Health care organization and use of technological devices in people with diabetes in Italy: Results from a survey of the Working Group on Diabetes and Technology.


Journal

Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474

Informations de publication

Date de publication:
10 2022
Historique:
received: 27 01 2022
revised: 13 06 2022
accepted: 05 07 2022
pubmed: 16 8 2022
medline: 5 10 2022
entrez: 15 8 2022
Statut: ppublish

Résumé

The use of technology offers recognized benefits to persons with diabetes. The aim of this study was to evaluate the organization of healthcare facilities, the composition of the diabetes team, and the use of Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring (CGM) in Italy. Diabetes care centers were asked to complete a web survey based on information collected in 2018. Sixty-one pediatric and 243 adult centers participated in the survey, accounting for 507,386 patients, mostly with type 2 diabetes (86.4%). Fifty-three percent of pediatric centers and 11% of adult centers reported a team composed of diabetologists, nurses, and psychologists. Overall, 13,204 patients (2.6%) were using CSII (95% with type 1 diabetes), and 28,936 (5.7%), were using CGM (74% with type 1 diabetes). When stratifying for the type of diabetes, 24% and 40.8% of patients with type 1 were using CSII and CGM, respectively, whereas low use of technology was reported for patients with type 2 and women with gestational diabetes. The percentage of adult and pediatric patients with type 1 diabetes on CSII and CGM was respectively 21% and 32%, and 35% and 57%. The spread of CGM and CSII increased in Italy between 2013 and 2018. However, the percentage of users is still lower than what is expected based on clinical indications for use of technology. The inadequate number of professionals in the diabetes care team and insufficient economic resources are relevant barriers to disseminating technology for diabetes management.

Sections du résumé

BACKGROUND AND AIM
The use of technology offers recognized benefits to persons with diabetes. The aim of this study was to evaluate the organization of healthcare facilities, the composition of the diabetes team, and the use of Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring (CGM) in Italy.
METHODS AND RESULTS
Diabetes care centers were asked to complete a web survey based on information collected in 2018. Sixty-one pediatric and 243 adult centers participated in the survey, accounting for 507,386 patients, mostly with type 2 diabetes (86.4%). Fifty-three percent of pediatric centers and 11% of adult centers reported a team composed of diabetologists, nurses, and psychologists. Overall, 13,204 patients (2.6%) were using CSII (95% with type 1 diabetes), and 28,936 (5.7%), were using CGM (74% with type 1 diabetes). When stratifying for the type of diabetes, 24% and 40.8% of patients with type 1 were using CSII and CGM, respectively, whereas low use of technology was reported for patients with type 2 and women with gestational diabetes. The percentage of adult and pediatric patients with type 1 diabetes on CSII and CGM was respectively 21% and 32%, and 35% and 57%.
CONCLUSIONS
The spread of CGM and CSII increased in Italy between 2013 and 2018. However, the percentage of users is still lower than what is expected based on clinical indications for use of technology. The inadequate number of professionals in the diabetes care team and insufficient economic resources are relevant barriers to disseminating technology for diabetes management.

Identifiants

pubmed: 35970683
pii: S0939-4753(22)00291-5
doi: 10.1016/j.numecd.2022.07.003
pii:
doi:

Substances chimiques

Blood Glucose 0
Hypoglycemic Agents 0
Insulin 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2392-2398

Informations de copyright

Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest No competing of interest is applicable for the current study.

Auteurs

Dario Pitocco (D)

Diabetes Care Unit, UOSD Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

Andrea Laurenzi (A)

San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.

Letizia Tomaselli (L)

Diabetes Unit, ARNAS, Catania, Italy.

Roberta Assaloni (R)

Diabetes Unit ASS2 Bassa-Friulana Isontina, Udine, Monfalcone [GO], Italy.

Agostino Consoli (A)

Endocrinology and Metabolic Diseases, University of Chieti-Pescara, Chieti, Italy.

Paolo Di Bartolo (P)

AUSL Diabetes Unit Romagna, Ravenna, Italy.

Vincenzo Guardasole (V)

Department of Translational Medical Sciences, University Federico II, Naples, Italy.

Fortunato Lombardo (F)

Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy.

Claudio Maffeis (C)

Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy.

Antonio Rossi (A)

Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy.

Rosaria Gesuita (R)

Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.

Sergio Di Molfetta (S)

Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

Andrea Rigamonti (A)

Division of Pediatrics, San Raffaele Hospital, IRCCS, Milan, Italy.

Andrea Scaramuzza (A)

Division of Pediatrics, ASST Cremona, "Ospedale Maggiore di Cremona", Cremona, Italy.

Concetta Irace (C)

Department of Health Science, University Magna Graecia, Catanzaro, Italy. Electronic address: irace@unicz.it.

Valentino Cherubini (V)

Department of Women's and Children's Health, G. Salesi Hospital, Ancona, Italy.

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