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

Predominantlychildren

Prevalence~ 0,5 %

Predominantly adults

Prevalnece> 3-8 %

=

<

Type 1

Type 2

Better control in paediatric and adolescentdiabetes: 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

CountryIncidence Rate

per 100,000 (0-14)Prevalence

0-14Albania 3.0 180Austria 9.1 780Belgium 11.6 1,300Bulgaria 8.5 730Croatia 6.8 310Cyprus 9.8 120Czech Republic 8.9 890Denmark 16.0 820Estonia 10.3 160Finland 45.0 2,650France 8.3 5,990Georgia, Republic of 5.0 380Germany 13.0 10,800Greece 8.5 1,010Hungary 8.9 800Iceland 13.5 60Ireland, Republic of 15.0 820Israel 5.9 650Italy 9.0 5,130

Kazakhstan Republic 5.0 1,420Kyrgyz Republic 5.0 480Lithuania 7.4 300Luxembourg 12.1 50Macedonia 3.2 90Malta 13.6 70Netherlands 13.0 2,360Norway 21.2 1,090Poland 6.0 2,860Portugal 12.5 1,370Romania 5.0 1,240Slovakia 8.4 540Slovenia 7.6 150Spain 12.3 5,450Sweden 25.8 2,690Switzerland 7.9 630Turkey 5.0 5,380Ukraine 9.0 4,570United Kingdom 18.0 12,460

TOTAL EUROPEAN REGION 10.3 76,770

SWEET 39,350

Significant differences in avarage HbA1c betweenleading international pediatric diabetes centers

7

8

9

10

11

adjusted HbA1c (%) as measure for long-term metabolic control

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

mean HbA1c (adjusted for age, duration and gender)mean HbA1c (adjusted for age, duration and gender)8.62 ± 0.03 %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.

Ra

te o

f Ba

ckg

roun

d-R

etin

opa

thy

(per

10

0 p

atie

nt-y

ears

)

< 7 7-8 8-9 9-10 10-11 > 110

2

4

6

8

10

Average HbA1c (%)

Danne et. al, Diab Care 17: 1390-96, 1994

Berlin Retinopathy-Study (1977-94): Berlin Retinopathy-Study (1977-94): Continuous Exponential Relationship between Continuous Exponential Relationship between

retinopathy and long-term-HbA1cretinopathy and long-term-HbA1cVirtually 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

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9/12/06 12:00 9/12/06 18:00 10/12/06 0:00 10/12/06 6:00

Glu

cose

(m

g/d

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Projected Hypoglycemia Alarm

Data collectionData collection

ComparisonComparison

DiscussionDiscussion

Assessment of Quality of Care

Data Exchange for Benchmarking

CentralSWEET -Server

CORU.K.

CORGermany

CORFrance

Local System for Diabetes Patient Care

The Website

www.sweet-project.eu