diabetes

A new report on Laboratory Medicine in Poland highlights the role of laboratory diagnostics in the timely treatment of chronic conditions. Not only can investment in early diagnosis save and improve lives, it can also save money on long-term care. ‘There is not enough data on how health budgets are spent,’ says Jozef Jakubiec, Director General of IPDDL which compiled the report with Deloitte. ‘We wanted to show hard evidence to illustrate to decision-makers that that situation in Poland is considerably worse than in neighbouring countries, such as the Czech Republic.’ Take diabetes, for example. Serious complications from the advanced stages of the condition can include chronic kidney disease (CKD). This, in turn, may lead to a life-long dialysis or kidney transplantation – both of which come at a considerable personal and economic cost. Some people live with diabetes mellitus without symptoms for many years. Indeed, it may not be until complications arise that their condition is diagnosed. However, by that stage considerable damage may have been done. Even small changes in blood glucose can begin the process of degeneration of blood vessels. In order to intervene early and with the right treatment, glucose testing is essential. If Poland were to increase glucose testing by 25% a year, savings of PLN 0.5 billion (€0.12 billion) would be made within six years. For patients with diabetes-related conditions, the annual cost was estimated at PLN 5 (€1.17) in pre-diabetes compared to PLN 9,269 (€2,168) in diabetes with complications (an over 1800-fold difference). ‘The earlier the treatment is taken and monitored regularly, the more effective and less expensive it is,’ the report says. Prevention is cheaper than cure For CKD, it’s a similar story: the disease may remain asymptomatic until the last stage of renal failure. ‘There’s a big shift towards CKD because...
Authors: this article was written by Hans Martens, Martha Emneus , Anders Green and Camilla Sortso . This is the first blog of the series presenting the economic value of being in good health and the broader consideration of cost of disease. Europe’s health systems are struggling to maintain sustainability. One of the major challenges is the exponential increase in the prevalence of chronic diseases and the number of patients in advanced and costly disease stages. A challenge, which is predicted to only increase in the years to come. Chronic diseases make high demands on health systems for continuous, quality care. For patients, chronic diseases are associated with shorter lifetime, reduced quality of life and economic as well as socio-economic burdens on the patients, their caregivers - formal or informal. For society, the burden is excess healthcare, pharmaceuticals, nursing, reduced labour market participation and ability to be socially and economically active and premature mortality. Altogether these costs underpin the major challenge of chronic diseases for our societies – not least in Europe where health is a collective rather than an individualised responsibility. This challenge must be dealt with by the health systems and perhaps by reconsidering where investments should be made in the future as with many of the chronical diseases onset and progression can be prevented if diagnosed early and precisely and if the process is well managed. Among chronic diseases, diabetes mellitus is one of the most burdensome with app. 371 million people diagnosed globally and evidence of rapidly increasing prevalence. In a recent study from Denmark it was estimated that costs of diabetes amounted to 14,349 Euro per person year. Of these, health care costs accounted 17% and pharmaceuticals 4%, while for example loss of productivity amounted to 42%. And this is not the whole story, because...
Consider this: about 60 million people in Europe have diabetes. Out of those who have it for more than 20 years, 75% will develop some form of diabetic retinopathy (DR). It’s a startling statistic. Early detection of DR can prevent blindness, which is why people with diabetes should be tested every year. But because so many people have diabetes – and the numbers are rising – screening everyone for this debilitating eye disease is a huge challenge. For one thing, we do not have enough ophthalmologists to check the millions of eyes at risk of DR. And even if we did, the cost would be significant. New approaches are urgently needed. Fortunately, there is a solution on the horizon. By combining sophisticated cameras with artificial intelligence (AI), we can make diabetic retinopathy screening more efficient and cheaper – helping to deal with the growing demand for this crucial service. ‘Deep learning’ is a powerful kind of AI that can detect specific features in an image of the eye with high sensitivity. It allows health professionals to diagnose the stages of retinopathy in milliseconds. At DreamUp Vision, we are using this technology as a SaaS platform, as well as integrating it into a fundus camera – the kind of camera that ophthalmologists use to scan the eye. The technology is so flexible that any healthcare professional could scan a patient’s eye and get an immediate answer if the patient has signs of the disease or not. This could go a long way to addressing the shortage of ophthalmologists, while bringing expert care to people who do not live near specialist health centres. Learn by doing The incredible thing about this kind of AI is that it learns : the more eye scans it sees, the more accurate it becomes. We are...
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...
This April 7 th marks World Health Day (WHD). The first World Health Assembly, held by the World Health Organization (WHO) in 1948, declared that WHD would be celebrated on this date from 1950 onwards. I am pleased to see that for the first time ever, WHO has chosen diabetes as its theme for WHD in 2016. The decision to dedicate the day to diabetes is timely as diabetes is one of the largest global health emergencies of the 21 st century. Each year growing numbers of people are living with this condition, which can result in life-changing complications, including heart diseases, stroke, blindness, amputations and kidney failure. The risk of these complications can be reduced through early and accurate diagnosis of the disease, good blood sugar monitoring and sound management – but we need to empower health professionals and people with diabetes around the world with information and technologies if the burden of diabetes is to be controlled. According to the latest estimates published by the International Diabetes Federation (IDF), 415 million adults (83% in low- and middle-income countries (LMIC) were living with diabetes in 2015 and this number is expected to rise to 642 million (or 1 adult in 10) by 2040 despite better awareness and new developments in treatment and prevention. I am particularly concerned that around half of people currently living with diabetes do not know they have it. Failure to diagnose diabetes reduces the likelihood that the disease will be well managed, opening the door to complications. WHD on April 7 th is a golden opportunity for all of us – individuals and organisations – working for the benefit of people with diabetes and people at risk of diabetes. We must highlight the importance of all types of diabetes and continue our efforts for enhanced...
It’s remarkable that Europe’s obesity challenge doesn’t get more policy attention. The share of the population that’s overweight or obese is already high and growing fast. By 2030, around 40 and 30 percent of Brits and Germans, respectively, will be obese. These are large numbers and should concentrate political minds on coming up with better policies addressing the scale and growth of obesity. For sure, that’s important for those who suffer from obesity and type-2 diabetes, sleep apnea, musculoskeletal diseases, or other diagnoses linked to obesity. It is also important for Europe’s economy and fiscal health. Nutrition intake shapes the productive capacity of an individual, or indeed of a whole population. Hundred years ago, feeding people with more calories was a good way to boost the economy. Now the economic challenge is rather about finding ways for people to eat healthier and treat obesity at source. Governments should respond by improving methods and choice of dietary counselling and boost the efficiency of programmes for lifestyle changes, but also recognize that access to treatment – among them surgery – is key for those patients that could no longer benefit from prevention measures. That should be part of an economic strategy for Europe because it’s far cheaper to treat overweight and obesity than to finance all the medical symptoms directly linked to weight problems. Obese people, shows the OECD, has 25 percent higher healthcare costs than the average. In the UK, the government’s Foresight study estimated that obesity will represent 13% of total healthcare costs by 2050. A colleague and I did some calculations on the cost of obesity treatment compared to the cost of healthcare systems from obesity-caused type-2 diabetes, and what we found suggests that healthcare systems in Europe can save resources. We studied five countries (Germany, France, Spain, Sweden,...