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Report on National Conference on Diabetes Management 2016

31. 01. 2017
Diabetes is on the rise and thus one of the priority topics in Slovenia and abroad. In Slovenia, there are approximately 106,300 people on medications for diabetes treatment while this number increases each year for approximately three percent. An increase of the disease burden demands preparation, development and implementation of effective ways for disease management on systemic level. In the frame of National Diabetes Management Program 2010-2020, which manages diabetes in Slovenia on a strategic level, there have been many actions for better diabetes management carried out in the past six years; however, several challenges still remain, which need to be addressed in the future. In cooperation with the Ministry of Health, National Institute of Public Health (NIJZ) organized 7th National Conference on Diabetes Management.

The main topic of this year’s conference was a recognition of problems in the field of chronic diseases prevention and management and their possible solutions. It focusued on the priorities of diabetes management and quality patient care for people with diabetes in Slovenia in 2017 and further. The solutions and measures were highlighted with the support of findings from the Joint Action Chrodis (JA-CHRODIS), in which Slovenia played a significant role regarding the development of main results in the field of diabetes and multi-morbidity. In the frame of the conference there were presented also the activities, which have been planned and implemented in the framework of four priority topics, namely establishing a network of lay counsellors; ensuring equal quality care education of patients across different regions and levels of healthcare system; reducing the number of high amputations; and measures for early detection and treatment of diabetic retinopathy.   

With Joint Action towards a better diabetes management and management of other chronic diseases

European Commission has recognized the burden of diabetes and used it as a case study in Joint Action on Chronic Diseases and Promotions Healthy Ageing across the Life Cycle – JA-CHRODIS, which is financed by the European Union in the framework of Health Programme (2008-2013). National Institute of Public Health as one of the partners in JA-CHRODIS has been cooperating in the field of diabetes and multi-morbidity. The aim of the project is to recognize, exchange, and disseminate good practices and successful interventions in the field of chronic disease management. The special focus is on health promotion and prevention of chronic diseases, multi-morbidity, and additionally on diabetes as one of the chronic diseases. Health promotion and prevention are focused on behavioural risk factors, social determinants and health inequalities. Work in the field of multi-morbidity is focused on multidisciplinary and integrated care, patient safety and health professionals’ training. Diabetes serves as a case study for studying other chronic diseases from primary prevention to patient-care itself.

In the framework of JA-CHRODIS, Slovenian team played a crucial role in a development of key results in the field of diabetes and multi-morbidity. Thus, the work group for multi-morbidity presented a care modelfor multimorbid persons, which anticipates the systematic concern for patient’s self-management up to the point of his/her capability, support for family members and carers, and the connection with social environment.

Work package 7 (WP 7), working in the field of diabetes, prepared the first deliverable, namely Recommendations to improve early detection and preventive interventions, and to improve the quality of care for people with diabetes. The use and implementation of quality criteria and recommendations will mainly contribute to the decrease of inequalities in health and improvement of diabetes prevention and care within and across European countries. The second deliverable of WP 7 was   Policy Brief on National Diabetes Plans. On the basis of national diabetes strategies’ analyses factors that may facilitate the development, implementation, and sustainability of national diabetes plans were identifiedFurther, Policy brief on National Diabetes Planes served as a reference for the preparation of the third deliverable of WP 7, i.e.  Guide on National Diabetes Plans., The guide aims at the preparation and implementation of national programmes and strategies for diabetes management as well as management of other chronic diseases. It defines topics and processes that should be addressed in National Plans, and deals with complementary aspects of leadership (top-to-bottom, bottom-up, and leadership for establishing connections). The latter result in successful implementation and sustainable development of a national plan.         

The increase of people with diabetes calls for better systemic solution for disease management

As mentioned, Slovenia has a National Diabetes Management Programme 2010-2020 (hereinafter National Programme). Main objectives of the programme are type 2 diabetes incidence reduction; diabetes prevention, and a delay of onset of the disease of persons at high risk; an increase of the possibilities for early diabetes detection; and reduction of complications and mortality caused by diabetes. Since 2016 the implementation of the National Programme is complementary to the activities of The Resolution on National Healthcare Plan 2016-2025, which supports the systemic changes in health care.

Since 2012, partners of National Programme have been actively involved in the introduction and expansion of family medicine reference clinics in the field of diabetes. On an annual basis hey are implementing several regular educations of registered nurses to work in those clinics. According to data of the Department of Family Medicine at the Faculty of Medicine in Ljubljana, 584 family medicine reference clinics were active at the end of 2015. They included more than 53,000 people with diabetes in their programmes of prevention, early detection and complex care. In accordance with unified protocol on type 2 diabetes management, family medicine teams are taking care of those patients.

In 2014 there wasan international analyses Diabetes Powerhouse Index carried out (on national and on regional level); in 2015 the data of Organization for Economic Cooperation and Development (OECD) were published and a comprehensive analysis on the success of the National Programme in Slovenia was prepared in the framework of the preparation of Healthcare System Analysis in Slovenia. Thus National Programme activities in 2016 were (and will proceed in 2017) focused on ensuring equal quality and patient friendly educations on diabetes and equal care concerning diabetic foot between regions and levels of the healthcare system. We monitored the implementation of the programme for early detection and treatment of diabetic retinopathy. Key developmental moment of National Programme is establishing a network of lay counsellors. In 2016 first 27 lay counsellors finished training. These counsellors will be able to offer additional support in disease management for people with diabetes and their family members.