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IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

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Page 1: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

IDF Europe GAMunich October 16, 2005

Italian national database on diabetes and its

complications.

Marco A. Comaschi – AMD - Italy

Page 2: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

4242

4141

7878

6666

2020

5757

2828

3377

9898

11112121

4444

1414

3838

The Diabetes Units in ItalyThe Diabetes Units in Italy

994

1

11

5

3

2003 Survey

Total Number of Diabetes Units = 628

Page 3: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Total 73%

Hospital Units 85%

Outpatient Units 79%

Hospital Ambulatories 68%

Extra Hospital ambulatories53%

Private89%

Use of Electronic clinical sheetUse of Electronic clinical sheet

Internet connection 46%

Page 4: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Clinical Pathways for the assessment and Clinical Pathways for the assessment and cure of the complicationscure of the complications

0 10 20 30 40 50 60 70 80

31% ED

66% Retinopathy

51% CVD

44% Nefropathy

42% Cerebral VD

40% PVD

38% Diabetic Foot

37% Somatic Neuropathy

31% Autonomic Neuropathy

Page 5: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Geographic distibution of Diabetes Units in Geographic distibution of Diabetes Units in ItalyItaly

38 %

21 %

41 %

Inhabitants %

Northern 25.835.500 45

Central 12.767.000 22

Southern 19.242.000 33

Page 6: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Which Which informations?informations?

Which Which informations?informations?

Data that may allow to monitorate our activity

Data that may allow to monitorate our activity

Data that generate indicators

Data that generate indicators

The indicators allow to get an objective point of

view, and to measure the quality of care

The indicators allow to get an objective point of

view, and to measure the quality of care

To realize a control of the real quality of care

To realize a control of the real quality of care

Page 7: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

To create a list of items generated in an automatic way

from the software

AND PUBLISHING ITAND PUBLISHING IT

GOAL

Page 8: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

The “Data File” of AMD

• Has been realized• Has been published on AMD website (

www.aemmedi.it) • Is open for everyone that would like to use it

Page 9: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

The picture of the diabetic persons cared in 75 Italian

Diabetes Units in 2004

2005: the data collection by AMD from the electronic sheets

Page 10: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Total number of patients visited in 2004:

132.497

“new patients” in 2004 19.753

Page 11: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

33

22

22

22

66

55

22

22

55

88

44

44

88

5522

77

66

Number and distribution of the 75 Diabetes Units participating to the data collecting

11

Page 12: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

52,4%

47,6%

Male Female

Sex

Page 13: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

89,9%

8,1% 2,0%

Type 2 Type 1 Other

Type of diabetes

Page 14: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

3,9%

41,6%

54,5%

<=35 36-65 >65

Age

Page 15: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

58,6

21,3

11,0 9,2

<=7 7,1-8,0 8,1-9,0 >9,0

HbA1c

Page 16: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

6,06,7

7,6 7,5 7,7

Diet alone Insulin(type 2)

Combinedtherapy

HbA1c values according the therapy

OHA Insulin (type 1)

Page 17: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

62,271,2

63,4

0,010,0

20,030,0

40,050,0

60,070,080,0

90,0100,0

PA>130/85 LDL>=100 BMI>27

CV Risk Factors

Page 18: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Conclusions (1)• A large use of electronic clinical sheet is cheap and

easily available in Europe• The application of AMD Data File and Indicators is

possible on each type of electronic sheet present in the international market

• The merging of the data and of the intermediate and final indicators gathered from several countries might allow to get a better quality of care for the diabetic persons everywhere

• One of the main goals should be to reach a standard system, reprehesenting the real “benchmark” of the diabetes care

Page 19: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Conclusions (2)

• For this aim, AMD is going to invite IDF Europe to hold next GA in Italy, next autumn 2006, in Venice or Genoa, in order to present and discuss the different systems of organization of the care of the diabetic persons in Europe, and to find a “Consensus” about the best one. It will be an extraordinary tool for a public proposal to Health Authorities in every Country and in EU

Page 20: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

A AIELLO B DIODATI

A CHIAMBRETTI J GROSSO

M COMOGLIO M PUPILLO

M LEPRI F CERVELLINO

G SAGLIETTI A VENEZIA

SCHELLINO C GIOVANNINI

ARPAIA A LONGOBUCCO

G CAMPOBASSO C RINALDI

M CIGNARELLI S TURCO

C MASTRANGELO BOSI

A CORDA GAITI

A CICALO' P DI BARTOLO

L CARBONI S PARINI

M SONGINI E RASTELLI

M MANAI V MANICARDI

A MASSIDDA C TABOGA

A DI BENEDETTO A CERNIGOI

A CARDUCCI G FELACE

LORENTI G MARAGLINO

M DI MAURO M MERNI

P PATA M BALSANELLI

G REINA P TATTI

G SANFILIPPO G SANTANTONIO

O VASTA S SPOSITO

C BAGGIORE G TESTA

M DOLCI GHILARDI

G GIANNINI N MUSACCHIO

I TANGANELLI L SCIANGULA

R TRIFIRO' M TENCONI

G DIVIZIA U VALENTINI

C MARINO L COTTI

A BASSO P FUMELLI

L CONFORTIN G VESPASIANI

GARDINALI G MAOLO

R GELISIO P FOGLINI

A NOGARA S MANFRINI

G PANEBIANCO A SPALLUTO

PIPITONE M VASTA

Page 21: IDF Europe GA Munich October 16, 2005 Italian national database on diabetes and its complications. Marco A. Comaschi – AMD - Italy

Thank you for your kind attention