The Local Health Authority and the University Hospital of Ferrara have always been committed to the field of prevention and treatment of the pathology of diabetes. This year too, like every year, il 14 November World Day dedicated to this pathology is celebrated. The aim is to improve access to diabetes care and highlight the need for further action to prevent the disease and its complications. For the occasion, the two Ferrara healthcare companies have organized a conference which will take place on Tuesday 14 November in the Sala dell’Imbarcadero 2 at the Estense Castle in Ferrara.
Diabetes Mellitus is a condition of impaired glucose management by the body. In Type 1 Diabetes Mellitus it is due to the failure to produce the main hypoglycemic hormone, namely insulin; in Type 2 Diabetes Mellitus, however, it is linked to the poor sensitivity of the tissues to the action of insulin (insulin resistance), promoted by incorrect lifestyles.
THE CONFERENCE. The conference “Know your risk – know your answer”, organized by SIFA – Intercompany Training and Update Service Tuesday 14 November from 2.30 pm to 6.30 pm in the Sala Imbarcadero 2 of the Estense Castle in Ferrarahe means bring together the figures dedicated to the management of diabetic pathology in our province and compare them with patient associations and citizens.
Diabetes and celiac disease screening, recommended vaccinations and oral health in diabetic patients, treatment of the disease in hospital, management of insulin therapy, the role of the nurse, PDTA and telemedicine will be at the center of the debate which will involve the representatives of the Local Health Authority and the University Hospital, of the municipal institutions, of general practitioners but above all of people with diabetes.
THE USL PUBLIC HYGIENE INITIATIVE. Until November 17thPublic Hygiene Operational Unit of the Local Health Authority – directed by Dr. Clelia De Sisti – will open extraordinary vaccination clinics at the Antidiabetic Centers of the Province of Ferrara. Doctors, health assistants and nurses of the Service will be present at all the anti-diabetes centers in the area to offer the free vaccinations recommended by the National Vaccination Prevention Plan. Access for diabetic patients to dedicated clinics it will be free, without any reservation.
“As it is known – comments Dr. De Sisti – some infectious diseases are preventable with vaccination, one of the most effective and safest primary prevention interventions in public health. The most recent recommendations and scientific positions recommend various vaccinations for diabetic patients, exposed to an increased risk of contracting invasive infectious diseases and developing even serious complications”.
THE COMPLEX TERRITORIAL DIABETOLOGY OPERATIONAL UNIT AUSL – directed by Dr. Marcello Monesi – provides various outpatient services aimed at assisting people with various forms of diabetes: type II and type I diabetes, gestational diabetes and diabetic foot.
On the field a diabetes team made up of doctors, nurses and dieticians who operate in the headquarters in Cittadella San Rocco in Ferrara and in the peripheral offices in the hospitals of Argenta and Cento and in the Health Centers of Copparo, Portomaggiore, Comacchio, Codigoro and Bondeno. The team works in close contact with General Practitioners (GPs), which identify patients diagnosed with diabetic disease and send them to the center for treatment. After setting the therapy, the cases with the lowest care complexity are re-entrusted to the general practitioner, otherwise the patients remain in the care of the diabetes facility.
“Diabetes is a chronic disease which, affecting an ever-increasing number of patients, puts the very sustainability of healthcare systems at risk – explains the doctor. Monesi -. For this reason, prevention is of fundamental importance, which must revolve around healthy lifestyles, based on correct nutrition and above all on regular physical activity. Furthermore, theevolution of therapies and technologies provides us with very effective tools not only for the care of people with diabetes, but also for designing new methods of assistance: I am referring to telemedicine, which provides the possibility for our patients to be followed remotely through a video visit; to the teleconsulto, through which it will be easier to communicate with other specialists who assist people with diabetes; to the possibility of send data remotely coming from the self-monitoring of blood sugar, blood pressure and body weight to improve the control of the most fragile people; at the remote reporting of some fundamental tests for diabetics such as the ocular fundus exam. Futuristic scenarios but already present in our Ferrarese reality, which is pioneering new methods of assistance with the aim of constantly improving the quality of diabetes care with a view to equity and sustainability“.
THE ENDOCRINOLOGY AND REPLACEMENT DISEASES OPERATIONAL UNIT OF THE UNIVERSITY HOSPITAL OF FERRARA – directed by Prof. Maria Chiara Zatelli – contributes to the diagnosis of Diabetes Mellitus by carrying out, in its clinics, the diagnostic test (oral glucose load curve) in patients with risk factors for the disease. The patient is then referred for management by the General Practitioner or the local Antidiabetic Center (CAD), depending on the severity of the condition.
“Our Operational Unit – highlights Professor Zatelli – directly takes care of patients who present an acute glycemic decompensation, referred by General Practitioners, by the CAD or with access from the Emergency Department, admitting them. In the same setting, patients with Diabetic Foot who present a complex picture and require intensive hypoglycemic therapy, intravenous antibiotic therapy, aggressive medications and/or revascularization are managed. In recent years, an ever-increasing number of patients with this problem, managed by Endocrinologists together with Vascular Surgeons, Infectious Disease Specialists, Orthopedists and Rehabilitators. Taking charge of the patient at 360 degrees in the Inpatient Unit of the Endocrinology and Replacement Diseases Unit allows us to best manage this complex pathological situation, better coordinating the interventions of the Specialists present in the Hospital and therefore guaranteeing the best level of patient care. The agreement between the Ferrara Local Health Authority and the Maria Cecilia Hospital in Cotignola allows then to direct patients who need third level approaches to this structure, guaranteeing their complete care. World Diabetes Day is certainly a stimulus to raise awareness among citizens of this important, frequent and subtle disease”.
THE ILLNESS. Constantly high blood glucose levels can lead to the onset of acute complications (ketoacidosis and hyperosmolarity being the main ones) but also chronic complications. The latter accompany the diabetic patient throughout his life, compromising the function of the cardiovascular system and the kidneys; they can cause blindness and serious infections, alter the functions of the nerves and facilitate the appearance of foot ulcers that heal very difficult (Diabetic Foot), to the point of making amputations necessary. Approximately 5 million people in Italy have diabetes – i.e. 1 case in every 12 residents – and it is estimated that mortality in these subjects, compared to that of non-diabetics, is 1.9 times higher in men and 2.6 times higher in women. Mortality is mainly associated with the development and progression of chronic complications.
THE CONTEXT IN FERRARA. According to the latest available data, Ferrara was the province in the Emilia-Romagna Region with the higher rate of diabetics, due to the high average age and higher efficiency in identifying patients with diabetes thanks to early diagnosis. A reality also rich from an association point of viewthrough collaboration with ADFE (Diabetes Association Ferrara odv), ANIAD (Italian National Association of Diabetic Athletes), ADICO (Copparo Diabetics Association), affiliated to FEDER – Emilia Romagna Diabetes Federation, with the intention of strengthening these collaborations for listening of patients’ needs with a view to continuous improvement of diabetes care.