Subscribe to RSS
DOI: 10.1055/a-2060-2059
Diabetes-Technologie und Digitalisierung in der stationären Diabetologie: Time to act
Diabetes technology and digitalised diabetes care in the hospital: Time to act
Zusammenfassung
In Deutschland sind 304 stationäre Einrichtungen (inkl. 74 Pädiatrien) auf die Versorgung von Menschen mit Diabetes spezialisiert. Die Mehrheit der Diabetolog:innen DDG (2.521/4.267, 59%) ist im Krankenhaus tätig [11]. Die stationäre Diabetologie steht vor vielfältigen Herausforderungen: schwierige finanzielle Rahmenbedingungen, ein unzureichendes Bewusstsein für die Relevanz von Diabetes auf die Gesundheit der Patient:innen im stationären Setting, inkonsequente Diabetestherapie, prozessuale Hindernisse und eine abnehmende Anzahl an ausbildenden Kliniken. Die fortschreitende Digitalisierung und Verfügbarkeit neuer Diabetestechnologien eröffnet ein neues Feld an Herausforderungen und bietet jedoch gleichzeitig die Chance, Diabetesmanagement im Krankenhaus neu zu gestalten und die alten Probleme mit neuen Mitteln zu lösen. Ziel dieses Positionspapiers ist es, die komplexe Situation, die Vielfalt offener Themen und die besonderen Chancen der Diabetestechnologie zu umreißen und so eine Diskussion für eine Plattform für Diabetolog:innen des stationären Sektors und eine holistische Strategie des digitalisierten Diabetesmangements zur Optimierung und Sicherung der stationären Diabetesversorgung anzuregen.
Abstract
In Germany, 304 hospitals including 74 paediatric clinics offer specialised in-patient care for people with diabetes. The majority of German diabetologists (2.521/4.267, 59%) is working in the hospital [11]. Inpatient diabetology faces multiple challenges including an insufficient awareness of the impact of diabetes on the health of patients in the inpatient setting, inconsistent diabetes therapy, procedural obstacles and a decreasing number of educating clinics in addition to and due to difficult financial conditions. The advancing digitalisation and availability of new diabetes technologies opens a new field of challenges. However, at the same time it offers the opportunity to reshape diabetes management in hospitals and solve known problems with new tools. The aim of this position paper is to outline the complex situation, variety of open issues and the special opportunities of diabetes technology and thus stimulate a discussion for a platform for diabetologists working in the inpatient sector and a holistic strategy of digitalised diabetes management to optimize and secure inpatient diabetes care.
Publication History
Received: 17 March 2023
Accepted: 21 March 2023
Article published online:
02 August 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 2022 DGD. In. https://www.ddg.info/fileadmin/user_upload/Gesundheitsbericht_2022_final.pdf
- 2 Radtke G. Fallzahlen in deutschen Krankenhäusern in den Jahren 1998 bis 2021. Statistica 2023. In. https://de.statista.com/statistik/daten/studie/157058/umfrage/fallzahlen-in-deutschen-krankenhaeusern-seit-1998/
- 3 Auzanneau M, Fritsche A, Icks A. et al. Diabetes in the Hospital-A Nationwide Analysis of all Hospitalized Cases in Germany With and Without Diabetes, 2015–2017. Dtsch Arztebl Int 2021; 118: 407-412 DOI: 10.3238/arztebl.m2021.0151.
- 4 Kufeldt J, Kovarova M, Adolph M. et al. Prevalence and Distribution of Diabetes Mellitus in a Maximum Care Hospital: Urgent Need for HbA1c-Screening. Exp Clin Endocrinol Diabetes 2018; 126: 123-129 DOI: 10.1055/s-0043-112653. (PMID: 28750430)
- 5 Müller-Wieland D, Merkel M, Hamann A. et al. Survey to estimate the prevalence of type 2 diabetes mellitus in hospital patients in Germany by systematic HbA1c measurement upon admission. Int J Clin Pract 2018; 72: e13273 DOI: 10.1111/ijcp.13273.
- 6 Cromarty J, Parikh S, Lim WK. et al. Effects of hospital-acquired conditions on length of stay for patients with diabetes. Intern Med J 2014; 44: 1109-1116 DOI: 10.1111/imj.12538.
- 7 Lopez-de-Andres A, Lopez-Herranz M, Hernandez-Barrera V. et al. Sex Differences in Hospital-Acquired Pneumonia among Patients with Type 2 Diabetes Mellitus Patients: Retrospective Cohort Study using Hospital Discharge Data in Spain (2016–2019). Int J Environ Res Public Health 2021; 18 DOI: 10.3390/ijerph182312645.
- 8 Martin ET, Kaye KS, Knott C. et al. Diabetes and Risk of Surgical Site Infection: A Systematic Review and Meta-analysis. Infect Control Hosp Epidemiol 2016; 37: 88-99 DOI: 10.1017/ice.2015.249. (PMID: 26503187)
- 9 Wu HP, Chu CM, Lin CY. et al. Liver Cirrhosis and Diabetes Mellitus Are Risk Factors for Staphylococcus aureus Infection in Patients with Healthcare-Associated or Hospital-Acquired Pneumonia. Pulm Med 2016; 2016: 4706150 DOI: 10.1155/2016/4706150. (PMID: 26960007)
- 10 Karahalios A, Somarajah G, Hamblin PS. et al. Quantifying the hidden healthcare cost of diabetes mellitus in Australian hospital patients. Intern Med J 2018; 48: 286-292 DOI: 10.1111/imj.13685. (PMID: 29193646)
- 11 Valent F, Tonutti L, Grimaldi F. Does diabetes mellitus comorbidity affect in-hospital mortality and length of stay? Analysis of administrative data in an Italian Academic Hospital. Acta Diabetol 2017; 54: 1081-1090 DOI: 10.1007/s00592-017-1050-6.
- 12 Carvalho RC, Nishi FA, Ribeiro TB. et al. Association Between Intra-Hospital Uncontrolled Glycemia and Health Outcomes in Patients with Diabetes: A Systematic Review of Observational Studies. Curr Diabetes Rev 2021; 17: 304-316 DOI: 10.2174/1573399816666200130093523.
- 13 Umpierrez GE, Isaacs SD, Bazargan N. et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 2002; 87: 978-982 DOI: 10.1210/jcem.87.3.8341.
- 14 ISMP List of High-Alert Medications in Acute Care Settings (ISMP). In. https://www.ismp.org/sites/default/files/attachments/2018-08/highAlert2018-Acute-Final.pdf
- 15 Gregory GA, Robinson TIG, Linklater SE. et al. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol 2022; 10: 741-760 DOI: 10.1016/S2213-8587(22)00218-2.
- 16 Werner T, Overlack K, Graf C. Reformvorschläge zur stationären Versorgung. Diabetes-Forum 2022; 34 (09) 34-38
- 17 https://www.ddg.info/politik/projekte/code-of-conduct