title: Health care of pregnant women with diabetes in Spain: Approach using a questionnaire.
abstract: OBJECTIVE
  To ascertain how health care for pregnant women with gestational diabetes (GD) and pregestational diabetes (PGD) is organized, and to estimate the number of Pregnancy and Diabetes Units (PDUs) in Spain in 2013.
  
  
  METHODS
  The Spanish Group of Diabetes and Pregnancy (GEDE) developed and agreed on a questionnaire based on the recommendations of the group. The questionnaire was sent to members of the Spanish Society of Diabetes and the Spanish Society of Endocrinology and Nutrition.
  
  
  RESULTS
  Eighty-seven questionnaires were received from 81 hospitals, 4 outpatient specialty centers, and 2 primary healthcare centers, which accounted for 51% of the Spanish population and for 39% of births in 2013. GD was mainly diagnosed based on GEDE recommendations (98%), and less than 50% of women were reevaluated after delivery in primary care. Fourteen (26%) of the 53 centers identified as PDUs corresponded to a minimal model. Continuous subcutaneous insulin infusion (CSII) therapy was not available in 30% of centers, and 13% of hospitals had no preconceptional clinics. No nurse support was available in 20% of centers.
  
  
  CONCLUSIONS
  Care of women with PGD has a fair coverage with PDU, but significant deficits still exist, for instance, in preconception clinic and CSII. However, organization of care for women with GD appears to be adequate. There are aspects in need of improvement such as integration of diabetes educators and coordination with primary care for postpartum reclassification.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Universitario Príncipe de Asturias , Alcalá de Henares, Madrid, España; Departamento de Ciencias Biomédicas, Universidad de Alcalá, Alcalá de Henares, España. Electronic address: joseantonio.rubio@salud.madrid.org.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Rubio
authors.affiliation: Servicio de Obstetricia y Ginecología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Ontañón
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Mutua de Terrassa, Barcelona, España.
authors.forename: Verónica
authors.initials: V
authors.lastname: Perea
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Universitario Joan XXIII, Tarragona, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Megia
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000628:therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D011247:Pregnancy; D011295:Prenatal Care; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Diabetes gestacional; Diabetes mellitus; Diabetes pregestacional; Embarazo; Equipo multidisciplinario; Gestational diabetes; Implementación guías clínicas; Implementation guidelines; Multidisciplinary team; Pregestational diabetes; Pregnancy