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 Type 1 Type 2 Predominantly children Predominantly adults Prevalence ~ 0, 5 % = Prevalnece > 3 -8 % <
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 Albania Austria Belgium Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia, Republic of Germany Greece Hungary Iceland Ireland, Republic of Israel Italy Incidence Rate Prevalence per 100, 000 (0 -14) 0 -14 3. 0 180 9. 1 780 11. 6 1, 300 8. 5 730 6. 8 310 9. 8 120 8. 9 890 16. 0 820 10. 3 160 45. 0 2, 650 8. 3 5, 990 5. 0 380 13. 0 10, 800 8. 5 1, 010 8. 9 800 13. 5 60 15. 0 820 5. 9 650 9. 0 5, 130 Kazakhstan Republic Kyrgyz Republic Lithuania Luxembourg Macedonia Malta Netherlands Norway Poland Portugal Romania Slovakia Slovenia Spain Sweden Switzerland Turkey Ukraine United Kingdom 5. 0 7. 4 12. 1 3. 2 13. 6 13. 0 21. 2 6. 0 12. 5 5. 0 8. 4 7. 6 12. 3 25. 8 7. 9 5. 0 9. 0 18. 0 1, 420 480 300 50 90 70 2, 360 1, 090 2, 860 1, 370 1, 240 540 150 5, 450 2, 690 630 5, 380 4, 570 12, 460 TOTAL EUROPEAN REGION 10. 3 76, 770 SWEET 39, 350
Significant differences in avarage Hb. A 1 c between leading international pediatric diabetes centers 11 10 adjusted Hb. A 1 c (%) as measure for long-term metabolic control mean Hb. A 1 c (adjusted for age, duration and gender) 8. 62 ± 0. 03 % 9 8 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 center number Danne et al. (2001) Diabetes Care • • • • • 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) Berlin Retinopathy-Study (1977 -94): Continuous Exponential Relationship between retinopathy and long-term-Hb. A 1 c Virtually all children with diabetes from West-Berlin 10 8 6 4 2 0 <7 8 -9 Danne et. al, Diab Care 17: 1390 -96, 1994 Median age at onset: 11 (1 to 17) years Annual fluoresceine angiograms 7 -8 N= 494, 262 boys, 232 girls 9 -10 10 -11 > 11 Average Hb. A 1 c (%) Median follow-up: 9 years
COR´s for Pediatric Diabetes Structure Quality TOOLBOX Outcome Quality Process Quality
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 Glucose (mg/d. L) 250 Projected Hypoglycemia Alarm 200 150 100 50 0 9/12/06 12: 00 9/12/06 18: 00 10/12/06 0: 00 10/12/06 6: 00
Assessment of Quality of Care Data collection Discussion Comparison
Data Exchange for Benchmarking Local System for Diabetes Patient Care Central SWEET Server COR U. K. COR Germany COR France
The Website www. sweet-project. eu
Скачать презентацию The SWEET-Project Better control in paediatric and adolescent
2f2fdb8fcc009408b16d9f7bf7ba247a.ppt