Insulin affordability and availability across Europe are just part of the complex diabetes management dynamics challenging the EU’s fragile and diverse healthcare systems. Socioeconomic and regional disparities play their part, but so too does innovation.
Disparities in access to screening and care are plentiful, but recent developments such as Italy’s universal Type 1 diabetes (T1D) screening programme are signposting a new generation of affordable diabetes management, but the EU is far from harmonised – the learning curve is slow and steep.
If the EU doesn’t step-up, and soon, the burden on Europe’s health system will balloon rapidly and further cripple competitiveness. Europe needs an active, healthy workforce, not spiralling health bills draining innovation investment.
According to Eurostat, the prevalence of diabetes in the EU has been steadily increasing. In 2023, approximately 31.6 million people in the EU were living with diabetes, a figure projected to rise to 33.2 million by 2030. This increase is driven by factors such as population ageing, rising obesity rates, and lifestyle changes.
European countries have implemented various strategies to enhance diabetes care, focusing on education, integrated care models, and technological advancements.
Structured approaches such as those deployed in Germany and the Netherlands have established comprehensive diabetes education programmes. These initiatives aim to empower patients with the knowledge and skills necessary for effective self-management.
For instance, Germany’s Diabetes Information Service provides extensive resources and support for individuals living with diabetes, and the Netherlands is renowned for its integrated care approach, which involves multidisciplinary teams working collaboratively to provide holistic care. This model has been associated with improved health outcomes and reduced hospital admissions.
The adoption of digital health tools, such as continuous glucose monitoring (CGM) systems and telemedicine, has revolutionised diabetes care in countries like Sweden and Denmark. These technologies enable real-time monitoring and personalised treatment adjustments, enhancing patient outcomes.
National diabetes treatment inequities
Despite these advancements, significant inequities persist in diabetes treatment across the EU.
A recent report by the European Diabetes Forum highlights that people living in deprived areas and those from ethnic minority backgrounds face substantial barriers to accessing quality care.
Chantal Mathieu, President of the European Association for the Study of Diabetes, has emphasised, “We must address the systemic issues that contribute to these disparities, including socioeconomic factors and healthcare accessibility.”
In Italy, regional disparities in diabetes care are pronounced. Northern regions, with better healthcare infrastructure, tend to offer more comprehensive services compared to the southern regions. This inequity is reflected in the variation in diabetes-related complications and mortality rates across the country.
Inequalities in Access to Screening and Care
Access to diabetes screening and care varies widely across EU countries. The European Diabetes Forum’s “Blueprint for Action on Diabetes in the European Union by 2030” underscores the need for harmonised policies to reduce these disparities. The report states, “People across Europe face significant inequalities in access to care. This has been exacerbated by recent advances in treatment options and new technologies.”
In Eastern Europe, countries like Romania and Bulgaria struggle with limited access to screening programmes and essential diabetes medications. This is partly due to economic constraints and insufficient healthcare funding.
Conversely, Western European countries, such as Germany and France, have more robust healthcare systems that provide comprehensive screening and early intervention services.
Italy’s universal T1D screening programme
Italy has recently taken a pioneering step by implementing a universal screening programme for Type 1 diabetes in children. Approved by the Italian Senate in September 2024, this programme aims to detect T1D early and prevent severe complications such as diabetic ketoacidosis. The law mandates screening for children aged 1 to 17, using advanced diagnostic tools to identify those at risk.
Dr. Maria Rossi, a leading endocrinologist, said, “This initiative is a significant milestone in paediatric diabetes care. Early detection will not only save lives but also reduce the long-term burden on the healthcare system.”
The programme also includes the establishment of a National Observatory on Type 1 Diabetes, which will collect data to enhance understanding and management of the disease. Awareness campaigns funded by the Ministry of Health aim to educate the public about the importance of early diagnosis.
Affordable insulin a persistent challenge
Access to affordable insulin remains a critical issue in several EU countries.
While countries like Germany and the Netherlands have robust systems ensuring insulin availability, others, particularly in Eastern Europe, face significant challenges. A recent WHO report highlights that high insulin prices and limited availability are major barriers to effective diabetes management in these regions.
Emer Cooke, Director of Regulation of Medicines at WHO, states, “The simple fact is that the prevalence of diabetes is growing, the amount of insulin available to treat diabetes is too low, and the prices are too high. We need to do something.”
Efforts to address this issue include the WHO’s insulin prequalification programme, which aims to diversify production and reduce prices through increased competition. However, more coordinated action at the EU level is needed to ensure that all patients have access to affordable insulin.
United States, imperfect progress
The United States offers a comparative contrast in diabetes management, particularly in addressing treatment inequalities.
The U.S. has implemented several models to improve diabetes care, focusing on patient-centred approaches and addressing social determinants of health.
The United States Patient-Centered Medical Homes (PCMH) model emphasises coordinated care through primary care providers, aiming to improve health outcomes and reduce disparities. Studies have shown that PCMHs can lead to better diabetes management and lower healthcare costs.
Community health workers (CHWs) play a crucial role in bridging the gap between healthcare providers and underserved communities. They provide education, support, and advocacy, helping to improve diabetes outcomes among marginalised populations.
Innovating wellness
When it comes to technology and innovation, the U.S. has seen significant advancements in diabetes technology, including the widespread use of CGM systems and insulin pumps, which have been shown to improve glycemic control and reduce complications.
For reducing diabetes treatment inequalities, Dr Anne Peters, a prominent diabetes specialist, the importance of addressing implicit bias in medical care is emphasised “Healthcare providers must be aware of their biases and work to ensure that all patients receive equitable care, regardless of their background,” she states.
Additionally, expanding access to new therapeutics and technology is crucial. Dr. Jennifer Raymond highlights the need for policies that promote the availability of advanced diabetes treatments for all patients. “We must ensure that innovations in diabetes care are accessible to everyone, not just those who can afford them,” she asserts.
The European Diabetes Forum (EUDF) has been vocal about the need to address diabetes inequalities across the EU. In a recent statement, the EUDF emphasised the importance of using technology to bridge gaps in care. “Consideration should also be given to the use of technology, addressing inequalities in diabetes care and ensuring that psychosocial as well as metabolic health outcomes are addressed,” the forum stated.
Ireland modernising monitoring
In May, Ireland’s Minister for Health, Stephen Donnelly, said: “We have seen great advances in technology in recent years for the management of diabetes. More than 20,000 adults in Ireland live with type 1 diabetes, and it is heartening to see our national clinical guidelines reflect the best available evidence in relation to monitoring blood glucose for these patients.”
Donnelly was speaking at the launch of updated guidelines for adults with Type 1 Diabetes from the National Clinical Effectiveness Committee (NCEC), aimed at improving the access, quality, and safety of care for adults with the condition.
The Irish Health Service Executive (HSE) also launched an updated Integrated Model of Care today for people with Type 2 Diabetes Mellitus with recommendations around making continuous glucose monitoring (CGM) available for all adults with Type 1 Diabetes.
If Europe is to advance a robust economy, model competitiveness for a new generation, and compete globally, it has to invest in technology and education, as Ireland is doing, to save in the long term with effective, comprehensive diabetes management, starting with child nutrition and ensuring timely, affordable and continuous care.
Failing to do so will cripple Europe’s weakening social care structures.
It’s a sweet deal, Europe’s governments should grasp the opportunity now.
[By Brian Maguire | Euractiv’s Advocacy Lab ]
Source link : http://www.bing.com/news/apiclick.aspx?ref=FexRss&aid=&tid=6724450fd7b948ccae3ed3caa1b14b5f&url=https%3A%2F%2Fwww.euractiv.com%2Fsection%2Fdiabetes-cancer-hepatitis%2Fnews%2Fdiabetes-inequity-risks-damaging-europes-fragile-health-systems%2F&c=10185037195459701420&mkt=de-de
Author :
Publish date : 2024-10-31 19:58:00
Copyright for syndicated content belongs to the linked Source.