Abstract

Type 2 diabetes mellitus (DM) is a metabolic disorder and its prevalence has been increasing in the world population and represents one of the chronic diseases with the highest socioeconomic impact on the health systems. It is expected that in the next decade life expectancy and population aging will increase with the consequences of the increasing incidence of diabetes and its associated comorbidities. (DM) is the main cause of chronic kidney disease and it is associated with a significant increasing in cardiovascular risk. The coexistence of cardiac and kidney diseases on a metabolic basis, named “cardiorenal metabolic syndrome”, in elderly patients affected by multimorbidity increase their clinical and care complexity. In order to assess clinical complexity it is necessary to change paradigm from a reactive approach to a proactive one and the integration of territorial, hospital and social services according to the Chronic Care Model (CCM) is important. The proactive management of the complex patient suffering from chronic diseases and multimorbidity has been implemented at the National ARNAS Civico Hospital in Palermo with the MUSE (Multidimensional aSsessment of Elderly) project. The interaction between hospital and territorial services to respond to patients’ needs should be a priority. The hospital must therefore be conceived as a highly specialized center for chronic disease management that works with primary care according to a multidimensional and multidisciplinar model of care reducing rehospitalization and negative outcomes in patients affected by chronic diseases. KEY WORDS diabetes mellitus type2; comorbidity; management model; complexity; cardiorenal syndrome.

Highlights

  • Il diabete è un disordine metabolico sempre più prevalente nella popolazione mondiale e rappresenta una delle patologie croniche a più COMORBIDITÀ CARDIO-RENALI: MODELLO DI GESTIONE → S

  • La gestione di tali pazienti dovrebbe prevedere un cambio di paradigma da un approccio reattivo “d’attesa” ad uno proattivo “d’azione” e l’integrazione dei servizi territoriali, ospedalieri e socio-assistenziali secondo il modello Chronic Care Model (CCM)

  • Tra gli over 75 raggiunge circa il 20% e nel nostro Paese, su 100 persone affette da diabete mellito, 70 hanno più di 65 anni e di questi, 40 più di 75 anni[5]

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Summary

THE JOURNAL OF AMD

Il paziente diabetico complesso con comorbidità cardio-renali: proposta di un modello gestionale. The complex patient with diabetes and cardio-renal comorbidities: a management model proposal. Argano1 1Dipartimento di Medicina Interna Azienda di Rilievo Nazionale e di Alta Specializzazione ARNAS Civico, Di Cristina, Benfratelli, Palermo. D’Alessandro”, PROMISE, Dipartimento di Promozione della Salute, Università di Palermo Argano1 1Dipartimento di Medicina Interna Azienda di Rilievo Nazionale e di Alta Specializzazione ARNAS Civico, Di Cristina, Benfratelli, Palermo. 2Scuola di Biomedicina, Neuroscienze e Diagnostica avanzata BiND Università di Palermo. 3Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, PROMISE, Dipartimento di Promozione della Salute, Università di Palermo

Obesità e sovrappeso
Rilascio di glucosio e insulina ai tessuti
No diabete
Popolazione generale
Punti chiave
Key points

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