Carmen Yoldi

Pediatric Nurse, Carmen Yoldi, specialising in helping children with Type 1 diabetes is based at the Hospital San Joan de Déu in Barcelona/ Spain

What is your day-to-day work like?

I work at the Hospital San Joan de Déu in Barcelona. I’m a paediatric nurse specialising in supporting young patients – up to the age of 18 years old - with Type 1 diabetes. I am particularly focused on providing knowledge and support for diabetes management, as well as psychological and emotional support to patients and their families.

How do you help improve or save people's lives through your work?

My position primarily involves motivating my patients and inspiring them to take control of their health.

It’s an interesting but challenging role; as my patients are both very young children and teenagers I need to be sensitive to their emotional well-being when helping them and their parents manage their condition.

Having a condition like Type 1 diabetes can be a lot for a young person to handle; I support them and their family from the time they are diagnosed, advising them on how to maintain a healthy diet, particularly ensuring their intake of carbohydrates is controlled, and their glucose and insulin levels regularly monitored. I also help to equip them with coping skills, keep them motivated and active, and empower them with the knowledge they need to get on with their life and back to school, friends and hobbies. That’s all part and parcel of the work I do, every day.

What do you think are the top challenges facing your profession?

  • Helping patients to integrate into daily life despite their condition is vital but not easy. I am dedicated to helping improve their quality-of-life but it’s is not a ‘one-size-fits-all’ approach. I’m dealing with children and adolescents from all walks and backgrounds and this is a challenge.
  • The position I hold is quite specialised, combining clinical expertise as a diabetes paediatric nurse with a significant focus on psychological support. However, my type of work is not well-regulated in Spain. Despite the increasing prevalence of people with diabetes and therefore the need for diabetes management support, there wasn’t an established curriculum for nurses and it has not been recognised until very recently by the Spanish health authorities and management of hospitals. I and my colleagues, through the Spanish National Society of Diabetes, have been advocating for some time calling upon the authorities to recognise our specialisation. Significant progress has been made of late however; there is now a Masters degree offered at university level for nurses focusing specifically on the treatment and education of people of all ages with diabetes, covering both Type 1 and Type 2 conditions which is a great achievement and I’m proud to have been involved in getting this up-and-running.

If you had one ask to the decision-makers, what would it be?

I think the reimbursement of blood glucose sensors needs to be addressed in Spain. Many patients and their families with low incomes struggle to pay for the devices that people diabetes can’t live without.

Access to technology and treatment is not equal in Spain. For example in the hospital I work in in Barcelona, we are fortunate to have the necessary equipment and latest innovative technology to treat our patients; however in other Spanish hospitals, there is a limit placed on the technology that is allocated and in a number of cases patients are waiting to avail of insulin pumps due to limited availability.

Finally, human resources and staffing is an issue in diabetes management and care in Spain. Type 1 diabetes in young people comes with many difficulties and the treatment and care is equally complex: supporting patients and family members, helping patients to juggle school work with managing their condition, peer pressure…

The prevalence of diabetes more generally is a huge issue, as more and more people suffer from Type 2 diabetes. The onset of Type 1 is more prevalent in young children. Investing more in recruitment and providing expertise to patients is crucial in order to help the increasing number of people with diabetes.