[Importance of patient involvement in disease self-management: the expert patient. Role of new technologies to support patient autonomy].

Because of population aging in our geographical and social setting and progress in preventing premature death, there is an ever-increasing prevalence of chronic diseases, in this case diabetes. In our environment, the dietary changes and sedentariness that have led to the spectacular rise in obesity have increased the prevalence of diabetes. Our health system is reasonably well prepared to manage acute disease but neither health professionals nor referral circuits -nor probably patients- are prepared for the new scenario. Consequently, we should prepare ourselves for the management of chronic disease, encourage patient participation in decision-making and promote a new, less paternalistic, paradigm of the doctor-patient relationship. The experiences initiated by the University of Stanford, or in Spain by the National Patients' Forum, could serve as models. In the next few years, the figure of the expert patient will undoubtedly be highly useful. In general, physicians and patients place a great deal of faith in the contribution of new treatments and technologies to the relief or management of disease. To deny this in the XXI century would be ridiculous, but all the possibilities of these treatments and technologies only show positive results in suitably educated patients. This is a task that should never be forgotten.