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In Spain, from October 10th, 2023, the FreeStyle Libre 2 system offers the possibility to automatically changed from isCGM to rtCGM with a system update. Our study aimed to evaluate the glucometric before and after that date. We didn't find significant changes in TIR, however time of use increased and TBR decreased., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal interests' relationship that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Endocrinology and Nutrition (EyN) is an outpatient and hospital medical specialty. This study aims to understand the evolution of the activity of interdepartmental consultation (IC) carried out by EyN in hospitalization floor of a third level hospital, comparing its evolution with other medical specialties, and comparing endocrine IC with nutritional IC., Material and Methods: Longitudinal and retrospective study which analyzes IC notes of EyN and other medical specialties between 01-01-2013 and 31-12-2022., Results: A total of 76093 IC notes (12623 patients) were performed by the EyN service (average age 65.4 years; 59% male) with an average of 4.8 notes per patient. Average annual growth was 7% in notes and 4% in patients (versus 6% and 3% of all other medical services, differences statistically significant). Of all patients hospitalized for 4 or more days, EyN went from attending 7.9% (2013) to 12.3% (2022). 66% of the IC performed by EyN was for nutritional cause and 34% for other pathologies., Conclusions: The EyN service is the one that most patients attend in hospital IC activity, with growth over the last few years greater than other medical specialties. Nutritional pathology is the main reason for IC., (Copyright © 2024 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Subject-Matter: To assess the effect of the 2019 coronavirus (COVID-19) pandemic on gestational diabetes (GDM)., Material and Methods: In this retrospective, multicentre, non-interventional study carried out in Castilla-La Mancha, Spain, we compared 663 women with GDM exposed to the pandemic (pandemic group), with 622 women with GDM seen one year earlier (pre-pandemic group). The primary endpoint was a Large for Gestational Age (LGA) newborn as an indicator of poor GDM control. Secondary endpoints included obstetric and neonatal complications., Results: During the pandemic, the gestational week at diagnosis (24.2 ± 7.4 vs 22.9 ± 7.7, p = 0.0016) and first visit to Endocrinology (26.6 ± 7.2 vs 25.3 ± 7.6, p = 0.0014) were earlier. Face-to-face consultations were maintained in most cases (80.3%). The new diagnostic criteria for GDM were used in only 3% of cases. However, in the pandemic group, the final HbA1c was higher (5.2 ± 0.48 vs 5.29 ± 0.44%, p = 0.047) and there were more LGA newborns (8.5% vs 12.8%, p = 0.015). There were no differences in perinatal complications., Conclusions: Care for GDM in our Public Health System did not significantly deteriorate during the COVID-19 pandemic. However, this did not prevent a higher number of LGA newborns., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Objective: To evaluate the prevalence of autoimmune diseases (AD) associated with type 1 diabetes mellitus (T1DM)., Patients and Methods: Analytical cross-sectional study, nested in a multicenter prospective cohort of 1121 adults with DM1 with active follow-up in endocrinology clinics. Sociodemographic and clinical variables and the presence of AD were analysed in 2010 and 2020., Results: In this second analysis, 49,5% were male, mean age was 49.4 ± 12.8 years, median T1DM duration was 27,1 years (20,7-35,1) and mean glycated hemoglobin was 7.66 ± 1.06%. There is an absolute increase of 13% (95% CI 11-15) (p < 0.001) of patients with at least one AE and an absolute increase of 11.6% (95% CI 9.7-13.5) (p < 0.0001) of any type of autoimmune thyroid disease (ATD) after 10 years of follow-up. Likewise, the prevalence of celiac disease, autoimmune gastritis and other AD increased statistically significantly. In the multivariate logistic regression analysis, the factors that were independently associated with the presence of ATD were female gender [OR 2.9 (95% CI 2.3-3.7); p < 0.0001] and the presence of type 1 b diabetes (OR 0.5 [95% CI 0.3-0.9]; p = 0.041)., Conclusions: After 10 years of follow-up, there is a substantial increase in other types of AE in patients with DM1. It seems necessary to carry out a systematic screening of these AD to optimize the follow-up of patients with 1 TDM, mainly of the ATD., (Copyright © 2022 Elsevier España, S.L.U. All rights reserved.)

Introduction: Patients with advanced chronic kidney disease (ACKD) have a high prevalence of malnutrition. The dietary restrictions that we usually apply in terms of macro and micronutrients force our patients to follow dietary guidelines that deviate from healthy patterns., Objetives: To determine if a personalized nutritional intervention program, minimizing the usual restrictions would be justified in case it improved the evolution of kidney disease compared to standard treatment., Secundary Objetives: To determine changes in nutrient intakes and in anthropometric and biochemical parameters, as well as quantify episodes of hyperkalemia., Material and Methods: A single-center, randomized and controlled educational intervention clinical trial was conduct in patients from the ERCA outpatients clinic at the Complejo Hospitalario Universitario de Albacete. 75 patients were included, assigning 35 to a Control group and 40 to the Intervention group with 1-year follow-up. The nutritional status was determined using anthropometric data, body composition by Bioimpedance, blood and urine biochemical parameters and a 24-h recall questionnaire. The nutritional intervention was carried out in three different ways: individual, collective and telephone recall., Results: At the beginning of the study, the BMI showed a situation of weight excess with a mean of 28.83 kg/m 2 (5.4) in men and 26.96 kg/m 2 (4.09) in women. 70% of our patients had overweight. The abdominal circumference was 105.3 cm (10.2) and 92.3 cm (13.7) for men and women respectively without significant changes throughout the study. The percentage of fat mass (FM) was high in both groups for men and women throughout the study. We did not find biochemical parameters of malnutrition and only significant differences were observed in glomerular filtration rate (GFR), which increased in the intervention group. No patient presented any episodes of hyperkalemia during the study. The energy intake in both groups showed an inadequate distribution of macronutrients with a poor intake of carbohydrates (CH) that was supplemented with an excess of fat. In the case of micronutrients, we did observe an increase in potassium and fiber intakes with a decrease in sodium and phosphorus in the intervention group., Conclusions: Malnutrition is not exclusively an intake defficit and encompasses both the problems derived from a deficit and an excess of nutrients intake. Un to 70% of our patients showed weight excess and a fat mass higher than desirable. The implementation of an individualized nutritional education program, including a vegetables and fiber rich diet, less atherogenic, not only did not cause electrolyte alterations but also slowed the progression of kidney disease., (Copyright © 2021 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Patients with advanced chronic kidney disease (ACKD) have a high prevalence of malnutrition. The dietary restrictions that we usually apply in terms of macro and micronutrients force our patients to follow dietary guidelines that deviate from healthy patterns., Objectives: To determine if a personalized nutritional intervention program, minimizing the usual restrictions would be justified in case it improved the evolution of kidney disease compared to standard treatment., Secondary Objectives: To determine changes in nutrient intakes and in anthropometric and biochemical parameters, as well as quantify episodes of hyperkalemia., Material and Methods: A single-center, randomized and controlled educational intervention clinical trial was conduct in patients from the ERCA outpatients clinic at the Complejo Hospitalario Universitario de Albacete. 75 patients were included, assigning 35 to a Control group and 40 to the Intervention group with 1-year follow-up. The nutritional status was determined using anthropometric data, body composition by Bioimpedance, blood and urine biochemical parameters and a 24-h recall questionnaire. The nutritional intervention was carried out in three different ways: individual, collective and telephone recall., Results: At the beginning of the study, the BMI showed a situation of weight excess with a mean of 28.83 kg/m 2 (5.4) in men and 26.96 kg/m 2 (4.09) in women. 70% of our patients had overweight. The abdominal circumference was 105.3 cm (10.2) and 92.3 cm (13.7) for men and women respectively without significant changes throughout the study. The percentage of fat mass (FM) was high in both groups for men and women throughout the study. We did not find biochemical parameters of malnutrition and only significant differences were observed in glomerular filtration rate (GFR), which increased in the intervention group. No patient presented any episodes of hyperkalemia during the study. The energy intake in both groups showed an inadequate distribution of macronutrients with a poor intake of carbohydrates (CH) that was supplemented with an excess of fat. In the case of micronutrients, we did observe an increase in potassium and fiber intakes with a decrease in sodium and phosphorus in the intervention group., Conclusions: Malnutrition is not exclusively an intake deficit and encompasses both the problems derived from a deficit and an excess of nutrients intake. Un to 70% of our patients showed weight excess and a fat mass higher than desirable. The implementation of an individualized nutritional education program, including a vegetables and fiber rich diet, less atherogenic, not only did not cause electrolyte alterations but also slowed the progression of kidney disease., (Copyright © 2021 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: This study was promoted by Sociedad Castellano Manchega de Endocrinología, Nutrición y Diabetes to ascertain the characteristics of patients seen at the outpatient clinics of endocrinology and nutrition of the Castilla-La Mancha Health Authority and the case mix of diagnoses., Patients and Methods: This was a retrospective, cross-sectional study of the activity of the endocrinology and nutrition outpatient clinics of public hospitals of Castile-La Mancha during 2018. All visits made on 10% of the working days were analyzed. Data collected comprised patient age and sex, whether a first or subsequent had been made, and whether this was face-to-face or not, and up to five diagnoses per visit., Results: A total of 10,709 visits with a subsequent/first visit ratio of 3.4 were analyzed. Patient age was 52.1?±?18.2 years, and 67.1% were women. Type 2 diabetes mellitus, primary hypothyroidism, thyroid nodular disease, and obesity/overweight were the most common conditions recorded as first diagnosis, accounting for more than half of the total number of visits. Type 1 diabetes mellitus and thyroid cancer were the diagnoses in which the subsequent/first visit ratio was greater. Type 2 diabetes mellitus, obesity, and primary hypothyroidism accounted for almost half of the first visits., Conclusions: A wide variety of conditions were seen, some of which are among the most prevalent in the general population, while others are not so prevalent, but are complex and difficult to manage by other specialties. Improved knowledge and analysis of the data should allow for the identification of opportunities for improvement and for the implementation of specific actions., (Copyright © 2020 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: The activity of an Endocrinology and Nutrition (E&N) department consists of inpatient care both by those attached to the department and through consultations with specialists from other departments. The inpatient care activity of all the E&N departments of a public health system has not been studied in Spain., Material and Methods: This was a retrospective study of hospital ward activity during 2018 of the E&N departments of the Castilla-La Mancha Public Health Service. It was undertaken in order to ascertain the characteristics of the patients attended to, both by those in charge of the E&N departments and through interconsultation with other departments, as well as the case-mix of the pathology of these patients. All patients admitted to E&N and a 10% sample of those treated through interconsultation were analysed., Results: 261 admissions were recorded for Castilla-La Mancha Public Health Service E&N departments. 82.8% were urgent and 53.7% were due to type 1 diabetes mellitus. A total of 5955 patients were seen on an interconsultation basis, 591 of whom were analysed. The most frequent reason for interconsultation was diabetes mellitus/hyperglucemia (28.8%), requiring 6.1±6.7 days per patient. However, interconsultations for artificial nutrition required more days of attendance per patient and accounted for a higher percentage of the total number of days of interconsultation (60.4%)., Conclusions: The inpatient care activity of the E&N departments of Castilla-La Mancha Public Health Service mainly consists of attending to patients with chronic pathologies of high hospital prevalence such as diabetes mellitus/hyperglucemia and, especially, clinical nutrition., (Copyright © 2020 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The tools for analyzing the case-mix in outpatient clinics are scarce few and unsatisfactory. The objective of this study conducted by Sociedad Castellano Manchega de Endocrinología, Nutrición y Diabetes (SCAMEND) was to develop a tool that allows for analyzing the case-mix in outpatient endocrinology and nutrition clinics, considering bearing in mind the complexity of the conditions seen., Material and Methods: Using the Delphi method, the SCAMEND index of complexity in outpatient endocrinology and nutrition clinics (ISCCE-EyN) was developed by endocrinologists in two rounds, comparing the complexity of each condition being compared with that of a review visit of primary hypothyroidism., Results: The first visits were considered more complex than the subsequent visits. Non-neoplastic thyroid disease and uncomplicated overweight/obesity were considered as the least complex diseases, while metabolic diseases, multiple endocrine neoplasia syndromes, and adrenal carcinoma were considered as the most complex. The degree of agreement was high in most of the diseases analyzed., Conclusions: This tool allows for analyzing the case-mix in outpatient endocrinology and nutrition clinics, based on the inherent complexity of the disease of the patient is reported. This tool may be used for comparisons between centers, to better allocate resources within a given service, or for self-evaluation., (Copyright © 2020 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Introduction: the strict dietary recommendations we impose on patients with advanced chronic kidney disease (ACKD) have negative impact on quality of life. Objective: determine whether such restrictions are justified and if an educational program can improve health-related quality of life (HRQL) parameters. Methods: we carried out an educational intervention, single center, randomized, controlled clinical trial on ACKD outpatients in Albacete. Seventy-five patients were included, 35 in the control group and 40 in the intervention group. Nutritional assessment was based on the Subjetive Global Assessment (SGA) and body mass index (BMI). We used the SF-36 health questionnaire to measure HRQL. In the intervention group we carried out individual, collective and telephone nutritional interventions, adapting diet advice and restrictions in a personalized way. Results: malnutrition measured by Subjective Global Assessment (SGA) in the control group was 20%; meanwhile, in the intervention group it was 29.3% and it improved at the end of the study, but not significantly. BMI showed overweight with a mean of 28.83 kg/m² (DE: 5.4) and 26.96 kg/m² (DE: 4.09), respectively, and did not change throughout the study. The nutritional intervention improved the score in all the subscales except for body pain score. Besides, mental and physical components also improved their scores in the intervention group and worsened them in the control group (p < 0.001). Conclusions: quality of life can be improved in ACKD patients applying an educational nutrition program.

Introduction: The prescription of parenteral nutrition is a medical procedure that should be properly documented and that requires adequate communication between physicians, pharmacists and nurses. Prescription may be made by orders and paper forms or with software applications, in which case their integration with the rest of the hospital information systems may be difficult. We present our experience with a software for prescribing artificial nutrition integrated with the electronic medical record., Methods: In order to develop a software application for artificial nutrition prescription, meetings between the Clinical Nutrition Unit and the Computing Service staff were held, which set the needs of the clinical services and features that should have the application. DESCRIPTION OF THE SOFTWARE: The software allows the prescription of parenteral nutrition component by component or using predesigned templates, generates alerts if extreme value of components or possible physical- chemical incompatibility, imports and stores the results of the labs of patients and records the composition of parenteral nutrition formula in the electronic medical record, among other features., Discussion: Our experience shows that collaboration between clinical services and hospital Computing permits to develop useful applications for the clinical teams and that can be integrated with other hospital software., (Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)