European Diabetes Nursing最新文献

Today, there is a controversy about adequate quality of diabetes care and the best concept for the implementation of National Diabetes Plans. In September 2011, the United Nations Summit for Non-Communicable Diseases agreed on a consensus that national plans for prevention and control of diabetes have to be developed, implemented and monitored.

The goal of the Global Diabetes Survey (GDS) is to present an annual report about the quality of national diabetes care which will be assessed by the use of a standardised questionnaire. The GDS will be based on the appraisals of different groups of people such as patients, diabetes educators and general practitioners. The assessment will be performed globally on an annual basis and the results will make possible a comparative analysis between regions and countries. The findings will be freely available for everyone's use and will provide information for politicians and stakeholders to encourage them to improve the quality of diabetes care in its medical, economical, structural and political dimensions.

Your are the expert and you are invited – if you are interested in the GDS – to register on the website: www.globaldiabetessurvey.com. © 2012 FEND. Published by John Wiley & Sons, Ltd.

This is just as well, as in Europe it is largely estimated that 1 in 20 of us has diabetes, and many will need insulin immediately, or at some point in their life journey with the condition. Despite political and economic decisions which prevent universal usage, insulin remains one of the discoveries of the century.

However, science does not stand still for long. While we were praising the miracle treatment that was insulin therapy other problems arose. ‘The era of coma as the central problem for people with diabetes gave way to the era of complications’ (Joslin). Those complications are vast and, together with the obesity epidemic, we continually strive to find answers to emerging diabetes complications and a cure for this debilitating condition.

Some of these problems as we now know are psychological and this edition reports on attitudes to health and lifestyle from adolescents with type 1 diabetes in Portugal (Serrabulho), and also attitudes of UK practice nurses as they take on additional diabetes case management in the community (McDowell).

Then there is the relatively new phenomenon of ‘diabesity’ (Finer) – a description of people with both obesity and diabetes. Here, two authors describe quite different approaches: O'Connell discusses the need to manage obesity in a multidisciplinary team, while Kennedy investigates bariatric surgery in Europe as a treatment for morbid obesity and diabetes.

In the last 90 years things have moved on quite dramatically with regard to diabetes treatments and knowledge. In marking the great discovery which is insulin we can draw inspiration of what might be achieved in the next few decades – stem cell research, transplants, immunotherapy and pharmacological agents, diabetes screening and prevention strategies. Hard work is still needed on every possible front. But take some time in the year of 2012 to marvel at what has already been achieved.

The third edition of the Policy Puzzle, a collaboration between EURADIA, PCDE and IDF Europe, was launched on 14 November 2011, World Diabetes Day. This edition is different from previous ones because it surveyed the whole of Europe. A copy of the survey was presented to Mr John Dalli, Commissioner, DG Sanco. You can download a copy from the FEND website and distribute it to colleagues and key opinion leaders in your countries. The survey indicates the increasing prevalence of diabetes among European citizens, the disparity of services and the deficiencies of national plans for diabetes in Europe.

The next FEND ENDCUP course is scheduled for 9–13 July 2012. Full information and application forms can be downloaded from: www.fend.org/projects/fend-endcup. Further enquiries should be addressed to Professor Angus Forbes, email: [email protected]. This pan-European academically accredited programme is exclusively available to FEND members who meet the criteria for acceptance. The closing date for applications is 1 April 2012.

A courteous reminder to renew your membership. This can be easily done online at www.fend.org/membership. FEND membership needs to be renewed by 31 March to be eligible for reduced member rates for conference registration and to ensure you receive the FEND journal European Diabetes Nursing. This journal is a significant publication for nurses working in the specialty of diabetes.

This year's FEND conference will be in Berlin, 28–29 September. The provisional programme can be viewed on the FEND website. Online registration will be open by the end of February. Please take advantage of the ‘early bird’ period for lower registration fees. An important element of the programme is the opportunity for abstract submission – the closing date for this is 12 May 2012. Guidelines for abstract submission are available from the FEND website.

I look forward to meeting you in Berlin in September, and encourage you to share your research and projects through the EDN journal.

The changes during adolescence can affect adherence to diabetes treatment and the quality of life of adolescents with type 1 diabetes.

The aims of this study were to evaluate the behaviours and lifestyles, psychological adaptation and social support of adolescents with type 1 diabetes, and to compare the results with those of ‘The Health of Portuguese Adolescents’ study.

Study participants comprised 91 adolescents with type 1 diabetes, aged between 11 and 16 years, who were receiving diabetes monitoring consultations at the Portuguese Diabetes Association. Data were collected via a questionnaire consisting of 57 questions which were answered by the adolescents. This study used quantitative research methods with descriptive analysis, and comparative, correlational and inferential statistics.

The results showed that adolescents with diabetes have healthier eating habits and a more positive attitude towards their satisfaction with life, but their health perception is less positive than that of other adolescents. Body weight, height, and physical and leisure activities are similar in all of the adolescents. Youngsters show satisfactory adherence to insulin therapy, eating habits, physical exercise and glucose monitoring (59–92%). However, they present a high level of HbA_1c (mean 9.9% [85mmol/mol]). The highest levels of HbA_1c have been related to poor health perception ( p<0.01) and less frequent blood glucose monitoring ( p< 0.05). The best representations and the best psychological adaptation to diabetes are positively correlated to regular physical exercise ( p<0.05). Study participants reported that they have good social support from family, teachers, friends and their health care team (64–95%) and refer to the benefits of group sessions and summer camps with other youngsters with type 1 diabetes.

It was concluded that metabolic control in adolescents with type 1 diabetes is unsatisfactory, in spite of good adherence to diabetes treatment and a healthy lifestyle.Copyright © 2012 FEND. Published by John Wiley & Sons, Ltd.

Institution where the research was done: Portuguese Diabetes Association

This study aimed to describe a diabetes specialist nurse (DSN) telemedicine advice service in a UK university hospital diabetes service in terms of the payment by results (PbR) tariff costs, potential admissions avoidance and casemix.

The source, purpose, duration, outcome and patient age were recorded prospectively over 12 months for every patient-initiated, diabetes-related telephone consultation.

In all, 5703 patient-initiated telephone consultations were recorded. Of these, 3459 (60.7%) involved insulin dose management for those receiving insulin therapy for longer than six months. In contrast, 530 (9.3%) consultations covered dose adjustment for individuals started on insulin therapy within the previous six months. A total of 235 (4.1%) consultations involved managing insulin, food and fluid intake during intercurrent illness (‘sick day’ advice) – 103 (1.8%) with ketonuria and 132 (2.3%) without ketonuria. Of these, only 17 required referral to their general practitioner for review for a hospital admission, representing 218 potentially avoided admissions over the study period. Individuals over 60 years of age accounted for 3610 (63.3%) consultations. The PbR tariff for each telephone consultation was £23 ($37.66; €26.10), with an estimated annual cost of £131 169 ($214 781; €148 908). The national average unit costs (for 2008–09) for an emergency long-stay admission related to dysglycaemia range from £846 ($1384; €961) to £2634 ($4311; €2991), representing potential cost savings of between £179 414 ($293 759; €203 715) and £569 198 ($932 008; €646 400) for these 218 avoided admissions.

In conclusion, DSNs provide hundreds of hours of telephone advice annually that improve ongoing diabetes care and represent a cost-effective method of reducing the number of acute hospital admissions. Copyright © 2012 John Wiley & Sons

The purpose of this study was to survey primary health care professionals' perceptions of type 2 diabetes, an evaluation during a service redesign. Management of people with type 2 diabetes has been led by hospital based secondary care. The objective of the service redesign was to transfer the management of the majority of people with type 2 diabetes from secondary care to general practitioner (GP) led, multidisciplinary primary care (comprising the GP, practice nurses, dietitians and podiatrists) delivered closer to the patients. Prior to implementation, all primary health care professionals undertook accredited educational preparation and there was infrastructure development by the creation of new posts and streamlining of IT systems to support the planned change.

The study aim was to examine health care professionals' perspectives of diabetes, its management, the value of clinical guidelines and the impact of practice organisation.

A cross-sectional survey design was used. Primary health care professionals in one geographical area were sent the validated Perceptions of Diabetes Questionnaire (n=112).

The response rate was 34% (n=38). Professionals attached great importance to ongoing education of people with type 2 diabetes in essential areas of care. Type 2 diabetes was perceived as more difficult to treat than other chronic conditions. There was a high level of satisfaction with the workload associated with the service redesign and a team approach is valued. There is an association between diabetes-specific education and confidence in diabetes management. Professionals identified some barriers to using clinical guidelines.

Overall, professionals were satisfied with the new model of multidisciplinary, GP led care management and their workload with the support of additional education in diabetes. Copyright © 2012 FEND. Published by John Wiley & Sons, Ltd.