In the lower Molise area alone, over 7,000 diabetics are getting telemedicine

TERMOLI. Diabetes is a disease in which there is an increase in blood glucose levels (sugar; blood sugar) due to a deficit in the quantity and, often, in the biological effectiveness of insulin, the hormone that controls blood sugar and which is produced by the pancreas.

Diabetes is not a contagious disease: living with a diabetic does not cause diabetes. Diabetes is not a hereditary disease, in the sense that, except for a few very rare varieties (eg MODY), there is no inevitable passage of the disease from one generation to another. However, there is a family predisposition, especially in the case of type 2 diabetes, for which those who have a diabetic among first-degree relatives (parents, siblings) have a higher risk of getting sick than those who do not have relatives with the disease.

A rampant disease that affects children, teenagers and adults without distinction and, at the moment there is no cure but only drugs to be taken to keep blood sugar in range.

In the Termoli health district there are 7051 patients with exemption 013. The highest percentage in the whole region.

And all of Molise has 16598.

Molise, together with Calabria, is among the Italian regions with the highest prevalence of diabetes (over 7%) Among the causes of diabetes there is certainly genetic predisposition, but incorrect eating habits, more sedentary lifestyles, little attention to primary and secondary prevention, much more widespread behavior among the most deprived segments of the population. There are strong differences between the north and south of the country, with many southern regions above the national average. Calabria (8%), Molise (7.6%) and Sicily (7.3%) are the Regions with the highest disease prevalence rates and well above the Italian average (5.8%), while PA of Bolzano (3.4%), PA of Trento (4.2%) and Veneto (4.9%) show the best values.

The demand for health services for people with chronic diseases has become increasingly high in recent years and, consequently, the amount of health resources allocated to this segment of the population has increased. It is estimated that almost a third of general and specialist visits are provided to the multi-chronic population and, of these, about 30% to people with serious chronic diseases. In Italy, out of a population of 51 million people over the age of 18, over 14 million have a chronic disease, and of these 8.4 million are over 65 years old.

According to lstat, the most common chronic pathologies (in a list of 22) are osteoarthritis (47.6%),

hypertension (47%), lumbar pathology (31.5%) and cervical pathology (28.7%). hyperlipidemia (24.7%), heart disease (19.3%) and diabetes (16.8%).

Therefore that of chronicity represents an area of ​​particular attention due to the impact on the quality and duration of people’s lives, on direct and indirect health and social costs, on the workloads of the Health and Social Services, on the resources and energies necessary to ensure quality of care and continuity of care.

The approach to patients suffering from chronic pathologies can only be multidisciplinary by integrating health and social services in local assistance networks involving Primary and specialist Care, hospital and territory.

The Ministerial Decree n.77 / 2022 defines a new organizational model of the territorial healthcare network, and provides for the definition of homogeneous structural, organizational and technological standards for territorial assistance and the application of telemedicine systems for healthcare territory, identifies the need to enhance the healthcare offer for chronic pathologies through the development of proximity structures, through the strengthening of home care, through the integration between healthcare and social assistance and with digitized service models, useful for identification of the people to be assisted and for the management of their paths.

The Diagnostic Therapeutic Assistance Path (PDTA), through an approach that observes the process as a whole, allows to structure and integrate activities and interventions in a context in which different specialties, professions and areas of action (hospital, territory) are involved in the assistance and care of the person with a health and/or welfare problem, evaluate the adequacy of the activities carried out with respect to the objectives, guidelines and/or references in the literature and available resources, compare and measure the activities (processes) and the intermediate results (outcomes) through specific indicators that allow for the analysis of the deviations between the expected and the observed, with the aim of achieving a continuous improvement of the effectiveness, efficiency and appropriateness of each intervention.

The PDTA of type 2 diabetes mellitus in adults is therefore configured as a work tool aimed at ensuring the uniformity of behavior of the operators involved in all the care settings dedicated to the diabetic patient relating to interventions aimed at the prevention, diagnosis and treatment of diabetes mellitus, with the aim of improving the processes and outcomes of the care of people with diabetes through the early diagnosis of the disease and the prevention of its complications.

In the integrated management of chronic conditions, understood as long-term care programmes, the main contacts for patients affected by them are the general practitioner (GP) who, through a generalist approach, contributes together with the specialists to defining a program of individual assistance and, through the relationship of trust, facilitates the adherence of the patient with a view to integrated management.

This procedure applies to all adults with type 2 diabetes mellitus diagnosed by the GP or by the ASReM specialist structures, in an integrated management model between general practitioners and diabetes services, and involves all health and social workers health professionals working in the “Diabetes” UOC of the Cardarelli Hospital and in the district specialist diabetes outpatient clinics, the GPs, and all the ASReM specialists who are consulted for the evaluation and management of the complications of the diabetic patient. Third sector associations and entities operating in the field are involved.

The Dpta provides for the remote approach to the diabetic patient which can be carried out according to the tools provided by the “Guidelines – Telemedicine” of the Ministry of Health, implemented by the Molise Region.

Teleconsultation is a medical act in which the doctor interacts remotely with the patient. Teleconsultation is an indication of diagnosis and/or choice of therapy without the physical presence of the patient. It is a remote consultancy activity between doctors which allows a doctor to seek the advice of one or more doctors, based on specific training and expertise, on the basis of medical information related to taking charge of the patient.

Healthcare remote cooperation is an act consisting in the assistance provided by a doctor or other healthcare operator to another doctor or other healthcare operator engaged in a healthcare act. Remote patient management can be particularly useful for people with diabetes who require more regular doctor-patient interaction (difficulty with self-management, insufficient metabolic control, poor adherence to treatment…) and, moreover, in those situations in which it is difficult to easily reach diabetes services due to problems related to the territory, for example.

In recent years, technological innovation has allowed the diabetes specialist to be able to interact remotely with the patient by carrying out, for example, the control of blood sugar or insulin therapy through the use of digital platforms that allow you to safely create a Remote Patient Monitoring .

Teleassistance is a social-welfare system for taking charge of the elderly or frail person at home, through the management of alarms, activation of emergency services, “support” calls from a service centre. Teleassistance has a predominantly social content, with blurred boundaries towards the health one, with which it should be connected in order to guarantee continuity of care.