Fernanda L. Santos, Brazil

CENTRO DE DIABETES E ENDOCRINOLOGIA DO PARÁ - CEDEPA Endocrinologia

Presenter of 2 Presentations

DEVELOPMENT OF STRUCTURED CARE PROGRAM FOR TYPE 1 DIABETES INDIVIDUALS USING A CONTINUOUS SUBCUTANEOUS INSULIN INFUSION IN THE BRAZILIAN PUBLIC HEALTH SYSTEM

Session Name
INSULIN PUMPS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
10:01 - 10:02

Abstract

Background and Aims

Background: Diabetes is a complex condition, requires multifaceted approaches, where self-management is an essential element. Innovative technology approaches offer a great promise. The Continuous subcutaneous insulin infusion (CSII) has its benefits already well described. CSII is complex for both, patients and professionals, requiring a high level of motivation/engagement. There are very few specialized centers in our country where the CSII is not part of the public health system protocols; therefore, patients receive CSII by lawsuit, with increased costs and without proper follow-up. Objective: To describe the Structured Program for Assistance to users of CSII (DM1), in Specialized Center

Methods

Method: increased legal decisions and related costs without: proper training, economic control, and adequate clinical follow-up; The Health Secretariat of our State has created the Structured Care Program with Clinical Inclusion/Follow-up Clinical Protocols, Educational Protocols: Strategies for Assessing/Encouraging Adherence and Self-Management skills development tools at the specialized Center for follow-Up users and families, focusing on: metabolic control and independence

Results

Results: Started September 2018 with 14 patients, 56% male, average age 23 years, initial average A1C 8.7% (5.8% to 12.1%). June 2019 - 46 patients, 66% women, average age 22,9 years, average A1C 7,84% (5,4 and 9,7%).

Conclusions

Conclusion: Clinical benefits and cost-effectiveness are only possible with the structuring of care, when the CSII is correctly programmed and the user is able to make appropriate decisions and manage problems. Education is structured, curriculum-based that prepares the individual to deal with the worst case scenario.

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IMPACT OF STRUCTURED CARE PROGRAM FOR INDIVIDUALS WITH TYPE 1 DIABETES USING CONTINUOUS SUBCUTANEOUS INSULIN INFUSION IN BRAZILIAN UNIFIED HEALTH SYSTEM: FOLLOW UP

Session Name
INSULIN PUMPS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
10:02 - 10:03

Abstract

Background and Aims

Background: Continuous subcutaneous insulin infusion (CSII) is the most advanced form of insulin administration but requires structured education to provide users with the necessary knowledge/skills and motivation support. CSII offers significant advantages over traditional therapy, but at higher costs, it has been recognized for decades as an integral component of diabetes therapy. Objective: To evaluate the impact in first nine months in Structured Education Program for CSII users in Specialized Center

Methods

Method: September 2018 to March 2019, we followed 46 Type 1 Diabetes Patients treated in Specialized Center in the Standardized Structured Education Program, specifically developed for CSII users, providing the necessary skills and knowledge for the effective use of this resource and dealing with Psychological barriers to enhance the beneficial effects of the therapy.

Results

Result: 66% women, average age 22,9 years. Averages of the glycemic values in target ranges (time in range-TIR): < 54 mg/dL ranged from 3.7 to 6.9%; 55-69 mg/dL ranged from 7.87 to 4.4%; 70-180 mg/dL ranged from 46.2 to 56.1; 181-249 mg/dL that ranged from 17.27 to 18.0; > 250 mg/dL ranged from 24.67 to 11.4. The mean A1C ranged from 8.7% (5,8%-12,8%) to 7.8% (5.5-10.8%).

Conclusions

Conclusion: Reduction of 0,92% in A1C, with improvement of the TIR, increase in range of 70-180 and decrease in others. Clinical benefits and cost-effectiveness are only possible with the care structuring, trained professionals and skilled user to make appropriate decisions, managing problems, assessing and acting based on blood glucose.

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