Presentation on theme: "The SWEET-Project Better control in paediatric and adolescent diabetes: working to create Centres of Reference Working Party on Information on Lifestyle."— Presentation transcript:
The SWEET-Project Better control in paediatric and adolescent diabetes: working to create Centres of Reference Working Party on Information on Lifestyle and Specific Subpopulations 14 May 08, Luxembourg
Paediatric patients with Type 1- and Type 2-Diabetes Predominantly children Prevalence ~ 0,5 % Predominantly adults Prevalnece > 3-8 % = < Type 1 Type 2
Better control in paediatric and adolescent diabetes: working to create Centres of Reference Facilitating the collection and monitoring of epidemiologic and economic data Encouraging the development of a minimum standard of care to prevent complications and improve quality of life Helping to share information and promote best practice at European level
Czech Republic France Germany Greece Luxembourg Netherlands Poland Romania U.K. Sweden (Italy)
Estimates of Type 1 Diabetes Mellitus for the Year 2000 EUROPEAN REGION Country Incidence Rate per 100,000 (0-14) Prevalence 0-14 Albania3.0180 Austria9.1780 Belgium11.61,300 Bulgaria8.5730 Croatia6.8310 Cyprus9.8120 Czech Republic8.9890 Denmark16.0820 Estonia10.3160 Finland45.02,650 France8.35,990 Georgia, Republic of5.0380 Germany13.010,800 Greece8.51,010 Hungary8.9800 Iceland13.560 Ireland, Republic of15.0820 Israel5.9650 Italy9.05,130 Kazakhstan Republic5.01,420 Kyrgyz Republic5.0480 Lithuania7.4300 Luxembourg12.150 Macedonia3.290 Malta13.670 Netherlands13.02,360 Norway21.21,090 Poland6.02,860 Portugal12.51,370 Romania5.01,240 Slovakia8.4540 Slovenia7.6150 Spain12.35,450 Sweden25.82,690 Switzerland7.9630 Turkey5.05,380 Ukraine9.04,570 United Kingdom18.012,460 TOTAL EUROPEAN REGION10.376,770 SWEET 39,350
Significant differences in avarage HbA1c between leading international pediatric diabetes centers 7 8 9 10 11 adjusted HbA1c (%) as measure for long-term metabolic control 123456789101112131415161718192021 mean HbA1c (adjusted for age, duration and gender) 8.62 ± 0.03 % Danne et al. (2001) Diabetes Care center number Belgium Canada Denmark Finland France Germany Italy Japan Macedonia Netherlands Norway Portugal Spain Sweden Switzerland U.K. U.S.A.
Rate of Background-Retinopathy (per 100 patient-years) < 77-88-99-1010-11> 11 0 2 4 6 8 10 Average HbA1c (%) Danne et. al, Diab Care 17: 1390-96, 1994 Berlin Retinopathy-Study (1977-94): Continuous Exponential Relationship between retinopathy and long-term-HbA1c Virtually all children with diabetes from West-Berlin N= 494, 262 boys, 232 girls Median age at onset: 11 (1 to 17) years Annual fluoresceine angiograms Median follow-up: 9 years
COR´s for Pediatric Diabetes Structure Quality Process Quality Outcome Quality TOOLBOX
The SWEET project has 5 specific objectives: 1) Strengthen the knowledge base regarding the status of pediatric and adolescent diabetes and related care in the EU. Description: In order to target actions, an overview of prevalence and related national programmes is needed. 2) Enhance and promote equal standards of treatment and care in pediatric and adolescent diabetes in the EU. Description: Good practice recommendations to reduce inequalities and improve control promoting minimum standards. 3) Improve control of diabetes and prevent complications by means of age appropriate patient education programmes. Description: Recommendations of good practice stimulating implementation of pediatric education programmes across the EU. 4) Support healthcare professionals in providing high quality specialised care to children and adolescents with diabetes. Description: Supporting healthcare professionals by developing pediatric training programmes. 5) Stimulate the development of centres of reference for pediatric and adolescent diabetes services in Europe. Description: Facilitate exchange of good practice and improve pediatric diabetes care by means of centres of reference.
Scientific progress needs to be translated into everyday care for children 0 50 100 150 200 250 9/12/06 12:009/12/06 18:0010/12/06 0:0010/12/06 6:00 Glucose (mg/dL) Projected Hypoglycemia Alarm
Data collection Comparison Discussion Assessment of Quality of Care
Data Exchange for Benchmarking Central SWEET - Server COR U.K. COR Germany COR France Local System for Diabetes Patient Care