Rubio José Antonio, Ontañón Marta, Perea Verónica, Megia Ana
Servicio de Endocrinología y Nutrición, Hospital Universitario Príncipe de Asturias , Alcalá de Henares, Madrid, España; Departamento de Ciencias Biomédicas, Universidad de Alcalá, Alcalá de Henares, España.
Servicio de Obstetricia y Ginecología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
Endocrinol Nutr. 2016 Mar;63(3):113-20. doi: 10.1016/j.endonu.2015.11.005. Epub 2016 Jan 7.
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.
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.
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.
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.
确定妊娠糖尿病（GD）和孕前糖尿病（PGD）孕妇的医疗保健是如何组织安排的，并估算2013年西班牙妊娠与糖尿病单元（PDU）的数量。
西班牙糖尿病与妊娠研究组（GEDE）根据该组的建议制定并通过了一份调查问卷。该问卷被发送给了西班牙糖尿病学会以及西班牙内分泌与营养学会的成员。
共收到来自81家医院、4家专科门诊中心和2家初级医疗保健中心的87份调查问卷，这些机构占2013年西班牙人口的51%以及分娩量的39%。GD主要是根据GEDE的建议进行诊断（98%），并且在初级保健中，产后接受重新评估的女性不到50%。在被确定为PDU的53个中心中，有14个（26%）符合最低标准模式。30%的中心无法提供持续皮下胰岛素输注（CSII）治疗，13%的医院没有孕前门诊。20%的中心没有护士支持。
PGD女性的护理通过PDU有一定的覆盖范围，但仍存在显著不足，例如孕前门诊和CSII。然而，GD女性的护理组织似乎是足够的。仍有一些方面需要改进，如糖尿病教育工作者的整合以及产后重新分类时与初级保健的协调。
