Implementing therapeutic patient education in Mayotte, taking into account patient's heterogeneity and social context [Développer l'éducation thérapeutique du patient à Mayotte en tenant compte de l'hétérogéné ité des personnes et du contexte social]
Balcou-Debussche M.,University of Reunion Island |
Rastami J.,Reseau de Sante |
Ramlati A.,Center Hospitalier Of Mayotte |
Said M.,Reseau de Sante |
And 2 more authors.
Medecine des Maladies Metaboliques | Year: 2012
In 2011, a research combined to action development aimed to question the conditions of operationalizing and the effects of the implementation of therapeutic patient education (TPE) intervention in Mayotte (Indian Ocean). In a socially and economically deprived context, 30 persons with diabetes and/or obesity beneficiated from learning sessions conceived at the University (Reunion island) and implemented in the health management network REDIAB-YLANG (Mayotte). Interviews conducted before and after TPE sessions showed that the individual and familial inscription of the work realized during TPE succeeded, even for the most deprived, but also that the social context is of great influence on the relations to illness and health of individuals. © 2012 - Elsevier Masson SAS - Tous droits réservés.
Abbet N.,Service de medecine interne generale |
Gastaldi G.,Service de Diabetologie et Endocrinologie |
Philippe J.,Service de Diabetologie et Endocrinologie
Revue Medicale Suisse | Year: 2016
Type 2 diabetes mellitus is a complex and progressive metabolic disease involving more than 400 millions of people worldwide. The treatments need to be constantly managed to maintain appropriate glycemic control and avoiding complications. There is a wide variety of therapeutic option including oral antidiabetes drugs or new insulin on the market. The initiation of insulin treatment seems a mandatory step for a large panel of patients. Therefore, it is important to know the indications to initiate insulin treatment and the best way to associate it with antidiabetes drugs.
Bouillet B.,Service de Diabetologie et Endocrinologie |
Vaillant G.,Service de Diabetologie et Endocrinologie |
Petit J.-M.,Service de Diabetologie et Endocrinologie |
Duclos M.,Center Hospitalier Of Chatillon Sur Seine |
And 3 more authors.
Diabetes and Metabolism | Year: 2010
Aim: In France, diabetes prevalence and ageing of the population are both on the increase, yet little information on diabetes in elderly patients living in geriatric institutions is available. Moreover, institutionalized diabetic patients are not included in the French recommendations for the management of diabetes in the elderly. For this reason, the aim of the present study was to evaluate diabetes management in older, institutionalized patients. Methods: The medical records of 100 diabetic patients, aged 65 years and over, and living in seven geriatric institutions in the Côte d'Or region of France, were studied from May 2008 to January 2009. Results: Prevalence of diabetes in these seven geriatric institutions was 15.46±4.9%, higher than in the general population. The diabetic patients had a mean age of 81.85±11.93 years, and 32% had glycated haemoglobin (HbA1c) less or equal to 6.5%, indicating a high risk of severe hypoglycaemia. A diet for diabetes was prescribed in 54% of the patients, but HbA1c levels did not differ between patients following and not following the diet (7.26±1.36% vs 7.11±1.10%, respectively; P=0.27). Creatinine was assessed in 87% of the patients, and 16% were ophthalmologically followed-up. Daily capillary blood glucose monitoring was performed in 100% of the patients taking insulin and in 17% of those taking oral antidiabetic treatment (P<0.0001). Conclusion: Our data show that, among older institutionalized patients, the prevalence of diabetes is high and the control of diabetes too tight, with a potential risk of hypoglycaemia. Antidiabetic treatment should be reduced when the HbA1c value is less than 7.5% in this frail and functionally dependent population. Furthermore, a diabetic diet, prescribed for more than half this population, is useless for glycaemic control and may even impinge on quality of life. © 2010 Elsevier Masson SAS.