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Steinau an der Straße, Germany

Aim: A substantial number of diabetes patients treated by diabetes-specialized practitioners (DSPs) use insulin pump therapy (CSII). The aim of this study was to evaluate the outcomes and issues involved in CSII in everyday conditions. Methods: All of the patients on CSII treated by forty DSPs from April 1, to June 30, 2012, were asked to fill out a questionnaire; the DSPs themselves filled out another questionnaire. Results: The forty DSPs were treating 2439 patients (22%) using CSII, 1142 of which responded to the patient questionnaire. Almost all of the patients (97%) were satisfied with their therapy. Most (76%) used a temporary basal rate, 63% a bolus calculator, and 49% used one of the bolus options. Teflon cannulas were used more often than steel cannulas (58% vs. 39%); 8 mm cannulas were used in 39% of patients compared to 22% using 6 mm cannulas. Slightly more than half of the patients (52%) changed their catheters every other day compared to 39% every third day; no correlation with HbA1c was found. Catheter issues were reported in 39% of patients, and 45% of DSPs reported difficulties in health insurance coverage for pumps last year. Conclusion: This study helps reveal the reality of pump therapy usage on the level of metabolic control achieved, infusion set use, and health insurance coverage. Further discussion and improvement are warranted in every regard.

Weber D.,winDiab gGmbH | Von Hubbenet J.,winDiab gGmbH | Heckermann S.,Profil Institute fur Stoffwechselforschung GmbH | Faber-Heinemann G.,winDiab gGmbH | And 5 more authors.
Diabetes, Stoffwechsel und Herz | Year: 2011

Aim: We were able to analyze morbidity profiles in diabetes patients treated using diabetes-specialized practices (DSP) after mandatory diagnosis coding to ICD-10. Methods: Sixty-five winDiab (the scientific institute of DSPs) partner DSPs extracted ICD-10 codes from ADT files using special software over seven quarters from the first quarter of 2009. These data were fed into a database. All patient-related data were pseudonymized. Results: 2 123672 ICD codes from 105 156 patients with diabetes were collected over twenty-one months - 24 187 patients with type 1, 74 468 with type 2, 5 115 patients with gestational diabetes - as were data from 186 pregnant women with type 1 and 113 with type 2 diabetes; 1 087 patients had other types. The percentage of diabetes-related complications (DRCs) coded in patients with type 1/type 2 diabetes were: neuropathy 43.1%/41.8%, retinopathy 27.4%/14.0%, nephropathy 27.1%/20.1%, vascular disease 19.7%/20.7%, and diabetic foot syndrome (DFS) 5.1%/7.1%; 41.6%/43.2% showed no DSCs, 22.3%/27.6% one, 16.3%/16.2% two, 13.2%/8.9% three and 6.6%/4.1% more than three. Conclusion: Analysis on a large number of ICD codes shows almost 60% of these patients to have developed DRCs, a considerable number of them multiple DRCs. Our approach allows data collection from routinely generated data and a systematic analysis of ICD-10 codes in a cross-sectional and longitudinal manner.

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