Transcript Slide 1

Living with Diabetes in Europe
How to improve quality of life
15 July 08
 Welcome
 Diabetes across Europe
 Living with diabetes
 Discussion with representatives from Diabetes Associations
 What the EU can do
 Conclusions and Recommendations “Towards an EU strategy for Diabetes”
17-Jul-15
IDF | Promoting diabetes care, prevention and a cure worldwide
1
17-Jul-15
IDF | Promoting diabetes care, prevention and a cure worldwide
2
A Policy Perspective
Diabetes across Europe
Diabetes Working Group
15 July 2008
Michael Hall, IDF Europe
Anne Marie Felton, FEND
17-Jul-15
3
Significance of National Diabetes Frameworks
Existence of national
diabetes framework
Indication that
diabetes is a
government priority
Measures/funding to
address disease
burden/complications
Recognises importance of national plans
1989 St
Vincent
Declaration
Most countries in Audit signed Declaration
Supported by WHO Europe
Commitment to multiple initiatives against diabetes
Many countries failed to fulfil key requirement: national plans
Subsequent
declarations: Council
of EU, MEPs, UN
17-Jul-15
Global consensus on
importance of national
plans
Why so little
progress?
4
The Diabetes Policy Puzzle:
Towards Benchmarking in the EU25
No benchmarks to
assess existence of
national plans
National plans in
12
countries (EU 25)
17-Jul-15
2005: IDF Europe / FEND
carry out first pan-European
audit: assess existence and
implementation of national
plans
Signific
ant
differe
nces in
plans
and
guideli
nes
First Edition
(2005)
Inequalities:
Life expectancy
Health status
Access to high-quality
services
For people living with
diabetes across Europe
5
Why a Second Edition?
Update 2005 report
Set benchmarks to
measure progress in
development of plans
Focus on national
policies and practices
Prevention
Screening
Management
Timely
Explosion in incidence:
EU and industrialised
world
Second Edition
(2008)
Best practice
Stakeholder
priorities
Aim: raise standards of care
Provides strong
evidence
Aim: show urgent need to address diabetes
through targeted policy action
17-Jul-15
6
About the 2008 Audit
Snapshot of current
EU diabetes situation
Detailed country
reports: EU-27 + 3
New focus section on
at-risk groups
Highlights growth in prevalence
Audit
summary
Estimates cost to governments
Records status of national policies
Impact on patient access
17-Jul-15
Formal launch to Commissioner Vassiliou in Autumn 2008
7
A few key findings
Prevalence rates:
4
%
United Kingdom
Germany
At least
have rates higher than
13
17-Jul-15
11.8
countries (mainly new MSs)
9
%
%
of the adult population
8
A few key findings
Prevalence rates:
Country
2003
2006
2025 estimate
EU-27 average
7.63
8.62
10.31
Belgium
4.2
5.2
9.7
Germany
10.2
11.8
13.3
Ireland
3.4
5.6
6.4
Latvia
9.9
10.0
11.0
Luxembourg
3.8
6.9
8.2
Malta
9.2
9.7
11.6
Portugal
7.8
8.2
9.8
UK
3.9
4.0
4.6
17-Jul-15
9
A few key findings
Cost:
€
Significant and growing
Where data available, likely to be underestimated: lack of
consideration for direct and indirect costs of disease
Growing diabetes
prevalence rates
Increasing cost
burden
Repeated calls for
action – Europe and
internationally
17-Jul-15
Progress low and frustratingly slow
Varying levels of implementation, monitoring,
evaluation of national plans
In some countries, differences between
reimbursement policy and access levels
suggest lack of information on treatments
10
Conclusions
Striking differences in priorities remain on prevention,
treatment and management
National practices vary and comparable data may be
imperfect… but report tells shows need for coordination
IDF Europe and FEND believe solution lies in a Council
Recommendation urging use of best practice
Only by acting together will we begin to have an impact
on the diabetes pandemic
17-Jul-15
11
Towards EU Policy on Diabetes
2004
2005
2006
Otocec
Declaration
(Nov 2004)
Irish
Presidency
Conclusions
(2004)
.
Stakeholders
17-Jul-15
2007
Austrian
Presidency
Conclusions
(June 2006)
European
Parliament Written
Declaration
(April 2006)
.
Parliament
Commission
Action
????
UN Resolution
on Diabetes
(Dec 2006)
. .
Council
2008
UN
COMMISSION
12
Coming soon – The 2008
Diabetes EU Policy Audit
17-Jul-15
13
Report Funding
This research was carried out by Burson-Marsteller Brussels, an EU
public affairs consultancy, on behalf of IDF-Europe and FEND. The
work was supported by unrestricted educational grants from Eli Lilly,
Novartis, Pfizer and Roche. The project has been carried out with full
transparency and independently from its funding sources.
17-Jul-15
14
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
15
Living with diabetes in Europe
– a Romanian perspective -
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
16
• Some thirty years ago I felt very
unlucky when the doctors told me
that I have diabetes;
• My parents were unlucky enough not
to receive any peer support – so they
carried their feeling of “guilt” to their
last day.
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
17
Looking back, now I feel that I was also lucky:
• …because Romania has a long time tradition in
treating diabetes, and I was correctly diagnosed
and the best available treatment was offered to
me;
• …because over the years quality medication and
specialized services were available and supported
by the Romanian health system;
• …because I was offered in due time one of the
most comprehensive training programs, that kept
me out of a hospital for 25 years;
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
18
Looking back … I felt lucky:
• …because I could finish my education, get
hired and appreciated for my performance
- not judged through my condition;
• …because I could establish a family and
my condition is not perceived as a burden;
• …because I can today to have a dynamic
life style – the kind I like to have;
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
19
I am saying all these because:
• …not all the Romanians and
Europeans with diabetes receive
tailored and continuous training to
manage their diabetes;
• …people with diabetes do not have
equal access to medication to fit
their life style or specialized health
services;
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
20
I am saying all these because:
• …even today people with diabetes do not
have equal opportunities in following their
careers, establish families or drive their
own cars;
• …even today family members have to
leave their careers to support some family
member with diabetes;
• …even today children are refused access
to the public education system because
they have diabetes.
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
21
What might be needed
• Improved awareness and prevention programs;
correct and responsible food labeling;
• Public support for coherent tailored training
programs for people with diabetes;
• Continuous support for equal access to
medication and medical services; enforce
informed-decision making; treatment should
match individual condition and life style;
• Enforce equal opportunities for education and
employment; access to acquiring driving licenses.
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
22
Romania – alarming figures
• Romania has 22,000,000 inhabitants and
about 600,500 people with diabetes (in
2006 the Romanian Ministry of Health
recorded 511,899 persons with diabetes 2.37% prevalence);
• A recent screening program (2008)
revealed that out of about 8 million
people, 30% have or might soon develop
diabetes!
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
23
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
24
Carla Duval
Diabetes care in National Healthcare Systems
+
+
+
+
100% coverage in France for
insulin, pump therapy &
glucose meters
Free follow up with education
nurses, dietician, psychologist
No expense advance in France
A “Prestataire” (services
company) is taking care of
the pump maintenance and
disposables associated in
France
17-Jul-15
Cost are not 100% fully covered
in Luxemburg
⊖ Quality of the patient’s life is not
an essential criteria in F & L
⊖ Low rate of pump therapy in F &
L
⊖ Difficulties to access to latest
technologies (continuous glucose
monitoring…)
⊖ Impossibility to have a private
medical insurance cover in Lux.
⊖
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
25
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
26
DIABETES HEALTH CARE IN
SLOVENIA
17-Jul-15
27
Vlasta Gjura Kaloper,
MD
• Slovenian Diabetes
Association, Slovenian
Patients Forum
• Has diabetes Type 1 since
1985 with consequent
complications arising from
this disease
• Has been actively
participating in improving
the quality of life of people
with diabetes and raising
public awareness last 15
years
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
28
Positive sides of Health Care for people with Diabetes in
Slovenia
Provided by government:
• Free health care for all people, stemming from the
compulsory health insurance (patient care service at GPs,
specialist diabetologists and other specialists; free
medications for treating diabetes; medical technical aid for
managing diabetes for people with diabetes Type 1)
• Initial education for new diabetes patients
Provided by non-governmental organisations:
• NGOs (SLODA, Diabetes Education Institute) provide
continuous informing and education, promote physical
activity through athletic events, organise interdisciplinary
conferences on diabetes for all who are involved in diabetes
health care, etc.
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
29
Deficiencies in Health Care for people with Diabetes in
Slovenia
• Lack of statistical data on the quality of health care for
people with diabetes in Slovenia
• Slovenia still does not have a national programme for
diabetes health care
• The abovementioned results in the lack of rational planning
of what our health care will be like in the future
• There is no systematic and continued education of people
with diabetes
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
30
17-Jul-15
31
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
32
João Nabais
Good / Positive
New
National Program for the Diabetes Prevention and Control
Portuguese Diabetes Association
Podology
Nutrition
Courses
Diabetes consultation
Physical activity
Psychology
Education
Ophtalmology
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
33
João Nabais
Bad / Negative
Primary Care
Hospital Care
Ophtalmology
Podology
Acute diseases
Difficult reimbursement for new therapies
Chronic diseases
17-Jul-15
Insulin Pumps
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
34
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
35
Lagrange Simon
(Belgium, Flanders – VDV)
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF
| Promoting
diabetes
prevention
andworldwide
a cure
IDF
| Promoting
diabetes
care, care,
prevention
and a cure
worldwide
36
Introducing myself
• Lagrange Simon
• Age: 22
• Diabetes type 1 since may 1996
(12 years)
• Student (master nursing)
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF
| Promoting
diabetes
prevention
andworldwide
a cure
IDF
| Promoting
diabetes
care, care,
prevention
and a cure
worldwide
37
Short reflections about national diabetes care
• Negative
• Positive
– Limitations about
Drivers licence
– Limitations in
getting pumptherapy
17-Jul-15
– Preventive care
– Highly
professional
(university hospital)
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF
| Promoting
diabetes
prevention
andworldwide
a cure
IDF
| Promoting
diabetes
care, care,
prevention
and a cure
worldwide
38
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
39
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
40
Gaston Dakulovic
• Age: 62
• Profession: magazines editor - events organizer
(salon du diabète)
• Type 2 diabetes
since: 2007 (1 year)
• Medical treatment: insuline
www.gdi.be
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
41
Gaston Dakulovic
Diabetes care in Belgium
Prevention:
- Press / Media info
- Salon du diabète (1 x 3 years)
Treatment:
- Regular medical check-up and follow-up
diabetes - dieet - feet - eyes - kidneys
- Good level of the intervention of the state in costs
Escort:
17-Jul-15
- Regular and general information from the associations
(ABD & VDV)
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
42
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
43
Diabetes in Malta
Chris J. Delicata,
Vice-President IDF-Europe
Vice-President, Maltese Diabetes Association
17-Jul-15
EU DiabetesWorking Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
44
Why did I get involved in Diabetes…..my story
• Eldest son was diagnosed with Type
1 Diabetes in 1999 aged 1.
• Active in the local association since
2001.
• Elected as board member of IDFEurope in 2003.
• Re-Elected in IDF Europe Board in
2006 and appointed Treasurer.
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
45
Why did I get involved in Diabetes…..my story
• In 2007, appointed Vice-President of
IDF-Europe
• 2007 to date: member of the IDF
Global Executive Board
• Son, now aged 10, diagnosed also
with Celiac Condition in 2007.
• Profession: Senior Underwriting
Manager with a leading insurance
company in Malta.
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
46
Malta – Some Statistics
• Population of circa
400,000 persons.
• Independent state
and member of the
EU since 2004.
• Statistics show
that around 10%
of the population
have diabetes.
17-Jul-15
In Malta Diabetes
is often referred to
as the ‘National
Disease’
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
47
Diabetes in Malta – Local Patient Association
•
•
•
•
•
Maltese Diabetes Association
Non govermental non-profit organisation
Founded in 1981
Circa 1,000 members
Committee members are led by Ms Anna Zammit
McKeon as President, Chris Delicata as Vicepresident and 4 other members.
• Excellent relationships with the Diabetes &
Endocrine Centre at Mater Dei Hospital, newly
built state of the art hospital in Malta.
• Website: www.diabetesmalta.org
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
48
Government Achievements in Diabetes
during Past years
• Free blood glucose strips for persons
with Type 1 Diabetes up to the age of
36.
• Pharmacy of your choice
• Introduction of new Insulins on the
market (Glargin)
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
49
The Improvements we would like to see to
ensure better Diabetes Management &
prevention in Malta
• National Diabetes Programme for Diabetes
• More Educational facilities at Mater Dei
(Diabetes & Endocrine Centre) including
psychological support for patients and parents
• More dieticians - only one available for the
whole hospital
• At the moment patients on the new insulins have
to inject using the syringes. We have been
promised that the change to pen is imminent
(already approved) but still awaiting
implementation.
• More use of Insulin Pumps subsidised by the
Government
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
50
The Improvements we would like to see to
ensure better Diabetes Management &
prevention in Malta
• We wish to see a society that does
not discriminate against people
with diabetes.
• Insurance Policies such as Life
Assurance, Travel Insurance and
Health Insurance should be available
at reasonable and affordable rates
for persons with diabetes.
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
51
My son, Jack and wife Michelle with
Hon. John Bowis MEP during the World
Diabetes Day activities in Strasbourg in
November 2007
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
52
Living with Diabetes in Europe
How to improve quality of life
15 July 08
 Welcome
 Diabetes across Europe
 Living with diabetes
 Discussion with representatives from Diabetes Associations
 What the EU can do
 Conclusions and Recommendations “Towards an EU strategy for Diabetes”
17-Jul-15
EU Diabetes Working Group Meeting - Brussels, 15 July 2008
IDF | Promoting diabetes care, prevention and a cure worldwide
53
17-jul-15
54