Proyecto manejos integral en la DM tipo 1. Acuerdo en el manejo integral del paciente con diabetes mellit us tipo 1

Abstract

Introduction Inadequate glycemic control in type 1 diabetes mellitus (DM1) is associated with the development of serious complications, so close monitoring of the disease is necessary, integrating the participation of both health professionals and the patient. Objective Revalidate aspects previously identified by experts, to set the performance standard for the proper management of patients with DM1. Material and methods The Spanish Society of Diabetes, the Spanish Society of Endocrinology and Nutrition, and the Spanish Society of Pediatric Endocrinology promoted among their members to assess the degree of agreement and consistency with 62 selected recommendations from the literature, by a national multicenter study Delphi in 2013. Results A total of 164 medical specialists in DM1 of all Spanish autonomous communities, completing the entire process 150. There were no disagreements, considering consistent agreements on 5 general assertions, 9 relating to insulin therapy and 7 monitoring and management aspects of patients with DM1. Conclusions None disagreed with any statements expressed by previous experts, although not all have been ratified. It's considered so important basal and posprandial glycemic control, interacting inadequate glycemic control with vascular disorders, nephropathies, polyneuropathies and retinopathies. It's required insulin with a predictable and similar effect to the physiological as with insulin analogues. Diabetes education, self-control and the coordinated, multidisciplinary and personalized monitoring for each patient is essential.