New approach to treat diabetes: empower the patient

In 2006, the study di@bet.es first analyzed the prevalence of alterations of hydrocarbon metabolism and diabetes in Spain.

It was observed that 30% of the population has some glucid metabolism disorder, and the prevalence of diabetes mellitus is 13.8%.

Most of these patients (90-95%) have type 2 diabetes mellitus, while type 1 diabetes mellitus includes 5-10%.

The diagnosis of diabetes is difficult for patients and their family since it implies numerous changes in their life, their diet, dependence on medication and an increased risk of morbidity and mortality.

Maintaining good adhesion to treatment and adequate metabolic control avoids these complications and allows people with diabetes to enjoy a full and healthy life.

In 2006 the study di@bet.es first analyzes the prevalence of alterations of hydrocarbon metabolism and diabetes in Spain.Similar to other European countries, it is observed that 30% of the population has some glycid metabolism disorder.The prevalence of diabetes mellitus is 13.8%, of which half are unaware of these disease.The vast majority of these patients (90-95%) have type 2 diabetes mellitus.

For its part, type 1 diabetes mellitus includes 5-10% of the total diabetes forms and is due to autoimmune destruction of pancreatic β cells.This destruction implies a total absence of endogenous insulin production and makes subcutaneous treatment with insulin (either by multiple doses or continuous subcutaneous infusion systems) is the only effective treatment.

Many times the diagnosis falls as a slab on the patient and his family since it implies numerous changes in his life, his diet, the dependence of medication and an increased risk of morbidity and mortality, including ischemic heart disease or chronic kidney disease, which is closely relatedwith the control of blood glucose and other cardiovascular risk factors.This also exponentially increases health spending and it is estimated that the expense of a patient with poorly controlled diabetes can duplicate or even triple that of a patient with adequate control.Maintaining good adhesion to treatment and adequate metabolic control avoids these complications and allows people with diabetes to enjoy a full and healthy life.

visual health and diabetes is intimately related.

In recent years, thanks to research and resources aimed at improving the lives of these patients there has been a technological revolution with continuous monitoring systems or glucose flash.The use of these systems improves the control of glycosilated hemoglobin that is the maximum determinant of chronic micro and macrovascular complications associated with diabetes such as retinopathy, renal disease (in Spain diabetes is the first cause of chronic renal disease) or ischemic heart disease.Currently in Madrid, patients who have access to continuous glucose monitoring systems are those diagnosed with type 1 diabetes mellitus and those with diabetes NO 1, no 2, with multiple doses of insulin.

In recent decades there have also been advances and a paradigm shift in medical practice, and we have gone from a paternalistic model, in which the patient was a mere spectator who followed the decisions regarding his illness to a model of patient's autonomy, in which decisions are agreed after proper information by the health professional.While it is always important that the patient is involved in the treatment of their disease, in the case of chronic diseases, particularly that of patientsDiabetics with multiple doses of insulin, this is essential to achieve better adherence to treatment, better results, lower complications and lower mortality.

The expenditure of a patient with poorly controlled diabetes can duplicate or even triple that of a patient with adequate control
Several studies have shown that the participation of patients in decision making is associated with better results in treatment and better diabetes control, reducing collateral damage to lack of adhesion.Given the progress that the development of continuous glucose monitoring systems for diabetes management has beenpatient and healthcare, and not only responding to economic criteria.

Given the intimate relationship between adhesion and a good adaptation of the system selected for each patient, it is essentialor strips.

The first objective of the II Humanization Plan for Health Assistance, presented by the CAM for the period between 2022 and 2025, is to promote mechanisms for participation of patients and citizenship, mentioning, specifically, as actions to be developedof the incorporation of patients and associations of patients in those organs of advice and participation related to humanization, and the promotion of creation and development of the Patient Councils or Committees.

Based on this, the introduction of the point of view of patient representatives also seems logical also in processes such as contests, being these related to products directly related to health care, such as monitoring sensors or reactive strips.

With this, it would be guaranteed that the criteria taken into account is not only that of price, but also the quality of the product and the adaptation for each person with diabetes.Each patient is unique and should be able to choose the device from those available in the market that best suits their specific needs, ensuring adherence and, ultimately, improving their quality of life.The adoption of this approach would also mean a first step of great relevance on the road to a personalized and precision medicine for people with diabetes.

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