Diabetes: The Experience of Spain

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Diabetes The Experience of Spain

• Isabel Fernández Fernández
• Director of the Diabetes Plan of Andalusia

10th Meeting of the MGSD Istanbul 2007
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Diabetes

• it is a frequent problem of health
• it causes problems,
• the situation admits improvements

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1921
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17 Autonomous communities
-1 y 2 Post 2006 Due to his recent beginning
we have not information
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- Spain 2004 - Cetoacidois - Hyperosmolar comma
Admissions ratio for acute complications Percentag
e of diversion with regard to the National
average
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• Spain
• Amputations

Admissions ratio for amputations Percentage of
diversion with regard to the National average
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Admissions ratio for vascular chronic
complications Percentage of diversion with regard
to the National average - Spain 2004 - Heard
attak - Stroke -
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17 Autonomous communities






Pre 2003 Post 2006 Diabetes
Progams
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Comprehensive Diabetes PlanFOR
ANDALUSIA2003-2007Andalusian Public Health
System
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Andalusian Map
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Strategies

• Public communication and information
• Prevention of diabetes
• Healthcare Management of the Comprehensive
  Healthcare Process disease management
• Special actions
• Associations of diabetes patients
• Information systems
• Research line
• Training line.
• Promotion of the Andalusian healthcare network
• Regulations Diabetes Advisory Committee

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Integral Plan
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Disease Management
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Implantation of Disease Management Phase II.
October 2006
Yes No
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Diabetes Mortality
Mortality ratio Men Hombres
Mortality ratio women
Andalucía, 1996-2004
Trend mortality ratio (men)
Trend mortality ratio (women
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21
20
19
Tasas de mortalidad estandarizadas por edad
/100.000
habitantes
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17
16
15
1996
1997
1998
1999
2000
2001
2002
2003
2004
18,51
17,76
19,36
18,10
18,21
18,99
19,02
18,65
17,96
Mortality Ratio men
20,36
19,44
20,85
19,63
18,98
18,30
18,44
18,10
15,70
Mortality Ratio women
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YPLL (ratio) Men
Years potential life Lost (YPLL) for Diabetes in
Andalucía (1996-2004)
Standardized ratio for 100.000 inhabitants
YPLL (ratio) Women
Trend YPLL (men)
Trend YPLL (women)
65
60
55
50
45
40
Tasas estandarizadas por 100.000 habitantes
35
30
25
20
1996
1997
1998
1999
2000
2001
2002
2003
2004
55,09
59,01
57,93
48,92
47,61
51,51
52,37
49,00
49,47
YPLL (ratio)Men
25,52
31,22
32,23
28,89
30,97
28,68
27,65
30,53
21,91
YPLL (Ratio) Women
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Hyperosmolar, 2005
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Stroke, 2005
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Admissions ratio for amputations
desviación respecto a la media andaluza
ALMERIA
100
50
CADIZ
SEVILLA
0
-50
-100
CORDOBA
MALAGA
GRANADA
JAEN
HUELVA
ANDALUCÍA, 2005
Amputations, 2005
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Coverage on total population
5,0
4,5
4,0
3,5
3,0
2,5
2,0
1,5
1,0
0,5
0,0
Cov. total
Cov. HbA1c
Cov. FO
Cov. foot ex
1,05
0,44
0,21
0,42
jun-03
2,57
1,13
0,51
0,97
jun-04
dec-04
3,13
1,30
0,63
1,09
3,83
0,74
0,31
0,62
dec-05
4,53
0,69
0,29
0,49
jun-06
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Coverage on patients with diabetes
60
40
20
0
Foot ex
HbA1c
OF ex
42,02
20,39
40,38
jun-03
43,84
19,91
37,92
jun-04
41,41
20,09
35,00
dec-04
19,30
8,14
16,09
dec-05
15,19
6,43
10,80
jun-06
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Technological equipment

Retinographs Primary Care 92
Retinographs Day Hospital / MI 6
Angiographs 9 / Lasertherapy 9
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Other strategies
Special actions children, pregnants,
institutionalized disabled Associations of
diabetes patients Information systems Research
line Training line. Regulations Diabetes
Advisory Committee
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Comprehensive Diabetes PlanFOR
ANDALUSIA2003-2007Andalusian Public Health
System
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Thank you