Health care of pregnant women with diabetes in Spain: Approach using a questionnaire

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• 作者：José ; Antonio Rubio^a ; ^b ; ^{joseantonio.rubio@salud.madrid.org" class="auth_mail" title="E-mail the corresponding author} ; ^{jarubiogarcia@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Marta Ontañ ; ó ; n^c ; Veró ; nica Perea^d ; Ana Megia^e ; on behalf of the Spanish Group of Diabetes ; Pregnant^&loz ;
• 关键词：Diabetes mellitus ; Pregnancy ; Gestational diabetes ; Pregestational diabetes ; Implementation guidelines ; Multidisciplinary team
• 刊名：Endocrinología y Nutrición (English Edition)
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：63
• 期：3
• 页码：113-120
• 全文大小：513 K

文摘

To ascertain how health care for pregnant women with gestational diabetes (GD) and pregestational diabetes (PGD) is organized, and to estimate the number of Pregnancy and Diabetes Units (PDUs) in Spain in 2013.

Material and methods

The Spanish Group of Diabetes and Pregnancy (GEDE) developed and agreed on a questionnaire based on the recommendations of the group. The questionnaire was sent to members of the Spanish Society of Diabetes and the Spanish Society of Endocrinology and Nutrition.

Results

Eighty-seven questionnaires were received from 81 hospitals, 4 outpatient specialty centers, and 2 primary healthcare centers, which accounted for 51% of the Spanish population and for 39% of births in 2013. GD was mainly diagnosed based on GEDE recommendations (98%), and less than 50% of women were reevaluated after delivery in primary care. Fourteen (26%) of the 53 centers identified as PDUs corresponded to a minimal model. Continuous subcutaneous insulin infusion (CSII) therapy was not available in 30% of centers, and 13% of hospitals had no preconceptional clinics. No nurse support was available in 20% of centers.

Conclusions

Care of women with PGD has a fair coverage with PDU, but significant deficits still exist, for instance, in preconception clinic and CSII. However, organization of care for women with GD appears to be adequate. There are aspects in need of improvement such as integration of diabetes educators and coordination with primary care for postpartum reclassification.