Diabetes is constantly growing in all European countries. Between 2008 and 2014, the number of European citizens with diabetes grew by 4.6 million, or 28 per cent in six years, with a growth 24 times greater than that of the population in the same period. This growth is also evident in Italy, where Istat estimates that from 2000 to 2019 people with diabetes increased by about 60 percent, from 3.8 percent of the population to 5.8 percent (i.e. over 3 million and means of people). This is documented by the fourteenth edition of the Italian Diabetes Barometer Report. This increase can be explained by a number of reasons, including the aging of the population, sedentary lifestyle, obesity and in general the lack of attention to healthy lifestyles have a significant impact. Continuing advances in combating chronic disease, such as improved diagnostic capabilities accompanied by a diagnosis at a younger age or the ability of the care system to extend the survival of people with diabetes and related complications also contribute to this growth.
As far as mortality is concerned, the trend to increase passing from the northern to the southern areas of the country is confirmed, with a certain variability according to the provinces of the same region. For example, in Piedmont, deaths from diabetes represent 2.9 per cent of total deaths, a percentage lower than the national average which stands at 3.5 per cent, but in the province of Vercelli the figure rises to 4.1 per cent. , and in that of Turin it drops to 2.5. Similarly, in Puglia, whose regional average is 4.6 per cent, it goes from 5.6 in Taranto to 3.6 in Lecce.
“These data indicate that there is still too much inequality in access to care and treatments between the various Italian regions, but also between the individual provinces of the same region, ending up providing an unacceptable framework within a national health service universalistic », comments Domenico Cucinotta, Coordinator and Editor of the Italian Diabetes Barometer Report.
«We are convinced that the collection and sharing of information, at the basis of discussion and decision-making processes, can help reduce the clinical, social and economic burden of diabetes. This report produced by the Italian Barometer Diabetes Observatory (IBDO) Foundation in collaboration with ISTAT and CORESEARCH illustrates a series of data and key steps that can contribute to successfully address the tumultuous growth of type 2 diabetes, even in the context of the current very serious global health crisis “, adds Renato Lauro, President of the IBDO Foundation. The increase in the population with diabetes in recent years has obviously led to an increase in expenditure for the Health System, but not as regards the average cost per capita. In fact, according to data from the ARNO diabetes observatory, the average annual cost in 2018 (excluding costs for devices, such as strips, syringes, needles, item not present in 2010) amounts to 2,735 euros, practically the same as in 2010.
“The increase in the population with diabetes is found in all regions of Italy, but the increases have not been homogeneous throughout the territory. In particular, compared to 2000, standardized prevalences increased more in the Northern and Central regions (excluding Lazio), which started from lower levels. For the South, Sicily is an exception, passing from 4.4 per cent in 2000 to 6.9 per cent in 2019. Regional differences remain particularly high in the elderly population, over 15 percentage points the distance between Bolzano and Calabria, where the share of elderly people with diabetes exceeds 25 percent and the mortality rate from diabetes is higher than the national average ”, says Roberta Crialesi, Director of the Integrated Health, Assistance, Social Security and Justice System Service, Istat.
Analyzing the cost components, there is a slight increase in those for diabetes therapy (+78 euros) and for outpatient services (+94 euros) and a more marked increase in costs for other drugs (+224 euros), while the costs for hospitalizations were significantly reduced (-417 euros). “These data suggest that an investment in therapeutic appropriateness and specialist outpatient care may be the key to reducing the huge costs of hospitalizations, which in turn are indicative of diabetes complications. Only 9 percent of the expenditure is for drugs. antidiabete; 31 percent is linked to therapies for complications and concomitant pathologies, while over 40 percent is related to hospitalization “, explains Antonio Nicolucci, Director of CORESEARCH.
«The Italian model of diabetes care is one of the most efficient and great progress has been made in recent years in the fight against this chronic disease, but much more can be done. For example, the Diagnostic Therapeutic Assistance Pathways (PDTA) on diabetes should be implemented so that they are simple, shared and effective, and that, above all, they facilitate the overcoming of barriers to therapeutic intensification and favor the interaction of local medicine with the network. diabetes specialist, for which Italy represents an international model for taking care of the person with diabetes “, says Andrea Lenzi, President of the Health City Institute and of the Biosafety and Biotechnology Committee of the Presidency of the Council of Ministers . “Diabetes is a disease with a complex morbid picture, and is reported as the initial cause in about 23 thousand deaths, but it is present among the diseases that play a role in determining death (contributing) in about 4 times as many cases high (over 80 thousand deaths). Even before the spread of the SARS-CoV-2 virus, diabetes also had a significant association with infectious and parasitic diseases: among those with mention of diabetes there was in fact an excess of 10 percent of deaths “, explains Gian Carlo Blangiardo, President of Istat.
“The health organization and health policy makers cannot ignore the epidemiological information that nationally derives from numerous sources coordinated by scientific institutions and societies, which provide updates on the current status of numerous aspects related to diabetes, such as the number of affected people but also their quality of life, clinical management, access to health facilities, medical devices, home care, therapies “, concludes Silvio Brusaferro, President of the Istituto Superiore di Sanità.
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