Research Article
Volume 4 Issue 3 - 2020
The Gaps between Diabetes, the Patient and the Care Team. Strategy to Reduce Them
Arturo Orduz López1*, Hernán Urquijo Quintero2 and Yady González3
1Diabetologist-epidemiologist. Endocrinology Section, Department of Internal Medicine, Clinical Head of Diabetic Foot and Limb Rescue, Santa Fe Foundation of Bogotá, Colombia
2External Consultation Section, Epidemiology, Promotion and Prevention Program, Health Battalion, Colombia
3Chemical Engineer, Epidemiology, Secretary of Health of Bogotá, Colombia
*Corresponding Author: Arturo Orduz Lopez, Diabetologist-epidemiologist. Endocrinology Section, Department of Internal Medicine, Clinical Head of Diabetic Foot and Limb Rescue, Santa Fe Foundation of Bogotá, Colombia.
Received: February 07, 2020; Published: February 18, 2020




Abstract

Background: Diabetes is a disease of high prevalence and incidence that leads to chronic micro and macrovascular complications. Most of the patients are treated in external consultation, in successive controls according to the health plan that is available. However, many of them come with hba1c above goals. As an incurable, asymptomatic and poorly controlled dis- ease, the patient evolves in an indolent way for many years until it is clinically manifested by some chronic complications. On the other hand since their diagnosis, the patients are evaluated in a clinical course and are formulated by several specialists without there being uniformity in their follow up. These gaps cause con- fusion, adverse effects, poor control, loss of adherence to nutritional regimen and increased morbidity and mortality.

Objective: To develop and validate a simple and practical instrument to incorporate the patient and his family in the evolution of his diabetes. In addition to having a referent, achieve a clinical follow-up, integration of the different specialists who attend the disease, improve knowledge, nutritional compliance and self-monitoring by the patient.

Methods: We selected 120 randomly selected patients. A 60 was given a pre-written notebook and 60 (control group) were given standard consultation. The book was made up of 5 sheets, each of which had data related to their illness: first page contact phone number with medical doctor, second sheet, age, time of diabetes, results and date of last hba1c and medications currently taken with their doses. Third sheet human figure highlighting the organs involved with chronic complications (eyes, heart, kidneys and feet) with dates of last evaluation. Fourth sheet, nutritional information with feeding schedules, type and quantity of food suggested by the nutritionist. Fifth sheet, daily glucose fasting and two hours after the main meals ordered stepwise. At the beginning of the study and one year after all, an analysis of the clinical variables was performed and they were submitted to a satisfaction survey with 5 questions namely: 1 - it seems important to have a referent for the control of their disease?. 2. Do you know what medications you take and what are they indicated for? 3- Do you know how your metabolic control is? 4- Do you know what complications are caused by bad control and on what dates were they evaluated? 5- Do you eat according to nutritionist recommendation?

Results: The mean age was 64,3 years. 54% of the patients were women. The hbA1c average, at baseline was 7.25% in both groups. At the end of the study it was 6.7 in those who had a note- book (a decrease of 0.6%) and 7.3% in those who did not have it. Related to the satisfaction survey, the positivity of the responses in the notebook group increased by 53% at the end of the study.

Conclusion: Finding empowerment tools, such as the personal notebook, allows to the patients access to his/her r treating physician immediately, keep medication in mind with your doses, know your metabolic control and chronic complications, adjust to a circadian eating rhythm, and get a referral with an orderly self-monitoring.

Keywords: Control and Monitoring; Empowerment; Nutritional Compliance; Diabetes

References

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Citation: Arturo Orduz López., et al. “The Gaps between Diabetes, the Patient and the Care Team. Strategy to Reduce Them”. EC Nursing and Healthcare 2.3 (2020): 01-09.

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