Diabetes control reduces spending by 185 million euros

to raise awareness about the importance of early detection of DM2, as well as keeping blood glucose levels at bay, Vivactis Weber has produced a report—commissioned by the pharmaceutical company Lilly— on «The social value of a strict and early control of type 2 diabetes in Spain. The results of the study were presented this Monday at the meeting organized by Lift-EMV, Information and The Mediterranean Newspapertogether with Lilly, to put on the table what effect the disease causes in all areas, from the social to the economic drug.

In this way, at the debate table, moderated by Silvia Tomasdirector of Institutional Relations of Prensa Ibérica in Valencia, the doctor participated Ruth Used, general director of Public Health of the Ministry of Health; the doctor Rosa Casañtreasurer and representative of the Spanish Society of Endocrinology and Nutrition (SEEN) and specialist in the Endocrinology and Nutrition service of the University Hospital of Valencia; MªTeresa Marí, representative of the Federation of Diabetics of the Valencian Community (Fedicova) and the Spanish Diabetes Federation (FEDE); the doctor Teresa Millan, Director of Corporate Affairs at Lilly; and Maria Merino, director of the Health Outcomes Research department at Vivactis Weber.

The latter was in charge of presenting the main conclusions of the report, endorsed by SEEN and FEDEfor which a review of the scientific literature was carried out—of the 134 articles analyzed, only ten contained relevant information—and a multidisciplinary committee of experts to validate the data and contextualize the data in the Spanish reality. However, they established four areas of analysis: consume of health resources due to micro and macrovascular complications, impact on hospitalizationswaste of quality of life and losses in labor productivity due to premature mortality.

Thus, a person with a strict control (i.e., with glycosylated hemoglobin or average blood glucose below 6.5%) and early (that is, in the first five years after diagnosis) represents a expenditure of 13,473 euros in five years, while with a non-strict control would be 16,122 euros. The difference between the two translates into a positive social valuesince the economic impact would be reduced by 2,649 euros per patient.

In Spain as a whole, the social value figure could amount to 185 million euros of savings in the first five years, a reduction in 8.7% of the total cost caused by diabetes. «This reduction in the economic impact would mainly translate into hospitalizationswhere they could be generated 66 million euros of savings direct to the public health system; 22 million in complications; in quality of life, 56 million euros could be obtained; and 41 million in mortality reduction,” explains María Merino.

The expert also pointed out some limitations of the study, including the lack of other areas of analysis due to the absence of scientific literature on them, only working patients with DM2 have been included in the report, and acute complications have not been taken into account. «We do not have to be afraid to evaluate economically. It’s fundamental provide tools to the administration public to make decisions based on efficiency. He health system is not infinite», he noted. A help that the Director General of Public Health valued: “The report teaches us to quantify and translate the impact of diabetes.”

In this sense, the experts agreed to highlight the importance of having all the information possible, both for governments and for the patients themselves. For one hundred years now, the company Lilly pharmaceutical is dedicated to investigate and deepen in the knowledge of diabetes. In fact, they were the first to manufacture and market the insulin. «We have to work on innovation, make it available to patients, health professionals and, of course, the administration. We are the great producers of information scientific and technical. “This exchange is very important,” defended Teresa Millán.

Improvement of mechanisms

Another conclusion that the event left is the need to improve the control mechanisms and disease prevention. «We receive patients who already have complications when we diagnose them. That means we’re late. In prediabetes already has complications macrovascular. Sustained hyperglycemia (above 6.5%) causes microvascular alterations such as retinopathy, nephropathy and neuropathy. T2DM remains the most common cause of blindness in developed countries. Also kidney deterioration. AND all of this is avoidablee with early and comprehensive diagnosis and treatment. That is why it is so important strict control», explained Rosa Casañ.

One of the tools that experts point towards is automated detection in laboratory, with programs that when they register a blood glucose level above 100, the alarms go off and the treatment of prediabetes can begin as soon as possible. “Is communication essential of the area of ​​Endocrinology with Primary Care. We have to have referral criteria easy, fast and simple so that patients can benefit,” said the doctor.

Likewise, the speakers put on the table the need to promote diabetes education. MªTeresa Marí has ​​been on both sides of the disease, as a nurse and as a patient. For this reason, she knows perfectly the needs of those diagnosed, and she knows that the associative network can be key to provide support and transfer this information to the administrations.

«Many are not aware of the importance of therapeutic control. It depends a lot on the information and education received. Sometimes in consultation we do not check if the patient has understood what we have explained. It’s very important put ourselves in their rolelisten to their needs and attend to their personal reality,” claimed Marí, who recalled a study he presented in Lisbon in which, among other conclusions, he demonstrated how, with adequate information, the patient went from “a hemoglobin of 8.9%.” to 6.5 or 7%.

Along the same lines, Rosa Casañ recognized that, thanks to diabetes education and current therapeutic tools, a patient can achieve a “excellent metabolic control” in six months or a year, especially if it is detected early. «When they understand why we look for an HbA1c level below 6.5%, why we must control LDL (‘bad’ cholesterol), why we must take care of our eyesight and feet, among others, then is involved in your treatment», he shared.

Administration push

For her part, Ruth Usó valued the Diabetes Strategy of the Valencian Community 2017-2021, which has lines of action such as prevention, early diagnosis, the integrated care process, or training and research. “We are going to continue working on all of them, giving continuity to the effort that has been made,” he promised. Regarding the automated detection of diabetes, she recalled that it is an action that “was already drawn up” and that it is essential to “put it into action.” Usa also moved his proposal reactivate the supradepartmental commission which was formed last May to monitor the actions carried out and propose new ones.

Furthermore, the general director expressed her intention to «promote prevention and health promotion». «The approach to diabetes has to be the same as that of other chronic diseases. There are four risk factors: diet, physical activity, tobacco and alcohol. That is where we have to act, with specific tools and actions for the most vulnerable groups. If we know how to manage health, we know how to manage illness,” he concluded.