ESPE Abstracts (2019) 92 P1-331

Design and Implementation of an Integral System of Clinical Follow-Up and Glucose Monitoring in Children Affected of Type 1 Diabetes, in Andalusia

Rocío Hernández-Soto1, Luis Luque-Romero1, Alvaro Alcaide-Gantes1, Eduardo Mayoral-Sanchez2, M del Mar Romero3, Juan De Dios Dube4, Salvador Llamas-Porras4, Francisco Sanchez-Laguna4, Juan Antonio Gomez-Palomeque4, Asuncion Martinez-Brocca3,2


1Primary Care District Aljarafe-Sevilla Norte, Sevilla, Spain. 2Health and Families Counseiling, Sevilla, Spain. 3Pediatric Endocrinology Department, Hospital Virgen Macarena, Sevilla, Spain. 4Andalusian Public Health Service, Sevilla, Spain


Introduction: The incorporation of the interstitial glucose monitoring system, in the offer of services in the Andalusian Public Health System (APHS), means an opportunity for the implementation of a model of integration, and follow-up of glucose data, and the evaluation of their impact in health results.

Purpose (Aim): The design and implantation of a model that allows the identification, registration of clinical data, integration of interstitial glucose data and valuation of the results in health, in the pediatric population affected of type 1 diabetes, and user of flash monitoring systems in the APHS.

Methods: The target population (type 1 diabetes and age from 4 to 18) was estimated in 3000 patients. Thirty three hospitals, 50 endocrinology hospital services, and 350 sanitary professionals participated. The process of citation, structured formation and activation of the patients, started in May 2018, in a formalize procedure in the hospital services, included in the study.

The integral system of following up was designed in four steps:

1. Authorizations: the apply form of clinical data and indication for the monitoring system.

2. Registry: unequivocal identification in two registration Platforms(the APHS corporate and Free View).

3. Follow-up: extraction and loading of aggregate glucose data

4. Evaluation: analysis of clinical information

The processing and discharge of the data from glucometric analysis from MFG system, in the digital clinical history of the children, is scheduled every three months.

Results: A total of 2674 pediatric patients affected of type 1 diabetes, are registered and incorporated pattern, that register 3850560 glucose data every day, and the link to digital clinical history of 37436 of variables every three monthly Data mining is possible at various levels of disaggregation, individual-professional, hospital services, and regional, from the Integral Plan of Diabetes in Andalusia.

Conclusions: A whole system of clinical follow-up in diabetic pediatric patients and users of the MFG System has been set successfully up, in the Andalusia Public Health System. This allows the definition of cohorts, for the study of health result, that include the integration of glucose data in the digital clinical history. It brings an opportunity for a technological organized innovation.