%; p<0.001) than patients using IDeg (n=225). Total (0.77±0.36 unit/kg/day), basal (0.43±0.20 unit/kg/day) and prandial (0.33±0.23 unit/kg/day) DIDR were similar in IGla-300 and IDeg groups. Patients with HbA1c ≤7% (n=113) used significantly lower basal (p=0.045) and total (p=0.024) DIDR, but not prandial insulin (p=0.241), than patients with HbA1c between 7.1% and 8% and >8%. Patients using IGla-300 and IDeg used similar basal, prandial and total DIDR regardless of metabolic control subgroup. No difference in basal, prandial and total DIDR was observed between patients with T1D using IGla-300 or IDeg during at least 6 months in routine clinical practice.

Actitudes y percepción del profesorado de centros educativos públicos sobre la atención a alumnos con diabetes tipo 1 / Teachers' attitudes and perceptions about preparation of public schools to assist students with type 1 diabetes

Objetivo: Evaluar las actitudes y la percepción del profesorado sobre la preparación de los centros públicos de educación infantil, primaria y secundaria del área del Hospital Universitario Puerto Real para atender a alumnos con diabetes tipo 1 (DM1). Métodos: Estudio observacional descriptivo en el que se analizan las respuestas a un cuestionario de actitud y percepción sobre la preparación del centro educativo (17 preguntas) para la atención de los alumnos con DM1 de 765 profesores (edad media: 44,3±8,8 años; 61,7% mujeres) de 44 centros educativos públicos del área del Hospital Universitario Puerto Real (Cádiz, España) seleccionados mediante muestreo aleatorio. Resultados: El 43,2% había tenido o tiene actualmente alumnos con DM1 y solo el 0,8% reconoce haber recibido formación sobre diabetes. El 18,9% refería que alguno de sus alumnos con DM1 había experimentado al menos un episodio de hipoglucemia en el colegio (el 42,5% de los profesores que tienen o han tenido alumnos con DM1) y la mitad opinaba que su centro educativo no está capacitado para atender las urgencias diabéticas. El 6,4% refería que su centro dispone de glucagón en su equipo de primeros auxilios y el 46,9% estaría dispuesto a administrarlo personalmente. Las mujeres, los profesores de educación física y los directores mostraron una percepción más positiva del centro educativo con respecto a sus compañeros. Los profesores con percepción positiva de la preparación del centro y con actitud positiva para administrar glucagón eran significativamente más jóvenes que aquellos con percepción y actitud no positiva. Conclusiones: Los resultados del estudio orientan a que los profesores de los centros educativos públicos de nuestra área sanitaria no han sido formados específicamente en la atención a pacientes con DM1 y perciben que sus centros educativos no están capacitados para atender urgencias diabéticas (AU)

Objective: To assess teachers' attitudes and perceptions about preparation of public primary and secondary education schools in the Puerto Real University Hospital (Cádiz, Spain) area to care for students with type 1 diabetes mellitus (T1DM) Methods: A descriptive observational study where answers to an attitude and perception questionnaire on the preparation of schools to care for pupils with T1DM were analyzed. A total of 765 teachers (mean age, 44.3±8.8 years; 61.7% women) from 44 public schools in the area of the Puerto Real University Hospital were selected by random sampling. Results: Overall, 43.2% of teachers surveyed had or had previously had students with T1DM, but only 0.8% had received specific training on diabetes. 18.9% of teachers reported that one of their students with T1DM had experienced at least one episode of hypoglycemia at school, and half of them felt that their school was not prepared to deal with diabetic emergencies. 6.4% stated that their school had glucagon in its first aid kit, and 46.9% would be willing to administer it personally. Women, physical education teachers, and headmasters had a more positive perception of the school than their colleagues. Teachers with a positive perception of school preparation and with a positive attitude to administer glucagon were significantly younger than those with no positive perception and attitude. Conclusions: The study results suggest that teachers of public schools in our health area have not been specifically trained in the care of patients with T1DM and perceive that their educational centers are not qualified to address diabetic emergencies (AU)

Teachers' attitudes and perceptions about preparation of public schools to assist students with type 1 diabetes. / Actitudes y percepción del profesorado de centros educativos públicos sobre la atención a alumnos con diabetes tipo 1.

OBJECTIVE: To assess teachers' attitudes and perceptions about preparation of public primary and secondary education schools in the Puerto Real University Hospital (Cádiz, Spain) area to care for students with type 1 diabetes mellitus (T1DM) METHODS: A descriptive observational study where answers to an attitude and perception questionnaire on the preparation of schools to care for pupils with T1DM were analyzed. A total of 765 teachers (mean age, 44.3±8.8 years; 61.7% women) from 44 public schools in the area of the Puerto Real University Hospital were selected by random sampling. RESULTS: Overall, 43.2% of teachers surveyed had or had previously had students with T1DM, but only 0.8% had received specific training on diabetes. 18.9% of teachers reported that one of their students with T1DM had experienced at least one episode of hypoglycemia at school, and half of them felt that their school was not prepared to deal with diabetic emergencies. 6.4% stated that their school had glucagon in its first aid kit, and 46.9% would be willing to administer it personally. Women, physical education teachers, and headmasters had a more positive perception of the school than their colleagues. Teachers with a positive perception of school preparation and with a positive attitude to administer glucagon were significantly younger than those with no positive perception and attitude. CONCLUSIONS: The study results suggest that teachers of public schools in our health area have not been specifically trained in the care of patients with T1DM and perceive that their educational centers are not qualified to address diabetic emergencies.

Comentarios sobre «Hipoglucemia desapercibida en personas con diabetes tipo 1» / Comments on «Impaired awareness of hypoglycaemia in subjects with type 1 diabetes»

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Página web DiabeTIC: estudio piloto de la satisfacción e impacto sobre el control metabólico / DiabeTIC website: a pilot study of satisfaction and impact on metabolic control

OBJECTIVOS: Evaluar la satisfacción y el impacto sobre el control metabólico a corto plazo del seguimiento de la diabetes a través de la página web DiabeTIC. MATERIAL Y MÉTODOS: Estudio prospectivo de intervención no controlado realizado en 32 pacientes de 29,7 ± 9,7 años de edad (65% mujeres) incorporados a la plataforma de telemedicina DiabeTIC entre marzo y septiembre de 2012. Todos los pacientes cumplimentaron en el primer mes un cuestionario de satisfacción, analizándose la evolución del control metabólico a los 3 y 6 meses de seguimiento. RESULTADOS: En la encuesta de satisfacción realizada en el primer mes de seguimiento se obtuvieron las siguientes puntuaciones medias (0 a 10): impresión general con la plataforma: 8,6 ± 1,8; facilidad de uso: 8,1 ± 1,5; navegación intuitiva: 6,7 ± 3,0; utilidad de las mediciones: 9,1 ± 1,1; importancia de la plataforma en el control de la diabetes: 9,5 ± 0,9; sensación de seguridad: 9,5 ± 0,8; utilidad de la biblioteca: 9,4 ± 1,1; utilidad de los mensajes: 9,1 ± 1,4, y recomendación de uso de la plataforma: 9,4 ± 0,9. Las concentraciones de hemoglobina glicosilada mejoraron significativamente a los 6 meses de seguimiento respecto al inicio del estudio (7,0 ± 0,8 versus 8,1 ± 1,9%; p = 0,007). Nueve pacientes fueron dados de baja de DiabeTIC antes de completar 6 meses de seguimiento. CONCLUSIONES: Los pacientes con diabetes seguidos a través de la página web DiabeTIC comunican un elevado grado de satisfacción, observándose a corto plazo una evolución favorable del control metabólico

OBJECTIVES: To evaluate satisfaction and short-term impact on metabolic control of diabetes monitoring through the DiabeTIC website. PATIENTS AND METHODS: A prospective, uncontrolled intervention study was conducted in 32 patients aged 29.7 ± 9.7 years (65% female) incorporated to the telemedicine platform DiabeTIC between March and September 2012. All patients completed a satisfaction questionnaire in the first month, and impact on metabolic control was evaluated at three and six months. RESULTS: In the satisfaction survey conducted in the first month of follow-up, the following mean scores (0-10) were obtained: overall impression with the platform: 8.6 ± 1.8; ease of use: 8.1 ± 1.5; intuitive navigation: 6.7 ± 3.0; value of measurements: 9.1 ± 1.1; importance of the platform in diabetes management: 9.5 ± 0.9; sense of security: 9.5 ± 0.8; value of the library: 9.4 ± 1.1; value of messages: 9.1 ± 1.4, and recommendation to use the platform: 9.4 ± 0.9. Glycosilated hemoglobin concentrations significantly improved at six months as compared to study start (7.0 ± 0.8 versus 8.1 ± 1.9; p = 0.007). Nine patients were discharged from DiabeTIC before completing six months of follow-up. CONCLUSIONS: Patients with diabetes monitored through the DiabeTIC website report a high degree of satisfaction, showing improved metabolic control at short-term follow-up

[DiabeTIC website: a pilot study of satisfaction and impact on metabolic control]. / Página web DiabeTIC: estudio piloto de la satisfacción e impacto sobre el control metabólico.

OBJECTIVES: To evaluate satisfaction and short-term impact on metabolic control of diabetes monitoring through the DiabeTIC website. PATIENTS AND METHODS: A prospective, uncontrolled intervention study was conducted in 32 patients aged 29.7±9.7 years (65% female) incorporated to the telemedicine platform DiabeTIC between March and September 2012. All patients completed a satisfaction questionnaire in the first month, and impact on metabolic control was evaluated at three and six months. RESULTS: In the satisfaction survey conducted in the first month of follow-up, the following mean scores (0-10) were obtained: overall impression with the platform: 8.6±1.8; ease of use: 8.1±1.5; intuitive navigation: 6.7±3.0; value of measurements: 9.1±1.1; importance of the platform in diabetes management: 9.5±0.9; sense of security: 9.5±0.8; value of the library: 9.4±1.1; value of messages: 9.1±1.4, and recommendation to use the platform: 9.4±0.9. Glycosilated hemoglobin concentrations significantly improved at six months as compared to study start (7.0±0.8 versus 8.1±1.9; p=0.007). Nine patients were discharged from DiabeTIC before completing six months of follow-up. CONCLUSIONS: Patients with diabetes monitored through the DiabeTIC website report a high degree of satisfaction, showing improved metabolic control at short-term follow-up.

Obesidad e hipogonadismo en paciente con diabetes tipo 2 / Obesity and hypogonadism in a patient with type 2 diabetes

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